- Centene Corporation (Jefferson City, MO)
- …hearings, STARS metrics + Previous experience with ensuring high quality medical director training to review Medicare UM and appeals , Clinical review quality ... and cross functional stakeholders across the enterprise. + Provide medical leadership for all utilization management ( appeals ),...plus holidays, and a flexible approach to work with remote , hybrid, field or office work schedules. Actual pay… more
- Centene Corporation (Jefferson City, MO)
- …benefits including a fresh perspective on workplace flexibility. **Position Purpose:** Supervisory Medical Director at Centene plays a critical role in ... to our members. This role further assists the Senior Medical Director or Chief Medical ...care quality + Oversee and actively participate in the appeals process, ensuring that appeals are handled… more
- CenterWell (Jefferson City, MO)
- …compliance. Manages the Denials Management data analytics, denial and appeal process. The Director , Home Health Grievances & Appeals assists members, via phone ... caring community and help us put health first** The Director Denials Management provides leadership for the audit, appeal...required + Expert knowledge of all Medicare regulations and appeals processes + Excellent analytical skills with ability to… more
- Humana (Jefferson City, MO)
- …part of our caring community and help us put health first** The Corporate Medical Director provides medical interpretation and decisions about the ... and determining the best course of action. The Corporate Medical Director provides medical interpretation...protect member PHI / HIPAA information This is a remote position \#LI- Remote Travel: While this is… more
- Centene Corporation (Jefferson City, MO)
- …a fresh perspective on workplace flexibility. **Position Purpose:** The National Neonatology Medical Director role relies on high impact visionary leadership to ... implementation of performance improvement initiatives for capitated providers. + Assists Chief Medical Director in planning and establishing goals and policies… more
- Evolent (Jefferson City, MO)
- …in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional ... improvement, and clinical excellence. + **This position is 100% Remote and can be completed from any state. Multiple...per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to… more
- Humana (Jefferson City, MO)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... of service should be authorized at the Initial and Appeals /Disputes level. All work occurs within a context of...to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of… more
- Humana (Jefferson City, MO)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to… more
- Humana (Jefferson City, MO)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to… more
- Manulife (MO)
- **This is a remote role open to any location in continental...take you anywhere you want to go. The General Director is a people leader. The incumbent will also ... with higher level of service and professionalism. + Analyze and interpret medical , non- medical , and financial information. + Make decisions within approval… more
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