- Humana (Salem, OR)
- **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The ... Medical Director work assignments involve moderately complex to complex issues...materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and … more
- Humana (Salem, OR)
- …a part of our caring community and help us put health first** The Corporate Medical Director (CMD) relies on medical background to review health claims ... and preservice appeals. The Corporate Medical Director works on problems of diverse...experience + Knowledge of the managed care industry including Medicare , Medicaid and/or Commercial products + Must be passionate… more
- Humana (Salem, OR)
- …a part of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims and ... preservice appeals. The Corporate Medical Director works on problems of diverse...experience + Knowledge of the managed care industry including Medicare , Medicaid and or Commercial products + Must be… more
- Humana (Salem, OR)
- …of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home ... health, SNF, DME, dual Medicare /Medicaid and Waiver requests. The Medical Director provides medical interpretation and determinations whether services… more
- Humana (Salem, OR)
- **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The ... Medical Director work assignments involve moderately complex to complex issues...reference materials, internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and … more
- Humana (Salem, OR)
- **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
- CareOregon (Portland, OR)
- …is a federal contractor and must comply with all federal laws. Job Title Medical Director , NP - Primary Care Requisition # 25064 Exemption Status Exempt ... Direct Reports Physicians, Physician Assistants and Nurse Practitioners Manager Title Sr Medical Director - Clinical Services HCP Department Housecall PC Pay… more
- Humana (Salem, OR)
- …lead Medical Directors performing utilization management for inpatient authorizations training medical director team to assist and facilitate new hires and ... remediation of medical directors performing Medicare utilization management processes...rate with denials and overturns. Deliver the upmost consistent medical director decision making. + _Internal Operations… more
- CareOregon (Portland, OR)
- …is a federal contractor and must comply with all federal laws. Job Title Medical Director - Hospice Requisition # 25073 Exemption Status Exempt Management Level ... 10% bonus target, full benefits. www.careoregon.org/about-us/careers/benefits Posting Notes This Hospice Medical Director role is primarily remote, with 60%… more
- Evolent (Salem, OR)
- …business. Join Evolent for the mission. Stay for the culture. **What You'll Be Doing:** The Medical Director for MSK Surgery is a key member of the Medical ... questions. + Reviews statistical sample of cases for Field Medical Director audits and makes recommendations into...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
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