- Highmark Health (Columbia, SC)
- …URAC, CMS, DOH, and DOL regulations, etc.). Ensure that all aspects of the medical management process are consistent with community standards of care. + ... care (hospital, outpatient, or private practice) **Preferred** + 1 year in Medical Management in a Health Insurance Plan; strong knowledge of managed care… more
- Elevance Health (Miami, FL)
- **Clinical Operations Medical Director ** **Carelon Medical Benefit Management ** **Radiation Oncology** **Virtual:** This role enables associates to work ... **Clinical Operations Medical Director ** is responsible for supporting the medical management staff ensuring timely and consistent medical decisions… more
- Humana (St. Paul, MN)
- …reports to the Lead Medical Director .** **Other duties:** + Identify medical management operational improvements, including those within the medical ... part 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… more
- Humana (Denver, CO)
- …reports to the Lead Medical Director . **Other duties:** + Identify medical management operational improvements, including those within the medical ... part 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… more
- UPMC (Pittsburgh, PA)
- The UPMC Health Plan is seeking a licensed MD or DO for a fully remote Medical Director , Utilization Management role. The Medical Director , ... role._ Responsibilities: + Actively participates in the daily utilization management and quality improvement review processes, including concurrent, prospective and… more
- Dignity Health (Bakersfield, CA)
- … management , remote patient monitoring, and CRM. - Provide backup support to the Medical Director of Utilization Management in medical review ... offices primarily in the Bakersfield/Central CA region.** **Position Summary:** The Medical Director of Physician Engagement is responsible for developing… more
- Elevance Health (Morristown, NJ)
- …**Clinical Operations Medical Director ** is responsible for supporting the medical management staff ensuring timely and consistent medical decisions ... **Clinical Operations Medical Director ** ** Medical Oncology** **Carelon Medical Benefit Management ** **Virtual** : This role enables associates to… more
- Amgen (Washington, DC)
- …interactions, and regulatory submission + Assists Development Lead and Medical Sciences Director in medical monitoring and management of oncology phase 3 ... the lives of patients while transforming your career. Associate Medical Science Director - Late Development, Oncology...clarity + Provide input into & implementation of data management plan, CRF design, and data review oversight +… more
- Wellpath (Lemoyne, PA)
- …training, education, and point of care support. **How you make a difference** The Medical Director of Utilization Management leads and oversees utilization ... patient care and the appropriate utilization of medical services. The Medical Director of Utilization Management serves as a key liaison with external… more
- Elevance Health (Overland Park, KS)
- …Accounts Medical Director ** is responsible for serving as the Operational Medical Director for our care management models for our National Account ... we serve. The medical director supports product strategy/design through medical management that impact health care quality, cost, and outcomes, and… more
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