- Highmark Health (Richmond, VA)
- …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
- Humana (Richmond, VA)
- …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 (Richmond, VA)
- …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
- Elevance Health (Norfolk, VA)
- …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
- Humana (Richmond, VA)
- …a Lead Medical Director , depending on the line of business. The Medical Director conducts Utilization Management or clinical validation of the care ... **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement… more
- Evolent (Richmond, VA)
- …accountability for utilization management while working in conjunction with the Senior Medical Director . May assist the Senior Medical Director ... Be Doing:** As a Physician Clinical Reviewer, Interventional Pain Management , you will be a key member of the...process. + On a requested basis, may function as Medical Director for selecting health plans or… more
- Humana (Richmond, VA)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members ... **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 … more
- Veterans Affairs, Veterans Health Administration (Richmond, VA)
- …participants ineligible to apply. Responsibilities The Geriatrics Transitional Care Program Medical Director may practice in all settings, including inpatient, ... VA Health Care System. We are looking for a 1.0 FTEE Geriatric physician as medical director of the transitional care program. Join a Geriatrics & Transitional… more
- Genesis Healthcare (Bluefield, VA)
- …or on call)! We are seeking a Fee-For-Service (8-12 hours per week) Attending Physician/ Medical Director for our Westwood Center located in Bluefield, VA. This ... is a Dual Role Attending Physician/ Medical Director . It is clinical in nature....outcomes. This is accomplished by coordinating with Centers, Regional Management and AlignMed Partners to oversee the implementation, utilization,… more
- Grifols Shared Services North America, Inc (Portsmouth, VA)
- …in more than 110 countries and regions. The primary responsibility of the MSL Field Director is the management , performance, and coaching of a team of MSL direct ... (MSL primary call points include Immunology, Neurology, Hematology/Oncology). The Field Director ensures compliant execution of field medical plans, strategy,… more