- Highmark Health (Richmond, VA)
- …Inc. **Job Description :** **JOB SUMMARY** This role supports the Medical Policy team by bringing medical director level expertise, experience and ... **ESSENTIAL RESPONSIBILITIES** + Full-cycle ownership of commercial and Medicare Advantage medical policy creation process including writing clinical criteria… more
- Humana (Richmond, VA)
- **Become a part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and ... health, SNF, DME, dual Medicare/Medicaid and Waiver requests. The Medical Director provides medical interpretation...communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee… more
- Humana (Richmond, VA)
- **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...communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee… more
- Humana (Richmond, VA)
- **Become a part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and ... health, SNF, DME, dual Medicare/Medicaid and Waiver requests. The Medical Director provides medical interpretation...communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee… more
- Humana (Richmond, VA)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of...communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee… more
- Humana (Richmond, VA)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of...communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee… more
- Humana (Richmond, VA)
- …Become a part of our caring community and help us put health first The Medical Director actively uses their medical background, experience, and judgement to ... to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all...communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee… more
- Humana (Richmond, VA)
- **Become a part of our caring community and help us put health first** The Medical Director relies on broad clinical expertise to review Medicare drug appeals ... (Part D & B). The Medical director work assignments involve moderately complex...value based care in accordance with Medicare and Humana policy . All work occurs within a context of regulatory… more
- Elevance Health (Richmond, VA)
- ** Medical Director -Dermatology Appeals** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person ... locations may be considered. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable...an accommodation is granted as required by law. The ** Medical Director -Dermatology Appeals** is responsible for the… more
- Humana (Richmond, VA)
- …a part of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims. The ... Corporate Medical Director works on problems of diverse scope and complexity...at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee… more