- Elevance Health (Arlington, VA)
- ** Clinical Compliance Medical Director ** _Please note that per our policy t_ _his role enables associates to work virtually full-time, with the exception ... for employment, unless an accommodation is granted as required by law._ The ** Clinical Compliance Medical Director ** is responsible for providing … more
- Sumitomo Pharma (Washington, DC)
- …a dynamic, highly motivated, and experienced individual for the position of Senior Medical Director , Clinical Research (Ophthalmology) to join our R&D ... systems and final reports in compliance with appropriate scientific/regulatory/ medical standards + Contributes to developing clinical components of… more
- Gentiva (Fairfax, VA)
- …leadership, Director of Clinical Services jobs, Hospice nurse director , Hospice compliance RN, and Medicare Hospice regulations ReqID: 2025-127547 ... Excellence. Deliver Compassionate Care. Transform Hospice Services.** We are seeking a RN Director of Clinical Services to join our team. Reporting to the… more
- Highmark Health (Washington, DC)
- …responsibilities are performed in accordance with the highest and most current clinical standards. The incumbent reviews escalated cases electronically and using ... Medical Policy criteria sets to evaluate the ...to peer discussions may be required. The incumbent ensures compliance to NCQA, URAC, CMS, DOH, and DOL regulations… more
- Genesis Healthcare (Waldorf, MD)
- …Assist the Director of Rehab with monitoring the standard of clinical services delivered to ensure adherence to evidence-based care delivery standards and ... place for you. **Why Powerback?** + **Benefits:** We offer Medical , Dental, and Vision plans to Full-Time team members....team members. + **Support for New Grads:** Our Powerback Clinical Mentorship Program kicks off on day one, helping… more
- Highmark Health (Washington, DC)
- …anchor, including MAQCs and pharmacists, in collaboration with the partnership director who manages non- clinical workforce activity. + **Relationship Management ... :** **JOB SUMMARY** This role will support the leadership team for Clinical Transformation and executive physicians in leading the day-to-day operational model of… more
- Prime Therapeutics (Washington, DC)
- …our passion and drives every decision we make. **Job Posting Title** Sr Director Clinical Strategy and Oncology Specialty Solutions/PharmD required- REMOTE **Job ... Description** The Senior Director Clinical Strategy and Oncology Specialty Solutions...the development of strategic business roadmaps that integrate both medical and pharmacy solutions. This position will provide leadership… more
- Humana (Washington, DC)
- **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...authorized. All work occurs with a context of regulatory compliance , and work is assisted by diverse resources which… more
- Humana (Washington, DC)
- …Humana policies, clinical standards, and (in some cases) contracts. The Medical Director provides medical interpretation and decisions about the ... and experience with national guidelines such as NCD/LCD, MCG(R) or InterQual The Medical Director conducts clinical case reviews of requests received… more
- Humana (Washington, DC)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... level. All work occurs within a context of regulatory compliance , and work is assisted by diverse resources, which...to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of… more
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