- Highmark Health (Madison, WI)
- …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 ... necessity and appropriateness of the requested treatment of service . Depending on the nature of the case, telephonic… more
- Elevance Health (Waukesha, WI)
- …our care management models for our National Account clients. The medical director will be responsible for supporting the clinical vision and implementation ... the health improvement tools offered to clients/ members. The medical director provides clinical expertise...clinical relevance to account reporting regarding use of medical services by members. Involved in identifying… more
- Humana (Madison, WI)
- …and Waiver requests. The Medical Director provides medical interpretation and determinations whether services provided by other healthcare ... Humana policies, clinical standards, and (in some cases) contracts. The Medical Director provides medical interpretation and decisions about the… more
- Wellpath (Franklin, WI)
- …for training, education, and point of care support. **About this role** The Site Medical Director provides clinical leadership at the assigned facility and ... include documentation, emergency response, treatment planning, and formulary compliance. The Medical Director supports continuous quality improvement efforts and… more
- Molina Healthcare (Madison, WI)
- …NCQA-compliant clinical quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. ... and procedures that guide and support the provisions of medical staff services . Maintains a working knowledge...experience, including: + 2 years previous experience as a Medical Director in a clinical … more
- Prime Therapeutics (Madison, WI)
- …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
- Highmark Health (Madison, WI)
- …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
- Elevance Health (Waukesha, WI)
- …quality of life through home-care and community based services . **The Clinical Documentation and Claims Integrity Director ** will lead CareBridge's efforts ... ** Clinical Documentation and Claims Integrity Director **...understanding of end-to-end claims and encounter processing (including both fee-for- service and "zero-dollar" models). The ideal candidate may have… more
- AccentCare, Inc. (West Allis, WI)
- Overview Find Your Passion and Purpose as a Director of Clinical Operations SIGN ON BONUS - $15,000 Reimagine Your Career in Hospice As a medical ... to reimagine care because we want to provide the service we would seek for our own families. We...AccentCare-branded scrubs for patient-facing employees Qualifications Be the Best Director of Clinical Operations You Can Be… more
- Sodexo (Milwaukee, WI)
- …at customer service with proven success as an experienced ** Clinical Engineering System Director /** **Healthcare Technology Management Client Executive** to ... support **Healthcare Technology** services at Froedtert Health located in Milwaukee, WI. **Make an Immediate Impact.** This position will provide strategic… more