- Medalogix (Nashville, TN)
- About Forcura & Medalogix In March 2025, Forcura, the intelligent workflow management company, and Medalogix, a clinical decision support company, announced that ... about the merging of Forcura and Medalogix. Position Summary The Director , Clinical Operations leverages his/her extensive knowledge managing multiple agency… more
- familycarecenter (Brentwood, TN)
- …wellness, profit sharing and more. Position Overview: The Regional Medical Director provides therapy and/or medication management as needed to identify, ... Physician and adhere to the standards and principles of medical ethics of the American Medical Association,...principles of medical ethics of the American Medical Association, and all recognized associations or accrediting boards… more
- Highmark Health (Nashville, TN)
- …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 (Nashville, TN)
- **Clinical Operations Associate Medical Director ** **Carelon Medical Benefits Management ** **Post Acute Care Benefit Utilization Management ** ... for the people we serve._ The **Clinical Operations Associate Medical Director ** is responsible for supporting the... Director ** is responsible for supporting the medical management staff ensuring timely and consistent… more
- Humana (Nashville, TN)
- …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
- Evolent (Nashville, TN)
- …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 (Nashville, TN)
- … 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
- Grifols Shared Services North America, Inc (Nashville, TN)
- …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
- Humana (Nashville, TN)
- … medical management operational improvements, including those within the medical director area + Participate in call rotation + Develop collaborative ... Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an… more
- Humana (Nashville, TN)
- … 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
- Humana (Nashville, TN)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to… more
- CenterWell (Nashville, TN)
- …a part of our caring community and help us put health first** The National Medical Director for Home-Based Care Programs is a key clinical leadership position ... polychronic, and high-risk Medicare patients within a full-risk, value-based framework. The Medical Director collaborates in a dyad partnership with the Strategy… more
- Evolent (Nashville, TN)
- …non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional ... utilization management while working in conjunction with the Senior Medical Director . **Qualifications** + MD/DO/MBBS Degree + Current, unrestricted clinical… more
- Otsuka America Pharmaceutical Inc. (Nashville, TN)
- …medicines for those with CNS disorders, we are seeking a skilled and experienced Medical Director of CNS Early Assets, Global Medical Affairs, responsible ... , Franchise Lead CNS Early Assets. **Position Summary:** The Medical Director , Global Medical Affairs,...for any assigned assets in development. + Support lifecycle management initiatives and planning for assigned assets as applicable.… more
- Evolent (Nashville, TN)
- …for utilization management while working in conjunction with the Senior Medical Director . **Qualifications - Required and Preferred:** + MD/DO/MBBS Degree + ... culture. **What You'll Be Doing:** As a Cardiology, Field Medical Director you will be a key...Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + On… more
- Evolent (Nashville, TN)
- …for utilization management while working in conjunction with the Senior Medical Director . **Qualifications - Required and Preferred:** + MD/DO/MBBS- Required ... **What You'll Be Doing:** As a Vascular Surgery, Field Medical Director you will be a key...Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + On… more
- Parexel (Nashville, TN)
- …Parexel!** In anticipation of future needs, we are seeking an additional Associate / Medical Director to join Parexel's highly recognized Medical Sciences ... Immunology and Inflammation Therapeutic Franchise! As an Associate / Medical Director , you will work closely with...protocol Note that this does not include any direct medical advice on patient care or management … more
- HCA Healthcare (Nashville, TN)
- …care without reservations or limits? Our TriStar Health team is looking for a Medical Staff Services Director . HCA Healthcare is an advanced healthcare network ... save lives across the country? Apply today to our Medical Staff Services Director and be a...(APP) credentialing process under supervision of the AVP of Medical Staff Services. Responsibilities include management of… more
- Humana (Nashville, TN)
- …a part of our caring community and help us put health first** The Corporate Medical Director (CMD) relies on medical background to review health claims ... and preservice appeals. The Corporate Medical Director works on problems of diverse...focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience + Working with… more
- Parexel (Nashville, TN)
- …Patients First, Quality, Respect, Empowerment & Accountability. **Parexel is looking for a Medical Director with a very strong background in Ophthalmology to ... remo** t **ely in the US or Canada.** The Medical Director is a medical ...counterparts + Client-focused approach to work + Excellent time management skills + Excellent verbal and written medical… more
