- eviCore healthcare (Nashville, TN)
- Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a ... United States. Reviews appeals for denied services related to current relevant medical experience or knowledge in accordance with appeal policies, if so delegated.… more
- Aspire Healthcare (Nashville, TN)
- …healthcare system; guiding patients and caregivers through difficult and complex medical decision making; and providing interdisciplinary support to patients and ... central clinical functions At the request of the CMO and Clinical Director , will: Assist with health plan communication and coordination Provide resources for… more
- Lifenet Health (Nashville, TN)
- …outcomes. WHAT YOULL DO Relationship Management: Supports the Health Systems Director in managing the relationship with assigned IDNs including contract negotiation ... M&A activity, and shares relevant insights with Health Systems Director and other internal stakeholders to inform broader strategy...or BS) 5 years Sales experience in Biotech, Pharma, Medical device sales w/focus on major accounts dealing with… more
- TravelNurseSource (Brentwood, TN)
- …an award-winning travel healthcare company with an immediate opening for this Interim Director of Surgical Services in Brentwood , TN . Why Choose Host Healthcare? ... offer the best pay for our travelers. Day one medical , dental and vision insurance. License, travel, tuition, and...50 states at every major healthcare system . Day-1 medical benefits that last up to 30 days between… more
- CenterWell (Nashville, TN)
- **Become a part of our caring community and help us put health first** The Medical Director , Primary Care relies on medical background and reviews health ... claims. The Medical Director , Primary Care work assignments involve moderately complex to...data requires an in-depth evaluation of variable factors. The Medical Director relies on medical … more
- Humana (Nashville, TN)
- …our caring community and help us put health first** The Behavioral Health Medical Director is responsible for behavioral health care strategy and/or operations. ... The Behavioral Health Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires an… more
- Humana (Nashville, TN)
- **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...data requires an in-depth evaluation of variable factors. The Medical Director actively uses their medical… more
- Humana (Nashville, TN)
- **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 ... reviewing home health, SNF, DME, dual Medicare/Medicaid and Waiver requests. The Medical Director provides medical interpretation and determinations whether… more
- Humana (Nashville, TN)
- **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 ... reviewing home health, SNF, DME, dual Medicare/Medicaid and Waiver requests. The Medical Director provides medical interpretation and determinations whether… more
- Humana (Nashville, TN)
- …a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews preauthorization requests ... for services. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth… 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 to ... understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all submitted medical records,… more
- Elevance Health (Nashville, TN)
- …schedule: Monday - Friday. Half day Saturday rotation, once a month.** The ** Medical Director ** is responsible for the administration of behavioral health ... increase effectiveness and quality. + Provides oversight, direction, and guidance to Medical Director Associates. + Works independently with oversight from… more
- Parexel (Nashville, TN)
- …we are expanding our esteemed Medical Sciences Team and seeking an Associate/ Medical Director to support the growth of our Global Immunology and Inflammation ... Therapeutic Franchise. As an Associate / Medical Director , you will work closely with some of the best and brightest in the industry and assist our clients in… more
- Evolent (Nashville, TN)
- …the mission. Stay for the culture. **What You'll Be Doing:** As a Cardiology, Field Medical Director you will be a key member of the utilization management team. ... on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization… more
- Evolent (Nashville, TN)
- …in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional ... on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization… more
- Humana (Nashville, TN)
- **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 to complex issues where the analysis of situations or data requires a case by case… more
- Evolent (Nashville, TN)
- …mission. Stay for the culture. **What You'll Be Doing:** As a Vascular Surgery, Field Medical Director you will be a key member of the utilization management ... on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization… more
- HCA Healthcare (Nashville, TN)
- …Medicine **Job Summary:** CareNow Urgent Care is recruiting an Urgent Care Area Medical Director with demonstrated leadership qualities to join the management ... As the lead physician for this team under the direction of the Market Medical Director , it is important that the following traits and skills are demonstrated: +… more
- Elevance Health (Nashville, TN)
- **Clinical Operations Associate Medical Director ** **Carelon Medical Benefit Management** **Radiology Benefit Management** Surgery (Including: General, ... is granted as required by law._ The **Clinical Operations Associate Medical Director ** is responsible for supporting the medical management staff… 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 ... role can be based remo** t **ely in the US or Canada.** The Medical Director is a medical expert with specialized therapeutic expertise and some experience… more
