- Parexel (Hartford, CT)
- …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
- CVS Health (Hartford, CT)
- …continuum of our members' health care and social determinant needs. The Case Management (CM) Medical Director will participate in executing and deploying ... country. **Primary Duties and Responsibilities:** * Provides clinical oversight of the case management teams and the Interdisciplinary Care Team (ICT) processes… more
- Elevance Health (Wallingford, CT)
- …Accounts Medical Director ** is responsible for serving as the Operational Medical Director for our care management models for our National Account ... medical director supports product strategy/design through medical management that impact health care quality,... director is directly involved in Utilization Management and Case Management . +… more
- Humana (Hartford, CT)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members ... caring community and help us put health first** The Medical Director relies on medical ...in teams focusing on quality management , utilization management , case management , discharge planning… more
- Humana (Hartford, CT)
- … medical management operational improvements, including those within the medical director area + Participate in call rotation + Develop collaborative ... in teams focusing on quality management , utilization management , case management , discharge planning...on size of region or line of business. The Medical Director conducts Utilization Management … more
- Humana (Hartford, CT)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members ... caring community and help us put health first** The Medical Director relies on medical ...in teams focusing on quality management , utilization management , case management , discharge planning… more
- Highmark Health (Hartford, CT)
- …URAC, CMS, DOH, and DOL regulations, etc.). Ensure that all aspects of the medical management process are consistent with community standards of care. + ... outpatient, or private practice) **Preferred** + 1 year in Medical Management in a Health Insurance Plan;...need. **Preferred** + None **SKILLS** + Critical Thinking + Case Management + Customer Service + Oral… more
- Humana (Hartford, CT)
- …and experience with national guidelines such as NCD/LCD, MCG(R) or InterQual The Medical Director conducts clinical case reviews of requests received ... reports to the Lead Medical Director . **Other duties:** + Identify medical management operational improvements, including those within the medical … more
- Hartford HealthCare (Mansfield Center, CT)
- *_Associate Medical Director - Inpatient Services, Natchaug Hospital - Mansfield, CT_* Work where every moment matters. Every day, almost 30,000 Hartford ... part of Connecticut's most comprehensive healthcare network. *_Job Description_* The Associate Medical Director of Psychiatric Services at Natchaug Hospital is… more
- Humana (Hartford, CT)
- **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...in teams focusing on quality management , utilization management , case management , discharge planning… more
- Elevance Health (Wallingford, CT)
- …must be able to work East Coast time zone hours.** The ** Medical Director ** will be responsible for utilization review case management for Commercial ... ** Medical Director - Commercial** Location: This role...and external physicians. + May conduct peer-to-peer clinical appeal case reviews with attending physicians or other ordering providers… more
- Evolent (Hartford, CT)
- …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
- CVS Health (Hartford, CT)
- …anywhere in the US.** Aetna, a CVS Health Company, has an exciting opportunity for a Medical Director (Spine) that can be remote based, work from home. The ... Medical Director (Spine) will be a Subject...providers. Leads all aspects of utilization review/quality assurance, directing case management Provides clinical expertise and business… more
- The Cigna Group (Bloomfield, CT)
- …-- Cigna. **Summary description of position** : A Medical Principal performs medical review and case management activities. The physician provides ... results:** + Performs benefit-driven medical necessity reviews for coverage, case management , and claims resolution, using benefit plan information,… more
- CVS Health (Hartford, CT)
- …as part of Aetna's Pharmacy team. We are seeking an experienced and strategic Director to lead Pharmacy Performance & Profitability Management for Aetna. This ... data and translate it into actionable insights + Familiarity with pharmacy benefit management (PBM), health plan economics, or medical Rx strategy **Preferred… more
- The Cigna Group (Bloomfield, CT)
- …+ Complete time-sensitive, specialized evidence-based medical case reviews for medical necessity on EviCore's case management software. + Conduct ... improving the lives of others? Then look no further! As Infectious Disease Medical Director at EviCore, part of Evernorth Health Services, a division of The… more
- CVS Health (Hartford, CT)
- …(work from home) role and can be based anywhere in the US.** In the Medical Director role you will collaboratively implement medical policy. You'll ... implementation, and evaluation of clinical/ medical programs and promote Aetna's medical management programs and the Employer's (Plan Sponsor's) resources to… more
- Sedgwick (Hartford, CT)
- …Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Sr. VP Medical Director **PRIMARY PURPOSE** **:** To evaluate medical reports ... and assure efficient, cost effective, quality program delivery for medical and disability management . + Coordinating and...+ Provides MRO expertise in special cases where a case is escalated. + Provides assistance where occupational health… more
- Datavant (Hartford, CT)
- …experiences to realize our bold vision for healthcare. **Role Summary:** The ** Director of Internal Audit** will design, implement, and oversee Datavant's legal and ... audit standards. Reporting to the Chief Compliance and Privacy Officer, the Director of Internal Audit will evaluate the effectiveness of internal controls, risk… more
- Datavant (Hartford, CT)
- …experiences to realize our bold vision for healthcare. **Role Overview** As the Director of Prospective + Concurrent Risk Adjustment Products, you will lead the ... combines strategic thinking, clinical product development expertise, and people management responsibilities. You'll be accountable for ensuring our products deliver… more
