- Humana (Springfield, IL)
- …size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an assigned market, member ... work, communication of decisions to internal associates, and possible participation in care management . The clinical scenarios predominantly arise from inpatient… more
- Humana (Springfield, IL)
- …size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an assigned market, member ... work, communication of decisions to internal associates, and possible participation in care management . The clinical scenarios predominantly arise from inpatient… more
- Humana (Springfield, IL)
- …on size of team or line of business. The Medical Director conducts Utilization Management of the care received by members in an assigned member population of ... community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on...business metrics. + Experience working with Case managers or Care managers on complex case management , including… more
- Bausch + Lomb (Springfield, IL)
- …of R&D development projects within an assigned B&L business vertical (eg Vision Care ), as well as leadership/facilitation/ management of the new product ... launch planning, project scope, budget, resources, schedule, project risk management , and communication plan. The Director /Sr. ...project risk management , and communication plan. The Director /Sr. Director of Project Management … more
- Humana (Springfield, IL)
- …of our caring community and help us put health first** The Utilization Management (UM) Director , Clinical Strategy and Practice for Medicaid builds strategies ... capabilities interrelate across the function or segment. The Utilization Management (UM) Director , Clinical Strategy and Practice...3+ years of experience in Medicaid or healthcare Utilization Management , with a focus on outpatient care .… more
- United Therapeutics (Springfield, IL)
- …is innovative and inspiring where you can truly make a difference. The Regional Field Director , RNS Program Management serves as a director of all clinical ... the commercial non-promotional team. In addition, the Regional Field Director , RNS Program Management will: + Serve...years of PAH nursing experience, including ICU and critical care of PAH patients or + Master's Degree with… more
- CenterWell (Springfield, IL)
- …a part of our caring community and help us put health first** The Director , Account Management is responsible for growing membership within existing accounts and ... for directly managing business relationships with client accounts. The Director , Account Management requires an in-depth understanding of how organization… more
- Veterans Affairs, Veterans Health Administration (Springfield, IL)
- …Improvement and Utilization Review by stimulating parent services. Ensures that overall quality management is the goal for all Ambulatory care staff. Ensures ... Physician Total Rewards. Supervise and coordinate operations of the Ambulatory care including emergency and routine treatment procedures. These operations are… more
- Sumitomo Pharma (Springfield, IL)
- …highly motivated, and experienced individual for the position of **Associate Medical Director .** The Associate Medical Director will provide hands-on PVRM ... The incumbent will provide medical safety support for safety signal management throughout product lifecycle including signal detection, signal validation, signal… more
- Prime Therapeutics (Springfield, IL)
- …fuels our passion and drives every decision we make. **Job Posting Title** Senior Director Clinical Account Management - Remote **Job Description** The Sr ... Director of Clinical Account Management is responsible for providing strategic and operational leadership...for proactively addressing the constant changes in today's health care industry. Our employees are involved, empowered, and rewarded… more
- CVS Health (Springfield, IL)
- … Management in support of Key Clients as assigned. The Medical Director transacts Utilization Management UM activities (prior authorization and appeals) and ... 6 company, has an outstanding opportunity for a Medical Director (Medical Affairs). This is a remote based, work...located. **Preferred Qualifications** * Combination of five years of management and/or clinical experience in a managed care… more
- CVS Health (Springfield, IL)
- …candidates for this role in the central time zone, due to BOB The Lead Director , Account Client Management develops and executes account management strategy ... ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions… more
- Humana (Springfield, IL)
- …Information** Typically reports to a Lead Medical Director . The Medical Director conducts post-service, inpatient care reviews for accurate billing of ... of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations… more
- Evolent (Springfield, IL)
- …training classes as needed for new hires to educate and train on Utilization management system and Field Medical Director process, standards and resources. + ... and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented...for the culture. **What You'll Be Doing:** The Medical Director for MSK Surgery is a key member of… more
- CVS Health (Springfield, IL)
- …ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions ... Health company has an outstanding opportunity for a Medical Director . Ready to take your career to the next...clinical expertise and business direction in support of medical management programs to promote the delivery of high quality,… more
- CVS Health (Springfield, IL)
- …and it recognizes physicians for their clinical quality and effective use of health care resources. In the Medical Director role you will + Provide oversight ... programs to address member needs across the continuum of care . + You will support the Medical Management...consistent responses to members and providers. As a Medical Director you will + Focus primarily on overseeing utilization… more
- Evolent (Springfield, IL)
- …impact on patient care in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your ... Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + On a requested… more
- Otsuka America Pharmaceutical Inc. (Springfield, IL)
- …and Specialty Medicine products at different stages of development for a global health- care market. The duties assigned to the Director , Global Clinical ... personnel management experience, will support position at entry (Associate Director / Director ). + An advanced understanding of drug development principles and… more
- Otsuka America Pharmaceutical Inc. (Springfield, IL)
- …a global health- care market. The specific duties assigned to the Director , Global Clinical Development include the following: + Consults with patients or their ... **Job Description** Otsuka is seeking a Director , Global Clinical Development (GCD), who will be...management experience, will support position at entry (Associate Director / Director ). + An advanced understanding of drug… more
- CenterWell (Springfield, IL)
- …patient base growth, achievement of key performance indicators, and people management /development. The Branch Director supervises the branch/clinical staff. ... of our caring community and help us put health first** The **Branch Director ** is accountable for managing the day-to-day branch operations to ensure the following:… more