- Molina Healthcare (Madison, WI)
- JOB DESCRIPTION Job Summary Leads and directs a team supporting clinical systems . Responsible for provision of product ownership of clinical applications ... as industry subject matter expert in the functional area and leads clinical systems to meet critical needs. * Communicates and collaborates with customers to… more
- Sumitomo Pharma (Madison, WI)
- …highly motivated, and experienced individual for the position of Senior Medical Director , Clinical Research (Ophthalmology) to join our R&D Organization. This ... individual will contribute to the design and execution of clinical development plan(s) for assigned asset(s) and serve as the Clinical Research Lead for stem… more
- Humana (Madison, WI)
- …products, or other Medical management organizations, hospitals/ Integrated Delivery Systems , health insurance, other healthcare providers, clinical group ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....is assisted by diverse resources which may include national clinical guidelines, CMS policies and determinations, clinical … more
- Humana (Madison, WI)
- …products, or other Medical management organizations, hospitals/ Integrated Delivery Systems , health insurance, other healthcare providers, clinical group ... 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
- Humana (Madison, WI)
- …products, or other Medical management organizations, hospitals/ Integrated Delivery Systems , health insurance, other healthcare providers, clinical group ... 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
- CenterWell (Madison, WI)
- …National Medical Director for Home-Based Care Programs is a key clinical leadership position responsible for the medical direction, clinical oversight, and ... improvement. + Work collaboratively with the Strategy Advancement and Operations Director to align clinical and operational priorities. **Quality Improvement… more
- Grifols Shared Services North America, Inc (Madison, WI)
- …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, and… more
- Humana (Madison, WI)
- …products, or other Medical management organizations, hospitals/ Integrated Delivery Systems , health insurance, other healthcare providers, clinical group ... 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 … more
- Evolent (Madison, WI)
- …SOUTHWEST REGION We are seeking a strategic and collaborative Associate Director , Provider Engagement to lead our oncology-focused provider engagement and practice ... in the **New Mexico** . Reporting to the National Provider Engagement Sr. Director , you will be responsible for building and managing relationships with oncology… 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. + ... + 3+ years relevant experience, including: + 2 years previous experience as a Medical Director in a clinical practice. + Current clinical knowledge. +… more
- Option Care Health (Madison, WI)
- …patients with acute and chronic conditions in all 50 states. Through our clinical leadership, expertise and national scale, Option Care Health is re-imagining the ... the best and brightest talent in healthcare. **Job Description Summary:** The Director of Contracting is responsible for leading the entire contracting process from… more
- Grifols Shared Services North America, Inc (Madison, WI)
- …and services in more than 110 countries and regions. The Associate Director , Value Access Marketing & Reimbursement is responsible for developing and executing ... managed markets customer base, which consists of payers, GPOs, integrated health systems , specialty pharmacies, physician groups and channel partners . Develop and… more
- Catalent Pharma Solutions (Madison, WI)
- ** Director , Quality Control** **Position Summary** Catalent, Inc. is a leading global contract development and manufacturing organization (CDMO) whose mission is to ... disorders, HIV, diabetes, heart and lung diseases as well as Alzheimer's. The Director of Quality Control is responsible for all activities within the QC department.… more
- Molina Healthcare (Madison, WI)
- …in Psychiatry **REQUIRED EXPERIENCE:** * 2 years previous experience as a Medical Director in clinical practice * 3 years' experience in Utilization/Quality ... enterprise-wide teaching on psychiatric diagnoses and treatment * Provides second level BH clinical reviews, BH peer reviews and appeals * Supports BH committees for… more
- Wolters Kluwer (Madison, WI)
- As part of the Wolters Kluwer Health Clinical Effectiveness team, the Associate Director , Technology Product Management, role for Medi-Span will govern assigned ... for assigned areas in Medi-Span by closely collaborating with Engineering, Clinical Content, Product Management, Systems Implementation, Customer Support,… more
- Evolent (Madison, WI)
- …mission with a company behind it. **What You'll Be Doing:** **Associate Director , Performance Analytics - Oncology & Member Product Focus** **Overview:** Evolent is ... seeking an experienced and strategic **Associate Director of Performance Analytics** to lead data-driven initiatives focused on oncology and member-centric products.… more
- Evolent (Madison, WI)
- …the mission. Stay for the culture. **Who You'll Be Working With:** The Director , Performance Suite Analytics, utilizes and develops analytic tools to solve complex ... partnering with Business Development, Product Strategy, Finance/Accounting, Actuarial, EDWBI, Clinical , Performance Solutions and Partner Delivery. **What You'll Be… more
- Sedgwick (Madison, WI)
- …ADAA and FMLA + Knowledge of utilization review procedures + Knowledge of clinical quality systems and measurements + Knowledge of resources available regarding ... Fortune Best Workplaces in Financial Services & Insurance Sr. VP Medical Director **PRIMARY PURPOSE** **:** To evaluate medical reports escalated due to deficient… more
- Travelers Insurance Company (Madison, WI)
- …assigned. **What Will Our Ideal Candidate Have?** + Understanding of healthcare systems including Hospital Services, Pharmacy and Group Health insurance + Strong ... analysis skills **What is a Must Have?** + Licensed MD + 5 years clinical and utilization management experience + Certified by the American Board of Medical… more
- Cognizant (Madison, WI)
- …. Draft and submit the medical necessity determinations to the Health Plan/Medical Director based on the review of clinical documentation in accordance with ... Nurse you will make an impact by performing advanced level work related to clinical denial management and managing clinical denials from Providers to the Health… more