- Highmark Health (Phoenix, AZ)
- …responsibilities are performed in accordance with the highest and most current clinical standards. The incumbent reviews escalated cases electronically and using ... Medical Policy criteria sets to evaluate the ... necessity and appropriateness of the requested treatment of service . Depending on the nature of the case, telephonic… more
- Humana (Phoenix, AZ)
- …and Waiver requests. The Medical Director provides medical interpretation and determinations whether services provided by other healthcare ... Humana policies, clinical standards, and (in some cases) contracts. The Medical Director provides medical interpretation and decisions about the… more
- Molina Healthcare (Mesa, AZ)
- …Board Certification in Psychiatry **REQUIRED EXPERIENCE:** * 2 years previous experience as a Medical Director in clinical practice * 3 years' experience in ... case management programs for mental health and chemical dependency services . Works closely with the Regional Medical ...* Supports BH committees for quality compliance. * Implements clinical practice guidelines and medical necessity review… more
- Molina Healthcare (Mesa, AZ)
- …NCQA-compliant clinical quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. ... and procedures that guide and support the provisions of medical staff services . Maintains a working knowledge...experience, including: + 2 years previous experience as a Medical Director in a clinical … more
- Adelante (Phoenix, AZ)
- …Level MD degree or DO degree Job Category Health Care Description POSITION SUMMARY The Medical Director aids the Chief Clinical Officer with oversight and ... Medical Director Job Details Job Location...specialty medical directors to ensure consistency across service lines + Work with the Chief Clinical… more
- Dignity Health (Phoenix, AZ)
- **Job Summary and Responsibilities** In collaboration with the Department Director and Medical Director , the Senior. Clinical Support Scientist serves as ... a respected center for high-risk obstetrics, neuro-rehabilitation, orthopedics, and other medical services . St. Joseph's is considered a sought-after destination… more
- Envita Medical Center (Scottsdale, AZ)
- …over the past 20 years. Job Description: We are seeking a qualified Medical Director to oversee the operations and clinical care at Envita Medical ... Job Description: Medical Director Location: Scottsdale, AZ (North...medical specialty + Minimum of 5 years of clinical experience + Experience in integrative medicine or a… more
- CommonSpirit Health (Chandler, AZ)
- …in provision of clinical services In collaboration with the physician/ medical director , assumes clinical responsibility for tasks performed within ... Gastroenterology Division + Work closely with the administrative and clinical directors for the GI Service Program...sub-specialty services . The physicians and APPs provide clinical services in their areas of specialty… more
- HonorHealth (Scottsdale, AZ)
- …tests and study results to make recommendations for treatment options + Assists the Clinical Trials Medical Director with identification of medical ... services , a cancer care network, outpatient surgery centers, clinical research, medical education, a foundation, an...to share results of ongoing and completed research studies; service as an expert clinical researcher in… more
- Dignity Health (Phoenix, AZ)
- **Job Summary and Responsibilities** In collaboration with the physician/ medical director assumes clinical responsibility for tasks performed within Nurse ... Nursing. + Knowledge of professional nursing theory practice and medical care to give and evaluate patient care. +...few years and now provides more than 73 subspecialty services . The physicians provide clinical services… more
- Dignity Health (Phoenix, AZ)
- …education, and advocates for patient wellness. + In collaboration with the physician/ medical director assumes clinical responsibility for tasks performed ... as an advanced practice nurse, providing primary and specialty healthcare services to patients across the lifespan. Working collaboratively with physicians, nurses,… more
- Prime Therapeutics (Phoenix, AZ)
- …our passion and drives every decision we make. **Job Posting Title** Sr Director Clinical Strategy and Oncology Specialty Solutions/PharmD required- REMOTE **Job ... Description** The Senior Director Clinical Strategy and Oncology Specialty Solutions...the development of strategic business roadmaps that integrate both medical and pharmacy solutions. This position will provide leadership… more
- Cognizant (Phoenix, AZ)
- …submit the medical necessity determinations to the Health Plan/ Medical Director based on the review of clinical documentation in accordance with ... denials including but not limited to referral, preauthorization, medical necessity, non-covered services , investigational/experimental and billing resulting… more
- Highmark Health (Phoenix, AZ)
- …anchor, including MAQCs and pharmacists, in collaboration with the partnership director who manages non- clinical workforce activity. + **Relationship Management ... :** **JOB SUMMARY** This role will support the leadership team for Clinical Transformation and executive physicians in leading the day-to-day operational model of… more
- Maxim Healthcare (Phoenix, AZ)
- …$105,000 and $16,600 annual bonus paid out quarterly Maxim Healthcare is hiring a Clinical Director to provide management and oversight of clinical ... Performance Indicators (KPIs) and identified training needs + Responsible for the overall clinical care and quality of behavioral services provided to Maxim… more
- Grifols Shared Services North America, Inc (Mesa, AZ)
- …(MSL primary call points include Immunology, Neurology, Hematology/Oncology). The Field Director ensures compliant execution of field medical plans, strategy, ... and develop, produce and market innovative medicines, solutions and services in more than 110 countries and regions. The...solutions for the therapeutic area(s). + Partners with the Medical Directors, National MSL Sr Director , and… more
- Humana (Phoenix, AZ)
- …processes, and outpatient services and equipment, within their scope. The Medical Director may speak with contracted external physicians, physician groups, ... , requested level of care, and/or requested site of service should be authorized. All work occurs with a...**Responsibilities** The Medical Director provides medical interpretation and determinations whether services provided… more
- Humana (Phoenix, AZ)
- …an impact** **Responsibilities** The Medical Director provides medical interpretation and determinations whether services provided by other healthcare ... clinical documentation, dispute/grievance and appeals processes, and outpatient services and equipment, within their scope. Medical ...a Lead Medical Director . The Medical Director conducts post- service , inpatient… more
- Banner Health (Mesa, AZ)
- Banner Medical Group is actively recruiting for a Neurology Service Line Medical Director in the Phoenix metropolitan area.This is an exciting ... applicable internal and external constituents and stakeholders. + The Service Line Medical Director role...scope of responsibility with the remaining time assigned to clinical duties. + Medical Doctorate or Doctor… more
- Humana (Phoenix, AZ)
- …all activities. **Responsibilities** The Medical Director provides medical interpretation and determinations whether services provided by other ... Medical Director 's work includes reviewing of all submitted medical records, synthesizing complex hospital-based clinical scenarios, and providing expert… more