• Medical Director - Medicare

    Elevance Health (Dearborn, MI)
    ** Medicare Medical Director ** Location: This role requires associates to be in-office 3 days per week, fostering collaboration and connectivity, while ... Candidates must be able to work Eastern Time Zone hours. The ** Medicare Medical Director ** is responsible for the administration of physical and/or… more
    Elevance Health (05/20/25)
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  • Corporate Medical Director

    Humana (Lansing, MI)
    …a part of our caring community and help us put health first** The Corporate Medical Director (CMD) relies on medical background to review health claims ... and preservice appeals. The Corporate Medical Director works on problems of diverse...experience + Knowledge of the managed care industry including Medicare , Medicaid and/or Commercial products + Must be passionate… more
    Humana (04/24/25)
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  • Medical Director ( Medicare )

    Molina Healthcare (Grand Rapids, MI)
    …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... Medicare , Medicaid, NCQA and other regulatory requirements. + Reviews...experience, including: + 2 years previous experience as a Medical Director in a clinical practice. +… more
    Molina Healthcare (05/02/25)
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  • Medical Director - Medicare

    Humana (Lansing, MI)
    …a part of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims and ... preservice appeals. The Corporate Medical Director works on problems of diverse...experience + Knowledge of the managed care industry including Medicare , Medicaid and or Commercial products + Must be… more
    Humana (05/14/25)
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  • Medical Director - Care Plus…

    Humana (Lansing, MI)
    **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...materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and … more
    Humana (04/24/25)
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  • Medical Director - Pacific SW Region

    Humana (Lansing, MI)
    **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...materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and … more
    Humana (05/10/25)
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  • Medical Director - Medicaid N.…

    Humana (Lansing, MI)
    **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...group practice management. + Utilization management experience in a medical management review organization, such as Medicare more
    Humana (05/14/25)
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  • Medical Director - Florida

    Humana (Lansing, MI)
    **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...group practice management. + Utilization management experience in a medical management review organization, such as Medicare more
    Humana (05/22/25)
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  • Medical Director , MSK Surgery

    Evolent (Lansing, MI)
    …business. Join Evolent for the mission. Stay for the culture. **What You'll Be Doing:** The Medical Director for MSK Surgery is a key member of the Medical ... questions. + Reviews statistical sample of cases for Field Medical Director audits and makes recommendations into...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
    Evolent (05/20/25)
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  • Medical Director Specialty…

    Molina Healthcare (Warren, MI)
    **JOB DESCRIPTION** **Job Summary** The Medical Director for Specialty Medical Services & Market Performance will provide clinical expertise and support to ... quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to… more
    Molina Healthcare (04/09/25)
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  • Field Medical Director , Cardiology

    Evolent (Lansing, MI)
    …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. ... per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
    Evolent (05/16/25)
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  • Field Medical Director

    Evolent (Lansing, MI)
    …in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional ... per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
    Evolent (04/30/25)
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  • Field Medical Director , Oncology

    Evolent (Lansing, MI)
    …for the mission. Stay for the culture. **What You'll Be Doing:** As a Field Medical Director , Oncology, you will be a key member of the utilization management ... timely and accurate manner. . May assist the Senior Medical Director in research activities/questions related to...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
    Evolent (05/20/25)
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  • Field Medical Director , Radiology…

    Evolent (Lansing, MI)
    …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** As a Field Medical Director you will be a key member of the utilization management team. ... timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
    Evolent (03/21/25)
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  • Physician Manager 20 - Medical

    State of Michigan (Grand Rapids, MI)
    Physician Manager 20 - Medical Director Print (https://www.governmentjobs.com/careers/michigan/jobs/newprint/4848644) Apply  Physician Manager 20 - Medical ... at MVH, please click here (https://www.youtube.com/watch?v=o92V-nOxaKs) . Serve as Medical Director for Michigan Veteran Homes at...level of experience in following Centers for Medicaid and Medicare Services (CMS) for long-term care. + None +… more
    State of Michigan (05/21/25)
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  • Medical Director , Behavioral Health

    Molina Healthcare (Detroit, MI)
    …Certification in Psychiatry **REQUIRED EXPERIENCE:** * 2 years previous experience as a Medical Director in clinical practice * 3 years' experience in ... State Medical License, free of sanctions from Medicaid or Medicare . **Preferred Experience** * Peer Review, medical policy/procedure development, provider… more
    Molina Healthcare (04/26/25)
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  • Business Development Director -Government…

    R1 RCM (Detroit, MI)
    …enhancing the patient experience. As the Government Navigation Services (GNS) Business Development Director , you will focus on engaging and targeting new Tier 1 and ... in addition to prospecting and networking initiatives, the GNS Business Development Director will partner with the Business Development teams of in-house and… more
    R1 RCM (03/21/25)
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  • Branch Director Home Health

    Elara Caring (Bingham Farms, MI)
    …this mission. This means you have countless ways to make a difference as Branch Director . Being a part of something this great starts by carrying out our mission ... pioneer in delivering unparalleled care, we need a Branch Director with commitment and compassion. Are you one of...+ Opportunities for advancement + Comprehensive insurance plans for medical , dental, and vision benefits + 401(K) with employer… more
    Elara Caring (05/13/25)
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  • Director , Stars HOS Improvement…

    Humana (Lansing, MI)
    …our customers and delivering high plan quality as rated by the Centers for Medicare and Medicaid Services (CMS). The CMS Stars quality rating system evaluates ... Medicare Advantage and Prescription Drug Plans using approximately 40...management, health outcomes, patient experience, and plan operations. The Director , Stars HOS Improvement and Operations is responsible for… more
    Humana (05/13/25)
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  • Director of Rehab

    Genesis Healthcare (Petoskey, MI)
    …Powerback is the place for you. **Why Powerback?** + **Benefits:** We offer Medical , Dental, and Vision plans to Full-Time and Part-Time team members. + **Support ... expertise with our Clinicians in Action professional development program. Responsibilities The Director of Rehab PT is responsible for the efficient management of… more
    Genesis Healthcare (05/21/25)
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