- Highmark Health (Trenton, NJ)
- …URAC, CMS, DOH, and DOL regulations, etc.). Ensure that all aspects of the medical management process are consistent with community standards of care. + ... care (hospital, outpatient, or private practice) **Preferred** + 1 year in Medical Management in a Health Insurance Plan; strong knowledge of managed care… more
- Humana (Trenton, NJ)
- …reports to the Lead Medical Director . **Other duties:** + Identify medical management operational improvements, including those within the medical ... part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home… more
- Humana (Trenton, NJ)
- …reports to the Lead Medical Director .** **Other duties:** + Identify medical management operational improvements, including those within the medical ... part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home… more
- Evolent (Trenton, NJ)
- …accountability for utilization management while working in conjunction with the Senior Medical Director . May assist the Senior Medical Director ... Be Doing:** As a Physician Clinical Reviewer, Interventional Pain Management , you will be a key member of the...process. + On a requested basis, may function as Medical Director for selecting health plans or… more
- CenterWell (Trenton, NJ)
- …Information** Will report to the Director of Physician Strategy at Utilization Management . The Medical Director conducts Utilization review of the care ... **Become a part of our caring community and help us put health first** The Medical Director , Primary Care relies on medical background and reviews health… more
- Humana (Trenton, NJ)
- …relationships, value-based care, quality metrics, population health, and disease or care management . The Behavioral Health Medical Director may develop ... our caring community and help us put health first** The Behavioral Health Medical Director is responsible for behavioral health care strategy and/or operations.… more
- Humana (Trenton, NJ)
- …to the Lead Medical Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of the care received by members ... **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 … more
- Humana (Trenton, NJ)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members ... **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 … more
- CVS Health (Trenton, NJ)
- …cover urgent cases can be done from your laptop. **Fundamental Components:** * Utilization management - The medical director will perform concurrent and ... services to its membership. Aetna is looking for a medical director to be part of a...be part of a centralized team that supports the Medical Management staff ensuring timely and consistent… more
- University of Pennsylvania (Philadelphia, PA)
- …of health and wellness programs and resources, and much more. Posted Job Title Assistant Medical Director , Gender & Sexual Health Job Profile Title Director ... C, Healthcare Job Description Summary Reporting to the Medical Director , the Assistant Medical ...but is not limited to: contraception counseling, initiation and management , STI screening and treatment for students and partners,… more
- Humana (Trenton, NJ)
- …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 ... and will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all submitted medical … more
- J&J Family of Companies (Horsham, PA)
- …of America **Job Description:** We are searching for the best talent for Associate Medical Director , US Medical Affairs -Gastroenterology based in Horsham, ... https://www.jnj.com/innovative-medicine **Purpose:** J&J Innovative Medicine is seeking an Associate Medical Director , US Medical Affairs -Gastroenterology… more
- J&J Family of Companies (Titusville, NJ)
- …more at https://www.jnj.com/innovative-medicine **We are searching for the best talent for Director , Medical Writing, Oncology.** Please note that this role is ... will be considered as a single submission. **Purpose:** The Director of Regulatory Medical Writing (RegMW) is...within and across TAs. + Accountable for MW resource management and allocation within their portfolio(s). + Can represent… more
- Evolent (Trenton, NJ)
- …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
- Evolent (Trenton, NJ)
- …for utilization management while working in conjunction with the Senior Medical Director . **Qualifications - Required and Preferred:** + MD/DO/MBBS Degree + ... culture. **What You'll Be Doing:** As a Cardiology, Field Medical Director you will be a key...Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + On… more
- Otsuka America Pharmaceutical Inc. (Trenton, NJ)
- As a senior leader within Medical Affairs, the Executive Director will serve as a strategic thought partner and Chief of Staff to the Vice President of ... capabilities aligned with Otsuka's vision, direction, and growth strategy. The Executive Director , Medical Affairs Strategy, Excellence & Operations will lead… more
- Evolent (Trenton, NJ)
- …for utilization management while working in conjunction with the Senior Medical Director . **Qualifications - Required and Preferred:** + MD/DO/MBBS- Required ... **What You'll Be Doing:** As a Vascular Surgery, Field Medical Director you will be a key...Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + On… more
- BluePearl (Conshohocken, PA)
- …clinical experience to lead our team of emergency and specialty clinicians in the role of ** Medical Director ** . The Medical Director will partner in ... and all clinicians. Using excellent communication and interpersonal skills, the Medical Director will support veterinary partner relationships and enhance… more
- Parexel (Trenton, NJ)
- …we are expanding our esteemed Medical Sciences Team and seeking an Associate/ Medical Director to support the growth of our Global 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
- Organon & Co. (Plymouth Meeting, PA)
- …is an integral member of the Medical Affairs Leadership Team. The Regional Director provides leadership and management of the Dermatology Medical Science ... with Medical Affairs and Organon corporate objectives. The Regional Director is responsible for hiring, leading, managing, developing, and coaching MSLs; and… more