- Fresenius Medical Care (Wilmington, DE)
- About this role: As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical operations. As ... advance your career into an Area Team Lead or Director of Operations role. Our culture: We believe our...a tremendous asset that sets us apart. At Fresenius Medical Care, you will truly make a difference in… more
- Highmark Health (Dover, DE)
- …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 (Dover, DE)
- …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 (Dover, DE)
- …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
- Elevance Health (Wilmington, DE)
- …Accounts Medical Director ** is responsible for serving as the Operational Medical Director for our care management models for our National Account ... we serve. The medical director supports product strategy/design through medical management that impact health care quality, cost, and outcomes, and… more
- Evolent (Dover, DE)
- …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 (Dover, DE)
- …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 (Dover, DE)
- …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 (Dover, DE)
- …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 (Dover, DE)
- … 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
- UPMC (Media, PA)
- …Behavioral Health (CCBH) is seeking a qualified individual to fulfill the role of Regional Medical Director in Delaware County, PA. The Regional Medical ... for the clinical needs of Community Care members. The Medical Director also participates in regional leadership... aspects of cost and utilization reports generated by Medical Management Information System. + Acts as… more
- Genesis Healthcare (Millville, NJ)
- …balance flexibility (no weekends or on call)! We are seeking a FFS Attending Physician/ Medical Director for split position between our North Cape Center located ... our Millville Center located in Millville, NJ. This is a Dual Role Attending Physician/ Medical Director . It is clinical in nature. Must be BC/BE Internal… more
- Humana (Dover, DE)
- …a Lead Medical Director , depending on the line of business. The Medical Director conducts Utilization Management or clinical validation of the care ... **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement… 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 (Dover, DE)
- …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
- Merck (Dover, DE)
- …partnership with Precision Medicine Health Systems Oncology Medical Affairs Director (PM HSO-MADs), oncology account management , and precision medicine teams ... This role also serves as a resource for the Medical Affairs (MA) management team on strategic...resource for the PM MAD-HSO Team Lead, HSO Executive Director Medical Affairs, and other members of… more
- Evolent (Dover, DE)
- …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
- Merck (Dover, DE)
- **Job Description** The Regional Medical Scientific Director is a credentialed (ie, PhD, PharmD, DNP, MD, DO) Vaccines/Infectious Disease expert who engages in ... from SLs, including questions about Company products. The work of a Regional Medical Scientific Director is aligned to: Scientific Exchange, Research, Scientific… more
- Evolent (Dover, DE)
- …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
- VCA Animal Hospitals (Dover, DE)
- …The Medical Director (MD) under the direction of the field management team, is responsible for establishing the medical quality and patient care ... **Job** **Summary:** Join us as a ** Medical Director ** at **VCA Dover Animal...MD is also an integral part of the hospital management team responsible for the overall financial performance of… more
