- 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
- Elevance Health (Woodbridge, NJ)
- **Clinical Operations Medical Director ** **Carelon Medical Benefit Management ** **Radiation Oncology** **Virtual:** This role enables associates to work ... **Clinical Operations Medical Director ** is responsible for supporting the medical management staff ensuring timely and consistent medical decisions… 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
- Ascendis Pharma (Princeton, NJ)
- …Associate Medical Director supports the US Medical Director for deliverables and activities associated with management and implementation of phase ... Global Communications, and other functional group contributors to support the US Medical Director in successful management of Medical Affairs projects.… more
- Elevance Health (Morristown, NJ)
- …**Clinical Operations Medical Director ** is responsible for supporting the medical management staff ensuring timely and consistent medical decisions ... **Clinical Operations Medical Director ** ** Medical Oncology** **Carelon Medical Benefit Management ** **Virtual** : This role enables associates to… 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
- Genesis Healthcare (Cape May, 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 (Trenton, NJ)
- …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
- 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
- Ascendis Pharma (Princeton, NJ)
- …workplace for employees to grow and develop their skills. We are looking for an Associate Director , US Medical Training, who will work within the US Medical ... will be located in Princeton and reports to the Director , US Field Medical Training. Key Responsibilities...Management System. + Successfully create, prepare, and deliver medical affairs training materials and field assets to targeted… 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 actively uses their medical background, experience, and judgement… more
- Merck (Trenton, NJ)
- **Job Description** The Oncology Regional Medical Scientific Director , Oncology is a credentialed (ie, MD, PhD, PharmD, or DNP) therapeutic and disease expert ... claims about any drug, vaccine or biologic product. The Oncology Regional Medical Scientific Director provide to Scientific Leaders balanced, factual, scientific… more
- Mallinckrodt Pharmaceuticals (Bridgewater, NJ)
- Job Title Senior Medical Director - Rheumatology Requisition JR000015351 Senior Medical Director - Rheumatology (Open) Location Bridgewater, NJ ... Additional Locations Job Description Summary The Senior Medical Director , Rheumatology, will serve as a critical member of the Global Medical Affairs team.… more
- IQVIA (Shrewsbury, NJ)
- …the Account Director is responsible for simultaneously overseeing the management of multiple medical education projects from inception to completion. ... **Account Director , Medical Education & Communications** **Position...contact to client stakeholders partnering on strategic initiatives, project/financial management , and communications with client stakeholders. + Develop and… 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