- Daiichi Sankyo, Inc. (Chesapeake, VA)
- …pharmaceutical therapies to improve standards of care and address diversified, unmet medical needs of people globally by leveraging our world-class science and ... is comprised of nurses working under the general direction of the Regional Director of Clinical Nurse Managers. The OCE is responsible for educating HCPs/clinics… more
- Elevance Health (Ashburn, VA)
- ** Utilization Management Medical Director - NC Medicaid** Location: This role enables associates to work virtually full-time, with the exception of ... Alternate locations may be considered. The ** Medical Director ** will be responsible for utilization review case management for North Carolina Medicaid.… more
- Evolent (Richmond, VA)
- …setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional cardiology ... per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management … more
- Humana (Richmond, VA)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an ... caring community and help us put health first** The Medical Director relies on medical ...healthcare providers, clinical group practice management . + Utilization management experience in a medical… more
- Humana (Richmond, VA)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an ... healthcare providers, clinical group practice management . + Utilization management experience in a medical... management operational improvements, including those within the medical director area + Participate in call… more
- Humana (Richmond, VA)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an ... caring community and help us put health first** The Medical Director relies on medical ...healthcare providers, clinical group practice management . + Utilization management experience in a medical… more
- Cognizant (Richmond, VA)
- …. Draft and submit the medical necessity determinations to the Health Plan/ Medical Director based on the review of clinical documentation in accordance with ... . Educational background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management experience with managed health care plan . 3 years'… more
- Elevance Health (Norfolk, VA)
- …responsibilities means that the medical director is directly involved in Utilization Management and Case Management . + Daily case reviews for both ... Director ** is responsible for serving as the Operational Medical Director for our care management...director provides clinical expertise in all aspects of utilization review and case management . Provides input… more
- Evolent (Richmond, VA)
- …for utilization management while working in conjunction with the Senior Medical Director . May assist the Senior Medical Director in ... , you will be a key member of the utilization management team. We can offer you...process. + On a requested basis, may function as Medical Director for selecting health plans or… more
- Evolent (Richmond, VA)
- …per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management ... you will be a key member of the utilization management team. We can offer you...management while working in conjunction with the Senior Medical Director . **Qualifications - Required and Preferred:**… more
- Evolent (Richmond, VA)
- …per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management ... cases. you will be a key member of the utilization management team. We can offer you...management while working in conjunction with the Senior Medical Director . **Qualifications - Required and Preferred:**… more
- Humana (Richmond, VA)
- …health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a medical management ... caring community and help us put health first** The Medical Director actively uses their medical...with prior experience participating in teams focusing on quality management , utilization management , case … more
- Elevance Health (Norfolk, VA)
- …or healthcare leadership preferred. + Experience advising medical cost management , utilization management , payment integrity, or provider performance ... **Manager, Medical Director - Transformation Initiatives** Location:...+ **Cost of Care / Payment Integrity** + **Care Management / Utilization Management (CM/UM)… more
- Evolent (Richmond, VA)
- …in a timely and accurate manner. . May assist the Senior Medical Director in research activities/questions related to the Utilization Management process, ... the culture. **What You'll Be Doing:** As a Field Medical Director , Oncology, you will be a...Oncology, you will be a key member of the utilization management team. We can offer you… more
- Genesis Healthcare (Bluefield, VA)
- …or on call)! We are seeking a Fee-For-Service (8-12 hours per week) Attending Physician/ Medical Director for our Westwood Center located in Bluefield, VA. This ... is a Dual Role Attending Physician/ Medical Director . It is clinical in nature....Management and AlignMed Partners to oversee the implementation, utilization , and outcomes measurement of AlignMed Partners Clinical Programs.… more
- Evolent (Richmond, VA)
- …in a timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management process, ... the culture. **What You'll Be Doing:** As a Field Medical Director , MSK Surgery you will be...Surgery you will be a key member of the utilization management team. We can offer you… more
- Elevance Health (Richmond, VA)
- **Behavioral Health Medical Director -Psychiatrist Appeals** **Location:** This role enables associates to work virtually full-time, with the exception of ... Friday. Half day Saturday rotation, once a month.** The **Behavioral Health Medical Director -Psychiatrist Appeals** is responsible for the administration of… more
- University of Virginia (Charlottesville, VA)
- … Medical Center in Charlottesville, Virginia is seeking an experienced and visionary Director of Medical Laboratories to lead the day-to-day operations of the ... policy development, and continuous quality improvement. As a key member of the Medical Laboratories leadership team, the Director will partner closely with… more
- Elevance Health (Norfolk, VA)
- ** Medical Director - Medical Policy** Location: This role enables associates to work virtually full-time, with the exception of required in-person training ... required by law. Alternate locations may be considered. The ** Medical Director - Medical Policy** is...+ Supports coordination with external entities that develop clinical utilization management guidelines used by Company Plans… more
- Genesis Healthcare (Ashland, VA)
- …Area Director ). 9. Assumes responsibility for daily staffing and utilization with input from treating therapists, consideration of clinical requirements, and ... of the rehabilitation department, including oversight related to case management , quality improvement, care planning, clinical utilization , and patient… more
