- InterDent (Amboy, WA)
- …health outcomes. Position Overview We are seeking a dynamic Regional Clinical Director (RCD) to provide clinical leadership and operational support to approximately ... 30 Gentle Dental offices within the designated region and serve as a Dental Director (DD) for Capitol Dental. This is a high-impact leadership role central to our… more
- Seattle Children's (Seattle, WA)
- …Seattle Children's and University of Washington Department of Fetal Surgery leadership, Medical Director MFM and OB Services, Perioperative Services, Nursing to ... growth and support the mission of Seattle Children's Hospital. The perinatal director is responsible for the day-to-day clinical nursing functions of the Special… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …we serve through our Healthsource blog: https://healthsource.premera.com/ . The ** Medical Record Retrieval Specialist** **,** in coordination with Risk Adjustment ... and Quality Departments, will retrieve electronic medical records from provider systems, copy service systems, and...record retrieval efforts will be in support of Commercial, Medicare Advantage, Federal Employee Program or other Quality and… more
- Humana (Olympia, WA)
- …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
- Molina Healthcare (Tacoma, WA)
- …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
- Humana (Olympia, WA)
- …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
- Molina Healthcare (Everett, WA)
- …3+ years HMO/Managed Care experience **OR** 5 years experience as a Molina Medical Director + Demonstrated experience in Utilization/Quality Program management + ... Summary** Responsible for serving as the primary liaison between administration and medical staff. Assures the ongoing development and implementation of policies and… more
- Humana (Olympia, WA)
- …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 ... SNF, DME, dual Medicare /Medicaid and Waiver requests. The Medical Director provides medical interpretation and determinations whether services provided… more
- Molina Healthcare (Tacoma, WA)
- **JOB DESCRIPTION** **Job Summary** Responsible for analysis of Medicaid and Medicare financial reports, trend, and opportunities. Includes evaluation of and ... recommendations relating to business opportunities, Medicare bids, investments, financial regulations, and similar financial projects...early signs of trends or other issues related to medical care cost. + Design and perform actuarial studies… more
- Humana (Seattle, WA)
- …of everything it does. The MarketPoint Career Channel Team is looking for skilled Medicare Field Sales Agents. This is a field-based role, and candidates must live ... community. As part of a collaborative team of 8-12 Medicare Sales Agents, you'll work under the guidance of...under the guidance of a Senior Manager and Regional Director who are committed to your success. Together, you'll… more
- Humana (Olympia, WA)
- **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 (Olympia, WA)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... reference materials, internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and ...to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all… more
- Humana (Olympia, WA)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to… more
- Humana (Olympia, WA)
- **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
- CenterWell (Olympia, WA)
- …and high-risk Medicare patients within a full-risk, value-based framework. The Medical Director collaborates in a dyad partnership with the Strategy ... a part of our caring community and help us put health first** The National Medical Director for Home-Based Care Programs is a key clinical leadership position… more
- Evolent (Olympia, WA)
- …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 (Olympia, WA)
- …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 (Olympia, WA)
- …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 (Olympia, WA)
- …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** As a Field Medical Director , MSK Surgery you will be a key member of the utilization ... 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
- Provider Solutions & Development (Richland, WA)
- …seeking an experienced and board-certified Trauma & Acute Care Surgeon to serve as Medical Director in Richland, Washington. This role is split between 0.5 FTE ... area of sunny Southeast Washington. **Position Details:** + Full-time Medical Director role; 0.5 FTE clinical and...have earned a 5-star rating from the Centers for Medicare and Medicaid Services and an "A" grade from… more
