- Elevance Health (Waukesha, WI)
- **National Accounts Medical Director ** Location: This role enables associates to work virtually full-time, with the exception of required in-person training ... law. Alternate locations may be considered. The **National Accounts Medical Director ** is responsible for serving as...medical services by members. Involved in identifying and managing medical utilization trends, emerging trends and… more
- Humana (Madison, WI)
- **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...Goal) and community relations as directed. **Required Qualifications** + MD or DO degree + 5+ years of direct… more
- Humana (Madison, WI)
- …Business. + Support Home Solutions as needed + Other activities as assigned by the managing Medical Director Travel: While this is a remote position, ... caring community and help us put health first** The Medical Director relies on fundamentals of CMS...your skills to make an impact** Required Qualifications + MD or DO degree + Current and ongoing board… more
- Humana (Madison, WI)
- **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 operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of...objectives and community relations as directed. **Required Qualifications** + MD or DO degree + 5+ years of direct… more
- Humana (Madison, WI)
- **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 operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all...your skills to make an impact** **Required Qualifications** + MD or DO degree + 5+ years of direct… more
- Humana (Madison, WI)
- **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...departmental expectations, and meets compliance timelines. **Required Qualifications** + MD or DO degree + 5+ years of direct… more
- CenterWell (Madison, WI)
- …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 ... high-risk Medicare patients within a full-risk, value-based framework. The Medical Director collaborates in a dyad partnership...and vendor partners. **Required Qualifications** + Doctor of Medicine ( MD ) or Doctor of Osteopathy (DO) degree + A… more
- Otsuka America Pharmaceutical Inc. (Madison, WI)
- …medicines for those with CNS disorders, we are seeking a skilled and experienced Medical Director of CNS Early Assets, Global Medical Affairs, responsible ... , Franchise Lead CNS Early Assets. **Position Summary:** The Medical Director , Global Medical Affairs,...into cross functional leadership meetings and plans. **Requirements:** + Medical Doctor ( MD ), PhD or PharmD candidates… more
- Wellpath (Franklin, WI)
- …education, and point of care support. **How you make a difference** The Site Medical Director provides clinical leadership at the assigned facility and ensures ... include documentation, emergency response, treatment planning, and formulary compliance. The Medical Director supports continuous quality improvement efforts and… more
- Ascension Health (Sturtevant, WI)
- **Details** + **Specialty:** Primary Care/ Medical Director (Dual role) + **Schedule:** 0.6 FTE Clinical/0.4 FTE Administrative Medical Director + **Call ... Care Physician** to serve in a **dual-role** as both a practicing clinician and ** Medical Director ** for our Racine and Milwaukee South service areas. This… more
- Parexel (Madison, WI)
- …Parexel!** In anticipation of future needs, we are seeking an additional Associate / Medical Director to join Parexel's highly recognized Medical Sciences ... Immunology and Inflammation Therapeutic Franchise! As an Associate / Medical Director , you will work closely with...for Parexel studies, as applicable and/or appropriate for the MD + Providing risk assessment of clinical trials for… more
- Elevance Health (Waukesha, WI)
- ** Medical Director -Cardiology Appeals** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person training ... for employment, unless an accommodation is granted as required by law. The ** Medical Director -Cardiology Appeals** is responsible for the review of appeals for… more
- Humana (Madison, WI)
- …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...your skills to make an impact** **Required Qualifications** + MD or DO degree + A current and unrestricted… more
- Evolent (Madison, WI)
- …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...(NCQA) guidelines. + Ensures documentation of all communications with medical office staff and/or MD provider is… more
- Evolent (Madison, WI)
- …accountability for utilization management while working in conjunction with the Senior Medical Director . **Qualifications** + MD /DO/MBBS Degree + Current, ... setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your...(NCQA) guidelines. + Ensures documentation of all communications with medical office staff and/or MD provider is… more
- Evolent (Madison, WI)
- …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...Clinical Reviewers. + Ensures documentation of all communications with medical office staff and/or MD provider is… more
- Centene Corporation (Madison, WI)
- …quality accreditation standards. + Actively practices medicine **Position Purpose:** Assist the Chief Medical Director to direct and coordinate the medical ... in the community? **Qualifications for this role include:** + MD or DO without restriction + Board certified in...performance improvement initiatives for capitated providers. + Assists Chief Medical Director in planning and establishing goals… more
- Elevance Health (Waukesha, WI)
- **Clinical Operations Associate Medical Director ** **Interventional Pain** **Carelon Medical Benefits Management** **Virtual:** This role enables associates ... domains, including radiology, cardiology and oncology._ The **Clinical Operations Associate Medical Director ** is responsible for supporting the medical… more
- Humana (Madison, WI)
- …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...your skills to make an impact** **Required Qualifications** + MD or DO degree + A current and unrestricted… more
- Evolent (Madison, WI)
- …per inter-rater reliability process. + On a requested basis, may function as Medical Director for selecting health plans or regions, assuming overall ... expedited appeals. + Ensures documentation of all communications with medical office staff and/or MD provider is...utilization management while working in conjunction with the Senior Medical Director . May assist the Senior … more