- Beth Israel Lahey Health (Needham, MA)
- …and leadership in quality improvement activities to enhance patient care and improve service . Additionally, the Nurse Director participates in the development of ... of programs and processes to provide necessary patient care services using appropriate resources. Inherent in the role is...contributes to ongoing changes within the organization. The Nurse Director is a role model for service … more
- Humana (Providence, RI)
- …processes, and outpatient services and equipment, within their scope. The Medical Director may speak with contracted external physicians, physician groups, ... an impact** **Responsibilities** The Medical Director provides medical interpretation and determinations whether services provided by other healthcare… more
- Datavant (Providence, RI)
- …SMART software experience strongly encouraged to apply **You Will:** + Conduct inpatient coding audits on medical records, utilizing ICD-10-CM, CPT, and ... to realize our bold vision for healthcare. As an ** Inpatient Auditing Specialist** you will be instrumental in addressing...results for review by the facility or CCS HIM director . + Review disagreements on APC/DRG changes with the… more
- CenterWell (Providence, RI)
- …processes, and outpatient services and equipment, within their scope. The Medical Director may speak with contracted external physicians, physician groups, ... an impact** **Responsibilities** The Medical Director provides medical interpretation and determinations whether services provided by other healthcare… more
- Humana (Providence, RI)
- …scenarios arise from outpatient, inpatient or post-acute care environments. The Medical Director will have discussions with external physicians by phone to ... an impact** **Responsibilities** The Medical Director provides medical interpretation and determinations whether services provided by other healthcare… more
- Humana (Providence, RI)
- …resolution skills. Responsibilities The Medical Director provides medical interpretation and determinations on whether acute inpatient rehabilitation ... caring community and help us put health first** The Medical Director actively uses their medical...background, experience, and judgement to make determinations whether requested services , requested level of care, and/or requested site of… more
- Humana (Providence, RI)
- …innovate **Additional Information** Typically reports to an Associate Vice President of Health Services , Lead, or Corporate Medical Director , depending on ... 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 (Providence, RI)
- …all activities. **Responsibilities** The Medical Director provides medical interpretation and determinations whether services provided by other ... caring community and help us put health first** The Medical Director actively uses their medical...background, experience, and judgement to make determinations whether requested services , level of care, and/or site of service… more
- Humana (Providence, RI)
- …processes, and outpatient services and equipment, within their scope. The Medical Director may speak with contracted external physicians, physician groups, ... an impact** **Responsibilities** The Medical Director provides medical interpretation and determinations whether services provided by other healthcare… more
- Humana (Providence, RI)
- …all activities. **Responsibilities** The Medical Director provides medical interpretation and determinations whether services provided by other ... caring community and help us put health first The Medical Director actively uses their medical...meets compliance timelines. + Conduct comprehensive, timely, and compliant medical necessity reviews for inpatient services… more
- Humana (Providence, RI)
- …and Waiver requests. The Medical Director provides medical interpretation and determinations whether services provided by other healthcare ... caring community and help us put health first** The Medical Director relies on fundamentals of CMS...medical interpretation and decisions about the appropriateness of services provided by other healthcare professionals in compliance with… more
- Humana (Providence, RI)
- …and Waiver requests. The Medical Director provides medical interpretation and determinations whether services provided by other healthcare ... caring community and help us put health first** The Medical Director relies on fundamentals of CMS...medical interpretation and decisions about the appropriateness of services provided by other healthcare professionals in compliance with… more
- Veterans Affairs, Veterans Health Administration (Framingham, MA)
- …full time position in Boston, Massachusetts in vibrant and diverse clinics. The Medical Director is responsible for ensuring that excellent, high-quality care is ... and 49% administrative time. This person will be the Medical Director for the five VA Boston...teaching opportunities for both medical students and medical residents in the inpatient and outpatient… more
- Sumitomo Pharma (Providence, RI)
- …a dynamic, highly motivated, and experienced individual for the position of Associate Director , Market Access Engagement - Rare Disease, who will act as the face ... to innovative treatments for rare diseases + Collaborate with Patient Services , specialty pharmacies, and specialty distributors to streamline access to treatment… more
- University Medicine (East Providence, RI)
- …throughout the diverse state of Rhode Island. Brown Medicine physicians also lead many inpatient medical services at both Rhode Island and The Miriam ... Brown Medicine is a large non-profit, academic, multi-specialty medical group in Rhode Island with approximately 200...embracing all three missions that we provide a unique service to our patients, our colleagues and to the… more
- Datavant (Providence, RI)
- …appropriate letter language to author appeal letter Identification of referrals to the medical director for review + Select appropriate preferred and contracted ... Specialist is to effectively defend utilization of available health services , review of admissions for medical necessity...+ Work directly with the provider(s) and health plan Medical Director as needed to facilitate timely… more
- State of Massachusetts (Taunton, MA)
- …forensic consultations as requested by the Recovery from Addictions Program (RAP) Facility Medical Director . This may involve meeting with clients and their ... the skills necessary to thrive to apply for this role. **Job:** ** Medical Services * **Organization:** **Department of Mental Health* **Title:** *Psychiatrist -… more
- Cardinal Health (Providence, RI)
- …of billing for professional (physician) services and/or hospital (technical) services . This position will also support the Director with transactional ... and adequacy of documentation and coding related to physician or hospital ( inpatient and outpatient) billing and/or medical necessity reviews. + Prepares… more
- AccentCare, Inc. (Norwood, MA)
- … facilities and physician groups. + Act as a liaison with AccentCare Hospice Medical Director , Team Physicians and Hospice Physicians on behalf of providers and ... health regulations, Medicare requirements, and care plan development techniques + Previous medical sales experience preferred + Licensed RN currently licensed as a… more
- Beth Israel Lahey Health (Westwood, MA)
- …Pharmacist is responsible for the quality assurance of the provided pharmacy services . Ensures the correct medications are dispensed to the correct patients ... medication supply in the individual work area. Participates in Pharmacy staff in- services and meetings relating to system-wide and/or health care setting programs.… more