- Humana (Honolulu, HI)
- **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...data requires an in-depth evaluation of variable factors. The Medical Director actively uses their medical… more
- Humana (Honolulu, HI)
- **Become a 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 health, SNF, DME, dual Medicare/Medicaid and Waiver requests. The Medical Director provides medical interpretation and determinations whether… more
- Humana (Honolulu, HI)
- **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...data requires an in-depth evaluation of variable factors. The Medical Director actively uses their medical… more
- Humana (Honolulu, HI)
- **Become a 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 health, SNF, DME, dual Medicare/Medicaid and Waiver requests. The Medical Director provides medical interpretation and determinations whether… more
- Humana (Honolulu, HI)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all submitted medical records,… more
- Parexel (Honolulu, HI)
- …we are expanding our esteemed Medical Sciences Team and seeking an Associate/ Medical Director to support the growth of our Global Immunology and Inflammation ... Therapeutic Franchise. As an Associate / Medical Director , you will work closely with some of the best and brightest in the industry and assist our clients in… more
- Evolent (Honolulu, HI)
- …in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional ... on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization… more
- Evolent (Honolulu, HI)
- …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. ... on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization… more
- Evolent (Honolulu, HI)
- …mission. Stay for the culture. **What You'll Be Doing:** As a Vascular Surgery, Field Medical Director you will be a key member of the utilization management ... on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization… more
- Evolent (Honolulu, HI)
- …per inter-rater reliability process. + On a requested basis, may function as Medical Director for selecting health plans or regions, assuming overall ... accountability for utilization management while working in conjunction with the Senior Medical Director . May assist the Senior Medical Director in… more
- Evolent (Honolulu, HI)
- …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 ... a timely and accurate manner. . May assist the Senior Medical Director in research activities/questions related to the Utilization Management process,… more
- Evolent (Honolulu, HI)
- …recorded in a timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management ... Doing: + Serve as the Physician match reviewer in Medical Oncology and imaging cases, that do not initially...imaging cases, that do not initially meet the applicable medical necessity guidelines, as well as other imaging requests… more
- Sumitomo Pharma (Honolulu, HI)
- …dynamic, highly motivated, and experienced individual for the position of Senior Medical Director , Clinical Research (Ophthalmology) to join our R&D ... Provides oversight of clinical trial conduct, interacting with CROs, medical monitors, and vendors as required, and working with...and summarization of findings + Serve as the internal medical monitoring for clinical trials + Review and provide… more
- VCA Animal Hospitals (Honolulu, HI)
- Join us as a Medical Director at VCA Gentle Vets Animal Hospital and you'll quickly discover that you're well supported by world-class medicine, technology, ... offer competitive compensation along with a comprehensive benefits package, including medical , dental, vision and paid vacation/sick days, 401(k), generous employee… more
- Merck (Honolulu, HI)
- …high-priority objectives. Internal strategic excellence: In coordination with those in Executive Director Medical Affairs (EDMA), Global Director Medical ... **Job Description** **Role Summary** The Global Medical Excellence Director (GMED) reports to the Sr. Director , Global Medical Excellence, and is an… more
- Merck (Honolulu, HI)
- …with HSO MADs + Serves as a resource for the PM MAD-HSO Team Lead, HSO Executive Director Medical Affairs, and other members of US Medical Affairs on other ... **Job Description** + The Precision Medicine - Medical Affairs Director - Health Systems Oncology (PM MAD-HSO) develops ongoing professional relationships with… more
- Highmark Health (Honolulu, HI)
- …current clinical standards. The incumbent reviews escalated cases electronically and using Medical Policy criteria sets to evaluate the medical necessity and ... **ESSENTIAL RESPONSIBILITIES** + Conduct electronic review of escalated cases against medical policy criteria, which may include telephonic peer to peer discussions,… more
- Travelers Insurance Company (Honolulu, HI)
- …**What Is the Opportunity?** Lead the strategy and operations of Travelers Claim Medical initiatives focusing on how developments in the broader medical ... for Travelers: Develop strategies and direction to advance Travelers medical capabilities to keep Travelers at the leading edge...at the leading edge of the P&C industry. Develop medical management strategies that help injured employees return to… more
- Evolent (Honolulu, HI)
- …Tasks are performed within the RN/LVN/LPN scope of practice, under Medical Director direction, using independent nursing judgement and decision-making, ... and refers cases that do not meet established clinical criteria to the Medical Director . + Appropriately identifies and refers quality issues to UM Leadership. +… more
- Sumitomo Pharma (Honolulu, HI)
- …in prostate cancer care within both academic and community oncology. The Director will engage medical oncologists and radiation oncologists, ensuring ORGOVYX ... seeking a dynamic, motivated, and experienced individual for the position of ** Director , Thought Leader Liaison - Oncology (Prostate Cancer)** . This field-based… more