- Highmark Health (Augusta, ME)
- …URAC, CMS, DOH, and DOL regulations, etc.). Ensure that all aspects of the medical management process are consistent with community standards of care. + ... care (hospital, outpatient, or private practice) **Preferred** + 1 year in Medical Management in a Health Insurance Plan; strong knowledge of managed care… more
- Humana (Augusta, ME)
- …reports to the Lead Medical Director . **Other duties:** + Identify medical management operational improvements, including those within the medical ... 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… more
- Humana (Augusta, ME)
- …reports to the Lead Medical Director .** **Other duties:** + Identify medical management operational improvements, including those within the medical ... 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… more
- Humana (Augusta, ME)
- …a Lead Medical Director , depending on the line of business. The Medical Director conducts Utilization Management or clinical validation of the care ... **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement… more
- Evolent (Augusta, ME)
- …accountability for utilization management while working in conjunction with the Senior Medical Director . May assist the Senior Medical Director ... Be Doing:** As a Physician Clinical Reviewer, Interventional Pain Management , you will be a key member of the...process. + On a requested basis, may function as Medical Director for selecting health plans or… more
- Humana (Augusta, ME)
- …to the Lead Medical Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of the care received by members ... **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 … more
- Humana (Augusta, ME)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members ... **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 … more
- Genesis Healthcare (Waterville, ME)
- …balance flexibility, with no on call! We are seeking a Fee-For-Service Attending Physician/ Medical Director for our Oak Grove Center, located in Waterville, ME. ... This is a Dual Role Attending Physician/ Medical Director . It is clinical in nature....outcomes. This is accomplished by coordinating with Centers, Regional Management and AlignMed Partners to oversee the implementation, utilization,… more
- Humana (Augusta, ME)
- … medical management operational improvements, including those within the medical director area + Participate in call rotation + Develop collaborative ... Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an… more
- Merck (Augusta, ME)
- …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 (Augusta, ME)
- …partnership with Precision Medicine Health Systems Oncology Medical Affairs Director (PM HSO-MADs), oncology account management , and precision medicine teams ... This role also serves as a resource for the Medical Affairs (MA) management team on strategic...resource for the PM MAD-HSO Team Lead, HSO Executive Director Medical Affairs, and other members of… more
- Evolent (Augusta, ME)
- …non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional ... utilization management while working in conjunction with the Senior Medical Director . **Qualifications** + MD/DO/MBBS Degree + Current, unrestricted clinical… more
- Evolent (Augusta, ME)
- …for 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...Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + On… more
- Evolent (Augusta, ME)
- …for 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...Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + On… more
- Parexel (Augusta, ME)
- …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...protocol Note that this does not include any direct medical advice on patient care or management … more
- Evolent (Augusta, ME)
- …Evolent 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 ... is recorded in a timely and accurate manner. . May assist the Senior Medical Director in research activities/questions related to the Utilization Management … more
- Evolent (Augusta, ME)
- …is recorded in a timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management ... any license required per business needs + Active Board Certification in Medical Oncology + Strong clinical, management , communication, and organizational skills… more
- VCA Animal Hospitals (Lewiston, ME)
- Join us as a ** Medical Director ** at **VCA Lewiston Animal Hospital** and you'll quickly discover that you're well supported by world-class medicine, technology, ... motivated veterinarian to continue practicing medicine while establishing the direction and medical quality of the hospital like a practice owner. Plus, you'll have… more
- Travelers Insurance Company (Augusta, ME)
- … capabilities to keep Travelers at the leading edge of the P&C industry. Develop medical management strategies that help injured employees return to work as soon ... **What Is the Opportunity?** Lead the strategy and operations of Travelers Claim Medical initiatives focusing on how developments in the broader medical … more
- Western Digital (Augusta, ME)
- …Together, we can build the future of data storage. **Job Description** ** Director , Risk Management ** Employees can work remotely Full-time **Job Description** ... **Essential Duties & Responsibilities:** As the Director of Risk Management you will play...and grooming standards), sex (including pregnancy, childbirth or related medical conditions, breastfeeding or related medical conditions),… more