- Humana (Des Moines, IA)
- **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 (Des Moines, IA)
- **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 (Des Moines, IA)
- **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 (Des Moines, IA)
- **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 (Des Moines, IA)
- **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 (Des Moines, IA)
- …Parexel!** In anticipation of future needs, we are seeking an additional Associate / Medical Director to join Parexel's highly recognized Medical Sciences ... grow our Global Immunology and Inflammation Therapeutic Franchise! As an Associate / Medical Director , you will work closely with some of the best and brightest… more
- Humana (Des Moines, IA)
- …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 scope and complexity ranging from moderate to substantial. The Corporate … more
- Evolent (Des Moines, IA)
- …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 (Des Moines, IA)
- …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 (Des Moines, IA)
- …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 (Des Moines, IA)
- …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
- Molina Healthcare (Des Moines, IA)
- …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... years relevant experience, including: + 2 years previous experience as a Medical Director in a clinical practice. + Current clinical knowledge. + Experience… more
- Molina Healthcare (Des Moines, IA)
- …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... years relevant experience, including: + 2 years previous experience as a Medical Director in a clinical practice. + Current clinical knowledge. + Experience… more
- Evolent (Des Moines, IA)
- …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
- Trinity Health (Urbandale, IA)
- **Employment Type:** Part time **Shift:** **Description:** The **Contignent** Hospice Medical Director at Trinity Health at Home (THAH) oversees medical ... direction for patient and family services, collaborates with the Executive Director and clinical team, and supports Provider Relations and CPI Committee activities.… more
- Molina Healthcare (Des Moines, IA)
- …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
- Molina Healthcare (Des Moines, IA)
- …reviews behavioral health portions of state contracts. * Assists behavioral health medical director lead trainers in the development of enterprise-wide education ... JOB DESCRIPTION Job SummaryProvides medical oversight and expertise related to behavioral health...and chemical dependency services - working closely with regional medical directors to standardize behavioral health utilization management policies… more
- Evolent (Des Moines, IA)
- …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
- Molina Healthcare (Des Moines, IA)
- …Certification in Psychiatry **REQUIRED EXPERIENCE:** * 2 years previous experience as a Medical Director in clinical practice * 3 years' experience in ... health and chemical dependency services. Works closely with the Regional Medical Directors to standardized utilization management policies and procedures to improve… more
- Sumitomo Pharma (Des Moines, IA)
- …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