- Highmark Health (Hartford, CT)
- …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 (Hartford, CT)
- …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 (Hartford, CT)
- …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
- Elevance Health (Wallingford, CT)
- …Accounts Medical Director ** is responsible for serving as the Operational Medical Director for our care management models for our National Account ... we serve. The medical director supports product strategy/design through medical management that impact health care quality, cost, and outcomes, and… more
- Evolent (Hartford, CT)
- …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 (Hartford, CT)
- …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 (Hartford, CT)
- … 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
- Humana (Hartford, CT)
- … 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 (Hartford, CT)
- …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 (Hartford, CT)
- …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 (Hartford, CT)
- …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 (Hartford, CT)
- …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 (Hartford, CT)
- …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
- Hartford HealthCare (Bristol, CT)
- *Title:*Regional Medical Director , Primary Care Introducing an exciting opportunity to be a physician leader with Hartford HealthCare's highly respected, ... care are prioritized within a supportive, collaborative work environment. ** *Regional Medical Director , Primary Care Position Summary:* * * * *Role*:… more
- Parexel (Hartford, CT)
- …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
- Elevance Health (Wallingford, CT)
- …schedule: Monday - Friday. Half day Saturday rotation, once a month.** The ** Medical Director ** is responsible for the administration of behavioral health ... increase effectiveness and quality. + Provides oversight, direction, and guidance to Medical Director Associates. + Works independently with oversight from… more
- Elevance Health (Wallingford, CT)
- **Plan Performance Medical Director ** Location: This role enables associates to work virtually full-time, with the exception of required in-person training ... is granted as required by law. The **Plan Performance Medical Director ** serves as a lead clinician...**How you will make an impact:** + Supports the Medical Management staff to ensure timely and… more
- CVS Health (Hartford, CT)
- …anywhere in the US.** Aetna, a CVS Health Company, has an exciting opportunity for a Medical Director (Spine) that can be remote based, work from home. The ... Medical Director (Spine) will be a Subject...including post-graduate direct patient care experience specifically. Expands Aetna's medical management programs to address member needs… more
- Elevance Health (Wallingford, CT)
- ** Medical Cost AI Intelligence Director (IT Strategy & Planning Director )** Location: This role requires associates to be in-office **3 days per week** , ... resides within a commutable distance from an office._ The ** Medical Cost AI Intelligence Director ** is responsible...using data and qualitative performance measures, to advise senior management relative to IT strategy. + Synthesizes annual and… more
- Hartford HealthCare (Hartford, CT)
- …Cardiovascular Disease*experience to*lead*a team of highly trained cardiovascular specialists as* Medical Director of the Inherited Cardiovascular Disease ... HealthCare Medical Group Specialists* **Title:** *Cardiologist - Medical Director Inherited Cardiovasular Disease * **Location:** *Connecticut-Hartford-85… more