- AmeriHealth Caritas (Newtown Square, PA)
- …administrative services. Discover more about us at www.amerihealthcaritas.com. **Responsibilities:** The Medical Director , Utilization Management ... and related policy and practice initiatives in collaboration with the Corporate Medical Director (s), Utilization Management and the Vice President, … more
- Humana (Trenton, NJ)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an ... caring community and help us put health first** The Medical Director actively uses their medical...healthcare providers, clinical group practice management . + Utilization management experience in a medical… more
- Humana (Trenton, NJ)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an ... caring community and help us put health first** The Medical Director relies on medical ...healthcare providers, clinical group practice management . + Utilization management experience in a medical… more
- Humana (Trenton, NJ)
- …Information** Reports to a Lead Medical Director . The Medical Director conducts Utilization Management of the care received by members in an ... caring community and help us put health first** The Medical Director relies on medical ...Medical Hematology/Oncology specialties + Prefer Medicaid experience + Utilization management experience in a medical… more
- Humana (Trenton, NJ)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an ... caring community and help us put health first** The Medical Director relies on medical ...healthcare providers, clinical group practice management . + Utilization management experience in a medical… more
- The Cigna Group (Philadelphia, PA)
- **Overall** Responsible for leading clinical strategy development and product management for pharmacy utilization management and the coordination of rebate ... contracting efforts to ensure alignment across formulary, utilization management , SafeGuard, and other trend solutions. **Essential Functions:** + Ability to… more
- YesCare Corp (Philadelphia, PA)
- …or as requested by management . + In conjunction with the Regional Medical Director provide psychiatric leadership for the utilization management ... is a list of your responsibilities as a **Psychiatric Director ** with YesCare with the Philadelphia Contract + Provide... program in the region. Provide timely feedback in Utilization Management matters including outpatient and inpatient… more
- Evolent (Trenton, NJ)
- …LMSWs, LCSW, and LPCs, Clinical Reviewers. Opportunities to work collaboratively with other Utilization Management Leaders including our Director may also be ... the culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management ** at Evolent will serve as...also works with our clinical team, which includes our medical reviews: LVNs, LPNs, and RNs along with our… more
- Evolent (Trenton, NJ)
- …for utilization management while working in conjunction with the Senior Medical Director . May assist the Senior Medical Director in ... , you will be a key member of the utilization management team. We can offer you...process. + On a requested basis, may function as Medical Director for selecting health plans or… more
- Evolent (Trenton, NJ)
- …setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional cardiology ... per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management … more
- Evolent (Trenton, NJ)
- …per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management ... you will be a key member of the utilization management team. We can offer you...management while working in conjunction with the Senior Medical Director . **Qualifications - Required and Preferred:**… more
- GoTo (Trenton, NJ)
- …of opportunities for growth and learning, blaze your own trail with us. As the Senior Director or Director of Product Management for our ITSG Team, you will ... be at the forefront of our IT management product strategy, overseeing the development and execution of...business growth. **Your Day to Day** **As the** **_Senior Director or Director of Product Management_** **,… more
- Evolent (Trenton, NJ)
- …in a timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management process, ... for the culture. **What You'll Be Doing:** As a Field Medical Director you will be a key member of the utilization management team. We can offer you a… more
- Genesis Healthcare (Norristown, PA)
- …Area Director ). 11. Assumes responsibility for daily staffing and utilization with input from treating therapists, consideration of clinical requirements, and ... management of the rehab department, including oversight related to case management , quality improvement, care planning, clinical utilization , and patient… more
- CVS Health (Trenton, NJ)
- …timely and consistent responses to members and providers. As a Medical Director you will focus primarily on overseeing utilization review / quality assurance ... the ability to obtain a NJ License. In the Medical Director role you will provide oversight...clinical / medical programs and expand Aetna's medical management programs to address member needs… more
- CVS Health (Trenton, NJ)
- … will provide clinical, coding, and reimbursement expertise as well as directing case management when necessary. The Medical Director will act as a ... eg, Clinical Practice and Health Care Industry. *Prior UM ( Utilization Management ) experience *Active and current state medical license without encumbrances… more
- Humana (Trenton, NJ)
- …organization focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience + Working with ... 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… more
- Humana (Trenton, NJ)
- …a part of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims. The ... Corporate Medical Director works on problems of diverse scope and complexity...skills with prior experience leading teams focusing on quality management , utilization management , discharge planning… more
- Evolent (Trenton, NJ)
- …Stay for the culture. **What You'll Be Doing:** Evolent is seeking an **Associate Medical Director - Cardiovascular Medicine** to play a critical role in ... **Performance Suite risk arrangements with payers and strategic utilization management initiatives.** This is an opportunity for a **Cardiologist** to shape… more
- Merck (Trenton, NJ)
- **Job Description** **Role Summary:** + The Global Director Medical Affairs (GDMA) is responsible for supporting the execution of scientific & medical ... (ex-USA). + Manages programs (patient support, educational or risk management ) to support appropriate and safe utilization ...years regional medical affairs experience (eg, Regional Director Medical Affairs) with proven track record… more