- Parexel (Boise, ID)
- …accomplishments related to assigned project/study. + Participate in the development and/or review of study documents, such as clinical protocols, Medical ... anticipation of future needs, we are seeking an additional Associate / Medical Director to join Parexel's highly recognized Medical Sciences Team as we continue to… more
- St. Luke's Health System (Boise, ID)
- …St. Luke's is truly a great place to work. The ** Director of Clinical Review Management ** provides strategic and operational leadership across multiple ... Location : City** _Boise_ **Category** _Nursing Leadership_ **Work Unit** _Clinical Review Management System Office_ **Position Type** _Full-Time_ **Work… more
- Prime Therapeutics (Boise, ID)
- …our passion and drives every decision we make. **Job Posting Title** Sr Director Clinical Strategy and Oncology Specialty Solutions/PharmD required- REMOTE **Job ... Description** The Senior Director Clinical Strategy and Oncology Specialty Solutions...years of work experience within medical and pharmacy drug management within a PBM or managed care organization, or… more
- Humana (Boise, ID)
- …knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to complex clinical scenarios, review of ... + Utilization management experience in a medical management review organization, such as Medicare Advantage,..., depending on the line of business. The Medical Director conducts Utilization Management or clinical… more
- Evolent (Boise, ID)
- …when available, within the regulatory timeframe of the request. + Utilizes medical/ clinical review guidelines and parameters to assure consistency in the ... the culture. **What You'll Be Doing:** As a Physician Clinical Reviewer, Interventional Pain Management , you will...MD review process to reflect appropriate utilization and compliance with… more
- Humana (Boise, ID)
- …knowledge in their daily work. The Medical Director 's work includes computer based review of moderately complex to complex clinical scenarios, review of ... management . + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial… more
- Humana (Boise, ID)
- …knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to complex clinical scenarios, review of ... management . + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial… more
- Humana (Boise, ID)
- … management . + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial ... management operational improvements, including those within the medical director area + Participate in call rotation + Develop collaborative relationships… more
- Evolent (Boise, ID)
- …impact on patient care in a non- clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your ... when available, within the regulatory timeframe of the request. + Utilizes medical/ clinical review guidelines and parameters to assure consistency in the… more
- Cardinal Health (Boise, ID)
- **Position Overview:** Seeking a dynamic and forward-thinking Director of Product Management Commercial Technology to lead product development and ... patient outcomes. This is an individual contributor role that reports to the Director of IT Management . **Responsibilities:** + Owner of the product lifecycle… more
- CenterWell (Boise, ID)
- …community partners, and regulatory agencies. + Partner with analytics teams to review clinical data and utilize insights for continuous program improvement. ... National Medical Director for Home-Based Care Programs is a key clinical leadership position responsible for the medical direction, clinical oversight, and… more
- Humana (Boise, ID)
- …experience with national guidelines such as NCD/LCD, MCG(R) or InterQual** **The Medical Director conducts clinical case reviews of requests received by members ... of the Medicare population and reports to the Lead Medical Director .** **Other duties:** + Identify medical management operational improvements, including those… more
- Humana (Boise, ID)
- …experience with national guidelines such as NCD/LCD, MCG(R) or InterQual The Medical Director conducts clinical case reviews of requests received by members of ... the Medicare population and reports to the Lead Medical Director . **Other duties:** + Identify medical management operational improvements, including those… more
- Evolent (Boise, ID)
- …Provides clinical rationale for standard and expedited appeals. + Utilizes medical/ clinical review guidelines and parameters to assure consistency in the MD ... Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + On a requested… more
- Evolent (Boise, ID)
- …when available, within the regulatory timeframe of the request. + Utilizes medical/ clinical review guidelines and parameters to assure consistency in the ... Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + On a requested… more
- Datavant (Boise, ID)
- …of service. This is a leadership role that combines strategic thinking, clinical product development expertise, and people management responsibilities. You'll be ... product vision, strategy, and roadmap for the Prospective Suspecting and Concurrent Review solutions within Datavant's Clinical Insights Platform suite. + Define… more
- Highmark Health (Boise, ID)
- …SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and most current ... clinical standards. The incumbent reviews escalated cases electronically and...DOL regulations at all times. In addition to utilization review , the incumbent participates as the physician member of… more
- Evolent (Boise, ID)
- …provides clinical rationale for standard and expedited appeals. . Utilizes medical/ clinical review guidelines and parameters to assure consistency in the MD ... Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. . Participates in… more
- Molina Healthcare (Nampa, ID)
- …NCQA-compliant clinical quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + ... including: + 2 years previous experience as a Medical Director in a clinical practice. + Current... in a clinical practice. + Current clinical knowledge. + Experience demonstrating strong management … more
- Evolent (Boise, ID)
- …provides clinical rationale for standard and expedited appeals. + Utilizes medical/ clinical review guidelines and parameters to assure consistency in the MD ... Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + Participates in… more
