- Humana (Dover, DE)
- **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 (Dover, DE)
- **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 (Dover, DE)
- **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 ... home health, DME, skilled nursing facility and waiver requests. The Medical Director provides medical interpretation and determinations whether services… more
- Humana (Dover, DE)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to complex clinical… more
- Humana (Dover, DE)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to complex clinical… more
- Evolent (Dover, DE)
- …business. Join Evolent for the mission. Stay for the culture. **What You'll Be Doing:** The Medical Director for MSK Surgery is a key member of the Medical ... development of questions. + Reviews statistical sample of cases for Field Medical Director audits and makes recommendations into the types of cases to review.… more
- Otsuka America Pharmaceutical Inc. (Dover, DE)
- …medicines for those with CNS disorders, we are seeking a skilled and experienced Medical Director of CNS Early Assets, Global Medical Affairs, responsible ... Sr. Director , Franchise Lead CNS Early Assets. **Position Summary:** The Medical Director , Global Medical Affairs, CNS Early Assets will be responsible… more
- CSL Plasma (Dover, DE)
- …the Quality Assurance Team. Acts as a liaison between the Corporate or Divisional Medical Director and the Center Medical Staff, which includes preparation ... cell immunizations are given. Submits monthly report to Divisional (or Corporate) Medical Director . + Determines donor suitability following adverse reactions in… more
- University of Pennsylvania (Philadelphia, PA)
- …of health and wellness programs and resources, and much more. Posted Job Title Medical Director Job Profile Title Director F, Healthcare Job Description ... Summary The Medical Director will be responsible for overseeing clinical care, a...with a team of professionals across various disciplines. The Medical Director is a senior leader within… more
- University of Pennsylvania (Philadelphia, PA)
- …for the Department of Infection Prevention and Control as an Associate Medical Director . The department supports the Philadelphia campus hospital, newly ... and an expansive primary care and specialty care network. The Associate Medical Director collaborates with and supports the System Director of Infection… more
- University of Pennsylvania (Philadelphia, PA)
- …of health and wellness programs and resources, and much more. Posted Job Title Assistant Medical Director , Gender & Sexual Health Job Profile Title Director ... C, Healthcare Job Description Summary Reporting to the Medical Director , the Assistant Medical Director , Gender and Sexual Health oversees gender… more
- CVS Health (Dover, DE)
- …NJ License without encumbrances or the ability to obtain a NJ License. In the Medical Director role you will provide oversight for medical policy ... ensuring timely and consistent responses to members and providers. As a Medical Director you will focus primarily on overseeing utilization review / quality… more
- Centene Corporation (Dover, DE)
- …Services and Supports (LTSS) and Medicare-Medicaid Duals populations. Additionally, the Medical Director will collaborate with other key stakeholders to ... preferred. **DE LTSS Only:** A full-time Long Term Services and Supports Medical Officer/ Medical Director (LTSS CMO) who is a board certified physician… more
- Humana (Dover, DE)
- …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 (Dover, DE)
- …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 (Dover, DE)
- …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 (Dover, DE)
- …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
- Grifols Shared Services North America, Inc (Wilmington, DE)
- …and services in more than 110 countries and regions. **Position Overview:** The Medical Director will be responsible for clinical strategy relating to upcoming ... of human disease. **Pay Scale:** The estimated pay scale for the Medical Director (1-2) role based in the United States (non-California), is $170,000.00 -… more
- AmeriHealth Caritas (Newtown Square, PA)
- …Discover more about us at www.amerihealthcaritas.com. **Responsibilities:** The Medical Director , Utilization Management provides organizational leadership ... and related policy and practice initiatives in collaboration with the Corporate Medical Director (s), Utilization Management and the Vice President, Medical… more
- YesCare Corp (Philadelphia, PA)
- …regular physicians. Below is a list of your responsibilities as a **Site Medical Director with YesCare at the Philadelphia Industrial Correctional Center, ... to validate need for non-formulary medication on non-formulary request form for Medical Director 's approval when non-formulary medication is ordered. + Utilizes… more