- Highmark Health (Santa Fe, NM)
- …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 (Santa Fe, NM)
- …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 (Santa Fe, NM)
- …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
- Evolent (Santa Fe, NM)
- …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
- Veterans Affairs, Veterans Health Administration (Albuquerque, NM)
- …for executive management actions. This position reports directly to the Medical Center Director . Responsibilities The Assistant Medical Center ... New Mexico VAHCS is currently recruiting for one Assistant Medical Center Director . The incumbent is a...incumbent is a full member of the organization's top management and participates fully with the Director ,… more
- CenterWell (Santa Fe, NM)
- …Information** Will report to the Director of Physician Strategy at Utilization Management . The Medical Director conducts Utilization review of the care ... **Become a part of our caring community and help us put health first** The Medical Director , Primary Care relies on medical background and reviews health… more
- Humana (Santa Fe, NM)
- …relationships, value-based care, quality metrics, population health, and disease or care management . The Behavioral Health Medical Director may develop ... our caring community and help us put health first** The Behavioral Health Medical Director is responsible for behavioral health care strategy and/or operations.… more
- Humana (Santa Fe, NM)
- …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 (Santa Fe, NM)
- … 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
- Genesis Healthcare (Albuquerque, NM)
- …balance flexibility (no weekends or on call)! We are seeking a FFS Attending Physician/ Medical Director for float between several of our centers located in ... Albuquerque, NM. This is a Dual Role Attending Physician/ Medical Director . It is clinical in nature. Must be BC/BE Internal Medicine or Family Medicine with LTC… more
- Humana (Santa Fe, NM)
- …Become a part of our caring community and help us put health first The Medical Director actively uses their medical background, experience, and judgement to ... and will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all submitted medical … more
- Evolent (Santa Fe, NM)
- …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 (Santa Fe, NM)
- …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
- Otsuka America Pharmaceutical Inc. (Santa Fe, NM)
- As a senior leader within Medical Affairs, the Executive Director will serve as a strategic thought partner and Chief of Staff to the Vice President of ... capabilities aligned with Otsuka's vision, direction, and growth strategy. The Executive Director , Medical Affairs Strategy, Excellence & Operations will lead… more
- Evolent (Santa Fe, NM)
- …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
- Parexel (Santa Fe, NM)
- …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
- Molina Healthcare (Rio Rancho, NM)
- …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... medical personnel, not influenced by fiscal or administrative management considerations, and that the care provided meets the...experience, including: + 2 years previous experience as a Medical Director in a clinical practice. +… more
- Otsuka America Pharmaceutical Inc. (Santa Fe, NM)
- …the asset lifecycle. This role reports directly into the Executive Director , Medical Excellence and Operations. **Job Description** **Key Responsibilities ... The Director , Strategic Planning & Operations is a pivotal...multi-year strategic roadmaps tailored to each therapeutic area **Budget Management ** + Oversee budgets for global medical … more
- Humana (Santa Fe, NM)
- …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...focused on continuously improving consumer experiences **Preferred Qualifications** + Medical management experience, working with health insurance… more
- Parexel (Santa Fe, NM)
- …Patients First, Quality, Respect, Empowerment & Accountability. **Parexel is looking for a Medical Director with a very strong background in Ophthalmology to ... remo** t **ely in the US or Canada.** The Medical Director is a medical ...counterparts + Client-focused approach to work + Excellent time management skills + Excellent verbal and written medical… more