- CenterWell (Frankfort, KY)
- **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 ... claims. The Medical Director , Primary Care work assignments involve moderately complex to...data requires an in-depth evaluation of variable factors. The Medical Director relies on medical … more
- Humana (Frankfort, KY)
- …our caring community and help us put health first** The Behavioral Health Medical Director is responsible for behavioral health care strategy and/or operations. ... The Behavioral Health Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires an… more
- Humana (Frankfort, KY)
- **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 (Frankfort, KY)
- **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 ... reviewing home health, SNF, DME, dual Medicare/Medicaid and Waiver requests. The Medical Director provides medical interpretation and determinations whether… more
- Humana (Frankfort, KY)
- …a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews preauthorization requests ... for services. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth… more
- Humana (Frankfort, KY)
- **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 ... reviewing home health, SNF, DME, dual Medicare/Medicaid and Waiver requests. The Medical Director provides medical interpretation and determinations whether… more
- Humana (Frankfort, KY)
- **Become a part of our caring community and help us put health first** The Medical Director relies on broad clinical expertise to review Medicare drug appeals ... (Part D & B). The Medical director work assignments involve moderately complex to complex issues where the analysis of situations or data requires a case-by-case… more
- Humana (Frankfort, KY)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... this knowledge in their daily work specifically for DSNP. The Medical Director 's work includes computer-based review of moderately complex to complex clinical… more
- Humana (Frankfort, KY)
- **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 (Frankfort, KY)
- …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 ... understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all submitted medical records,… more
- Elevance Health (Louisville, KY)
- …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
- CVS Health (Frankfort, KY)
- … medical license without encumbrances in one of these states.** + In the Medical Director role you will provide oversight for medical policy ... timely and consistent responses to members and providers. + As a Medical Director you will focus primarily on overseeing utilization review and quality assurance… more
- Parexel (Frankfort, KY)
- …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 some of the best and brightest in the industry and assist our clients in… more
- Evolent (Frankfort, KY)
- …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 (Frankfort, KY)
- …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 (Frankfort, KY)
- …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
- Elevance Health (Louisville, KY)
- **Plan Performance Medical Director ** Location: This role enables associates to work virtually full-time, with the exception of required in-person training ... unless an accommodation is granted as required by law. The **Plan Performance Medical Director ** serves as a lead clinician and oversees the administration of … more
- CVS Health (Frankfort, KY)
- …do it all with heart, each and every day. **Position Summary:** Ready to take your Medical Director skills to the next level with a Fortune 6 company? Checkout ... of Kentucky primarily, and the Southeast Region (FL, LA and WV). This Medical Director will be a "Work from Home" position primarily supporting the Aetna… more
- Humana (Frankfort, KY)
- …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...and complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation… more
- Evolent (Frankfort, KY)
- …per inter-rater reliability process. + On a requested basis, may function as Medical Director for selecting health plans or regions, assuming overall ... accountability for utilization management while working in conjunction with the Senior Medical Director . May assist the Senior Medical Director in… more