- CenterWell (Columbia, SC)
- …part of our caring community and help us put health first** The National Medical Director for Home -Based Care Programs is a key clinical leadership ... polychronic, and high-risk Medicare patients within a full-risk, value-based framework. The Medical Director collaborates in a dyad partnership with the Strategy… more
- Humana (Columbia, SC)
- **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… more
- Humana (Columbia, SC)
- …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...and other healthcare providers, patient interaction, etc. **Work at Home Guidance** To ensure Home or Hybrid… more
- Humana (Columbia, SC)
- **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...work is assisted by diverse resources which may include national clinical guidelines, CMS policies and determinations, clinical reference… more
- Humana (Columbia, SC)
- …a part of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims and ... preservice appeals. The Corporate Medical Director works on problems of diverse...Emergency Medicine, and General Surgery clinical specialists **Work at Home Guidance** To ensure Home or Hybrid… more
- Humana (Columbia, SC)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to… more
- Humana (Columbia, SC)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... and will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all submitted medical … more
- Humana (Columbia, SC)
- **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...provided by other healthcare professionals are in agreement with national guidelines, CMS requirements, Humana policies, clinical standards, and… more
- Evolent (Columbia, SC)
- …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 (Columbia, SC)
- …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 (Columbia, SC)
- …for the mission. Stay for the culture. **What You'll Be Doing:** As a Field Medical Director , MSK Surgery you will be a specialty match reviewer for Spine ... on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization… more
- Evolent (Columbia, SC)
- …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
- Evolent (Columbia, SC)
- …for the mission. Stay for the culture. **What You'll Be Doing:** As a Field Medical Director , Oncology, you will be a key member of the utilization management ... recorded in a timely and accurate manner. . May assist the Senior Medical Director in research activities/questions related to the Utilization Management… more
- Evolent (Columbia, SC)
- …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** As a Field Medical Director , MSK Surgery you will be a key member of the utilization ... recorded in a timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management… more
- Humana (Columbia, SC)
- …Team within the Healthcare Quality Reporting and Improvement organization. They report to the National Medical Director and lead a diverse team driving ... . Integrate education offerings across HQRI-wide priorities and innovations Medical Director Support Responsibilities: . Work autonomously,...time that is best for your schedule. **Work at Home Guidance** To ensure Home or Hybrid… more
- Option Care Health (Columbia, SC)
- …patient's medical condition and prescribed therapy is suitable for home care. Provides continuing education to physicians, nurses, pharmacy technicians, and ... **Extraordinary Careers. Endless Possibilities.** **With the nation's largest home infusion provider, there is no limit to the growth of your career.** Option Care… more
- Humana (Columbia, SC)
- …part of our caring community and help us put health first** The Director , Internal Audit develops, plans and evaluates internal audit programs for the organization's ... ensure compliance with the organization's policies, procedures and standards. The Director , Internal Audit requires an in-depth understanding of how organization… more
- CenterWell (Columbia, SC)
- …a part of our caring community and help us put health first** The Associate Medical Director (AMD) is an instrumental clinical leader of our primary care team, ... (clinical, financial, operational) meetings on key topics such as Medical Risk Adjustment (MRA), budgeting, staffing, operational excellence, and clinical… more
- CenterWell (Columbia, SC)
- …part of our caring community and help us put health first** The Associate Director of WFM Capacity Planning is responsible for leading and optimizing the long-range ... can influence executive decision-making through data-driven insights. The Associate Director of WFM Capacity Planning is responsible for leading...time that is best for your schedule. **Work at home requirements:** To ensure Home or Hybrid… more
- Humana (Columbia, SC)
- …those customers at the center of everything it does. The MarketPoint Director , Channel Development defines the cross-channel implementation plan to support the sales ... markets and/or products. A major focus will be on developing and leading national and regional sales growth and retention initiatives. The Director , Channel… more