- CVS Health (Annapolis, MD)
- …continuum of our members' health care and social determinant needs. The Duals Care Management (CM) Medical Director will participate in designing, developing ... and socioeconomic needs. * Partner closely with the Executive Director of Duals and other Duals Care Management...and quality objectives are met. * Consults with plan medical staff regarding adverse determinations, addresses issues related to… more
- Humana (Annapolis, MD)
- …relationships, value-based care, quality metrics, population health, and disease or care management . The Behavioral Health Medical Director may develop ... and help us put health first** The Behavioral Health Medical Director is responsible for behavioral health...in teams focusing on quality management , utilization management , case management , discharge planning… more
- Humana (Annapolis, MD)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members ... caring community and help us put health first** The Medical Director actively uses their medical...in teams focusing on quality management , utilization management , case management , discharge planning… more
- Humana (Annapolis, MD)
- … medical management operational improvements, including those within the medical director area + Participate in call rotation + Develop collaborative ... in teams focusing on quality management , utilization management , case management , discharge planning...on size of region or line of business. The Medical Director conducts Utilization Management … more
- Evolent Health (Annapolis, MD)
- …training classes as needed for new hires to educate and train on Utilization management system and Field Medical Director process, standards and resources. ... Evolent for the mission. Stay for the culture. **What You'll Be Doing:** As a Medical Director for the Musculoskeletal department, you will be a key member of… more
- Highmark Health (Annapolis, MD)
- **Company :** Endorsed **Job Description :** **GENERAL OVERVIEW** The Medical Director will provide qualified medical direction and consultation for care ... delivery and complex case management for our community-based palliative care...leadership and guidance to the regional interdisciplinary team. The medical director collaborates clinically with the APP… more
- J&J Family of Companies (Annapolis, MD)
- Director , Regulatory Medical Writing (1 of 4)...countries. Remote work options may be considered on a case -by- case basis and if approved by the company. ... - 2406211847W **Description** Johnson & Johnson is currently seeking a Director , Regulatory Medical Writing. The primary location for this position is the United… more
- Merck (Annapolis, MD)
- …systems accounts + Serves as a resource for the HSO MAD Team Lead, HSO Executive Director Medical Affairs, and other members of Country Medical Affairs on ... **Job Description** **Health Systems Oncology Medical Affairs Director , US Medical...This role also serves as a resource for the Medical Affairs (MA) management team on strategic… more
- Evolent Health (Annapolis, MD)
- …the mission. Stay for the culture. **What You'll Be Doing:** As a Behavioral Health Field Medical Director will be a key member of the utilization management ... Opportunities:** Evolent Health is looking for a Behavioral Health Medical Director to be a member of...in risk management , claim adjudication, pharmacy utilization management , catastrophic case review, outreach programs, +… more
- Humana (Annapolis, MD)
- …our caring community and help us put health first** The Behavioral Health Medical Director responsible for behavioral health care strategy and/or operations. The ... Behavioral Health Medical Director work assignments involve moderately complex...experience post-training providing clinical services + Experience in utilization management review and case management … more
- CareFirst (Baltimore, MD)
- …based on business needs and work activities/deliverables that week. The Director , Utilization Management provides strategic leadership of the utilization ... for the design, assessment, implementation and outcomes of utilization management strategies using a multidisciplinary approach to enhance member engagement,… more
- Merck (Annapolis, MD)
- **Job Description** The Executive Director , Global Medical and Scientific Affairs (EDMA) GYN Malignancies is accountable for the development and execution of ... scientific & medical affairs Value and Implementation (V&I) plans for their...and Implementation (V&I) plan, in collaboration with the Executive Director of Scientific Affairs (EDSA), that guides TA scientific… more
- Johns Hopkins University (Baltimore, MD)
- …and administrative teams including clinic staff meetings, case consultation, high-risk case management , peer chart reviews, medical leave review, ... involvement in the medical leave of absence process. The Senior Associate Director of Clinical Services will actively lead and contribute to data management … more
- CVS Health (Annapolis, MD)
- …**Position Summary** Aetna, a CVS Health Company, has an exciting opportunity for a Medical Director (Cardiology) that can be remote based, work from home. This ... can be remote based anywhere in the US. The Medical Director (Cardiology) will be a Subject...will lead all aspects of utilization review/quality assurance, directing case management . In this role you will… more
- Mindoula Health (Baltimore, MD)
- Join Our Team as a Child & Adolescent Psychiatrist and Inpatient BHU Medical Director ! Are you a passionate and board-certified Child & Adolescent Psychiatrist ... Medical Center in Salisbury, Maryland. Role Overview: As the inpatient BHU Medical Director for Child & Adolescent Psychiatry, you will play a pivotal… more
- University of Maryland, Baltimore (Baltimore, MD)
- …*Education:*Master's degree in Social Work. *Preferred Experience:*Experience in case management . *Certification/Licensure:*Licensed Master Social Worker (LMSW) ... experience in related area of treatment. *Preferred Experience:*Experience in case management . *Certification/Licensure:*Licensed as (LCSW) or (LCSW-C) in… more
- CVS Health (Annapolis, MD)
- …preferably resides in North Carolina and have a NC License without encumbrances.** In the Medical Director role you will provide oversight for medical policy ... evaluation of clinical/ medical programs and expand Aetna's medical management programs to address member needs...In addition you will oversee utilization review/quality assurance, directing case management . In this role you'll provide… more
- Guidehouse (Baltimore, MD)
- …**Clearance Required** **:** None Job Posting **What You Will Do:** + The Management Consulting Director in Guidehouse's State and Local Government Practice ... **Job Family** **:** Management Consulting **Travel Required** **:** Up to 25%...**If you proceed to interview you will complete a case study that will be presented verbally by the… more
- CVS Health (Annapolis, MD)
- …**This is a remote based (work at home) based anywhere in the US.** The Medical Director (Ortho/Total Joint) will be a Subject Matter Expert (SME) with a ... direct patient care experience specifically. This role expands Aetna's medical management programs to address member needs...will lead all aspects of utilization review/quality assurance, directing case management . In this role you will… more
- Highmark Health (Annapolis, MD)
- …URAC, CMS, DOH, and DOL regulations, etc.). Ensure that all aspects of the medical management process are consistent with community standards of care. + ... outpatient, or private practice) **Preferred** + 1 year in Medical Management in a Health Insurance Plan;...need. **Preferred** + None **SKILLS** + Critical Thinking + Case Management + Customer Service + Oral… more