- CVS Health (Hartford, CT)
- …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 (Hartford, CT)
- …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 (Hartford, CT)
- … 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 (Hartford, CT)
- … 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 (Hartford, CT)
- …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
- The Cigna Group (Bloomfield, CT)
- …Healthcare (CHC) **Summary description of position** : A Medical Principal performs medical review and case management activities. The physician provides ... interested in a career in health care administration. The Medical Director role is a Medical...Performs benefit-driven medical necessity reviews for coverage, case management , and claims resolution, using benefit… more
- J&J Family of Companies (Hartford, CT)
- 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
- Highmark Health (Hartford, CT)
- **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
- The Cigna Group (Bloomfield, CT)
- …other weekend (Tuesday ALT Day).** + Must have experience in Medicare Appeals, Utilization Case Management or Compliance in Medicare Part C + Ability to ... provide a written detailed clinical summary for the Plan Medical Director . + Determine whether additional pre...report and summarize required changes to all levels department management and staff. + Support the implementation of new… more
- The Cigna Group (Bloomfield, CT)
- Medical Director , Post-Acute Care Summary: The Medical Director (MD) provides timely expert medical review of medical necessity requests for ... receiving care in a post-acute care facility, focusing on discharge planning, complex medical care management , quality of care, appropriate level of care, and… more
- Merck (Hartford, CT)
- …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
- The Cigna Group (Bloomfield, CT)
- …Name and Number: Product Clinical Management 2500 III. Reports to: Executive Medical Director , Durable Medical Equipment IV. Summary: The Medical ... **JOB SUMMARY** I. Evernorth Business Title: Medical Director , Durable Medical ...and communicate with DME administration for outreach and timely case processing. + Engage in continued review of guideline… more
- Evolent Health (Hartford, CT)
- …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
- The Cigna Group (Bloomfield, CT)
- Medical Director - Gastroenterology - Evicore by...evidence-based medical case reviews for medical necessity on eviCore's case management ... improving the lives of others? Then look no further! As a Gastroenterology Medical Director at eviCore, part of Evernorth Health Services, a division of The… more
- Humana (Hartford, CT)
- …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
- Moses/Weitzman Health System (Middletown, CT)
- …steps to ensure that productivity goals are met. Works collaboratively with on site Medical director to ensure patient access to safe, appropriate, high quality ... relate to more than one On Site Behavioral Health Director , in which case one, typically the.... Works with the Regional Vice President and site management team in the development of site-specific new services… more
- Merck (Hartford, CT)
- **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
- CVS Health (Hartford, CT)
- …**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
- CVS Health (Hartford, CT)
- …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
- CVS Health (Hartford, CT)
- …**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