- Humana (Atlanta, GA)
- **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 (Atlanta, GA)
- **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 (Atlanta, GA)
- **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 (Atlanta, GA)
- **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 (Atlanta, GA)
- …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 (Atlanta, GA)
- **Behavioral Health Medical Director -Psychiatrist Appeals** **Location:** This role enables associates to work virtually full-time, with the exception of ... Friday. Half day Saturday rotation, once a month.** The **Behavioral Health Medical Director -Psychiatrist Appeals** is responsible for the administration of… more
- Evolent (Atlanta, GA)
- …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 (Atlanta, GA)
- …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 (Atlanta, GA)
- …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
- Humana (Atlanta, GA)
- **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
- BluePearl (Atlanta, GA)
- …clinical experience to lead our team of emergency and specialty clinicians in the role of ** Medical Director ** . The Medical Director will partner in ... and all clinicians. Using excellent communication and interpersonal skills, the Medical Director will support veterinary partner relationships and enhance… more
- Elevance Health (Atlanta, GA)
- **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
- Otsuka America Pharmaceutical Inc. (Atlanta, GA)
- The Medical Director , Rheumatology and/or Dermatology Medical Strategy is a critical role responsible for shaping the strategic processes and planning for ... ability to balance competing priorities. This position reports directly to the Senior Director , Immunology Lead, who in turn reports to the Executive Director ,… more
- Elevance Health (Atlanta, GA)
- **Clinical Operations Medical Director ** **Carelon MBM** **Virtual:** This role enables associates to work virtually full-time, with the exception of required ... expanding set of clinical domains, including radiology, cardiology and oncology._ The ** Medical Director , Cardiology** is responsible for supporting the … more
- Elevance Health (Atlanta, GA)
- **Clinical Operations Medical Director ** ** Medical Oncology** **Carelon Medical Benefit Management** **Virtual** : This role enables associates to work ... of clinical domains, including radiology, cardiology and oncology._ The **Clinical Operations Medical Director ** is responsible for supporting the medical … more
- Parexel (Atlanta, GA)
- …Patients First, Quality, Respect, Empowerment & Accountability. **Parexel is looking for a Medical Director with a very strong background in Ophthalmology to ... role can be based remo** t **ely in the US or Canada.** The Medical Director is a medical expert with specialized therapeutic expertise and some experience… more
- Evolent (Atlanta, GA)
- …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
- Parexel (Atlanta, GA)
- ** Medical Director - Gastroenterology Specialty** **Location:** Remote - United States / **Travel:** 15-20% **About This Opportunity** Parexel is seeking an ... exceptional ** Medical Director ** with specialized expertise in **Gastroenterology** to join our Medical Sciences team. This is an outstanding opportunity for… more
- Molina Healthcare (Atlanta, GA)
- …to standardize policies and procedures. + Recruits, hires, trains, mentors, and develops medical director staff and team members as needed. + Ensures ... practice in behavioral health and at least 3 years as a medical director in a managed care setting supporting utilization management and quality initiatives.… more
- Evolent (Atlanta, GA)
- …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 ... a timely and accurate manner. . May assist the Senior Medical Director in research activities/questions related to the Utilization Management process,… more