- 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)
- … 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 relies on medical ...in teams focusing on quality management , utilization management , case management , discharge planning… 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
- 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
- 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
- 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 - Pediatric Cardiologist- Evicore-...evidence-based medical case reviews for medical necessity on eviCore's case management ... the lives of others? Then look no further! As a Pediatric Cardiologist Medical Director at Evicore part of Evernorth Health Services, a division of The Cigna… 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
- Merck (Hartford, CT)
- **Job Description** **Role Summary:** + The Global Senior Director Medical Affairs (GDMA), Oncology is responsible for driving execution of scientific & ... (ex-USA) + Manages programs (patient support, educational or risk management ) to support appropriate and safe utilization of Our...years regional medical affairs experience (eg, Regional Director Medical Affairs) with proven track record… 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
- Highmark Health (Hartford, CT)
- …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
- J&J Family of Companies (Hartford, CT)
- …able to thrive in a matrixed environment. Ability to build an effective business case and project management . Track record of successful leadership skills in the ... Director , Global Brand Protection Capabilities & Technology -...stakeholders (internally / externally) to develop an effective business case , strategies, and tactics to address and mitigate brand… more
- J&J Family of Companies (Hartford, CT)
- …processing, reporting and evaluation of adverse events * Understanding in single case medical assessment, post-marketing aggregate adverse event data reviews, ... Associate Director , Signal Detection Scientist - 2406212640W **Description** Johnson...the US or UK may be considered on a case -by- case basis and if approved by the… more
- J&J Family of Companies (Hartford, CT)
- Director , Health Economics and Market Access - Wound...candidates. Remote work options may be considered, on a case -by- case basis and if approved by the ... Healing and Biosurgery - 2406204292W **Description** Johnson & Johnson is recruiting a Director , Health Economics & Market Access (HEMA) for the Johnson & Johnson… more
- J&J Family of Companies (Hartford, CT)
- …to have but not required. * MS Office Tools * Investigations and Intelligence Case Management Systems experience * Fluency in English * Strong executive ... Director , Product Security Investigations & Intelligence - 2406207568W...security investigations and intelligence strategy, value recovery targets, ensure case and intelligence management systems effectiveness, and… more