- Centene Corporation (Jefferson City, MO)
- …including a fresh perspective on workplace flexibility. **Position Purpose:** Assist the Chief Medical Director to direct and coordinate the medical ... performance improvement initiatives for capitated providers. + Assists Chief Medical Director in planning and establishing goals...plus holidays, and a flexible approach to work with remote , hybrid, field or office work schedules. Actual pay… more
- Centene Corporation (Jefferson City, MO)
- …benefits including a fresh perspective on workplace flexibility. **Position Purpose:** Supervisory Medical Director at Centene plays a critical role in ... to our members. This role further assists the Senior Medical Director or Chief Medical ...plus holidays, and a flexible approach to work with remote , hybrid, field or office work schedules. Actual pay… more
- Humana (Jefferson City, MO)
- **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...in care management. The clinical scenarios predominantly arise from inpatient or post-acute care environments. Has discussions with external… more
- Datavant (Jefferson City, MO)
- …SMART software experience strongly encouraged to apply **You Will:** + Conduct inpatient coding audits on medical records, utilizing ICD-10-CM, CPT, and ... to realize our bold vision for healthcare. As an ** Inpatient Auditing Specialist** you will be instrumental in addressing...presenting solutions for customer issues. This role is fully remote with a flexible schedule, allowing you to help… more
- Humana (Jefferson City, MO)
- …Information** Typically reports to a Lead Medical Director . The Medical Director conducts post-service, inpatient care reviews for accurate billing ... caring community and help us put health first** The Medical Director actively uses their medical...to internal associates. The clinical scenarios predominantly arise from inpatient or post-acute care environments. A remote … more
- Humana (Jefferson City, MO)
- **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 operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of...or fellowship, which preferably includes some experience in an inpatient environment and/or related to care of a Medicare… more
- Humana (Jefferson City, MO)
- …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 ... to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all...meets compliance timelines. + Conduct comprehensive, timely, and compliant medical necessity reviews for inpatient services +… more
- Humana (Jefferson City, MO)
- …as needed** + **Other activities as assigned by the managing Medical Director ** Travel: While this is a remote position, occasional travel to Humana's ... caring community and help us put health first** The Medical Director relies on fundamentals of CMS...subject matter contribution** **Preferred Qualifications** + Experience in an inpatient environment and/or related to care of a Medicare… more
- CVS Health (Jefferson City, MO)
- …and implementing the CM plan, monitoring and evaluating the plan and involving the Medical Director as indicated and closing the case as appropriate when the ... and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices. ** Remote Work Expectations** + This is a 100% remote … more
- Evolent (Jefferson City, MO)
- …Tasks are performed within the **RN/LVN/LPN** scope of practice, under the Medical Director 's direction, using independent nursing judgement and decision-making, ... that do not meet established clinical criteria to the Medical Director . + Appropriately identifies and refers...of three years of direct clinical patient care (acute, inpatient , or critical care setting); strongly prefer direct Oncology… more