- CVS Health (Springfield, IL)
- …portion of most days completing assigned medication utilization reviews (PA) and/or medical necessity appeals for commercial clients, governmental ... **Position Summary** CVS Health, a Fortune 6 company, has an outstanding opportunity for a Medical Director ( Medical Affairs). This is a remote based, work… more
- Humana (Springfield, IL)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to… more
- Humana (Springfield, IL)
- **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...managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations,… more
- CVS Health (Springfield, IL)
- …of covered benefits in the Commercial and Medicare environment. This Medical Director provides subject matter expertise in clinical and payment policy ... CVS Health company has an outstanding opportunity for a Medical Director . Ready to take your career...of Aetna clinical and coding policy and experience with appeals , claim review, reimbursement issues, and coding is preferable,… more