- Humana (Atlanta, GA)
- …our caring community and help us put health first** Job Description Summary The Medical Director relies on fundamentals of CMS Medicare Guidance on following and ... episodic, home health per diem, DME, and waiver requests. The Medical Director provides medical interpretation and determinations whether services provided… more
- 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
- Conviva (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)
- …a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews preauthorization requests ... for services. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth… 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
- Elevance Health (Atlanta, GA)
- …candidate will live within 50 miles of one of our Elevance Health PulsePoint locations. ** Medical Director ** The ** Medical Director ** will be responsible ... cost of care opportunities. May serve as a resource to staff including Medical Director Associates. May be responsible for an entire clinical program. **How will… 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 ... understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all submitted medical records,… more
- CenterWell (Stone Mountain, GA)
- …a part of our caring community and help us put health first** The Associate Medical Director serves as a health-care professional and capable of handling a ... variety of health-related problems. The Associate Medical Director requires a solid understanding of how organization capabilities interrelate across… more
- Elevance Health (Atlanta, GA)
- ** Medical Director - Florida Medicaid** Location: This position will work a hybrid model (remote and office). The Ideal candidate will must live within 50 miles ... Health PulsePoint locations. **Build the Possibilities. Make an extraordinary impact.** The Medical Director is responsible for the administration of physical… more
- CVS Health (Atlanta, GA)
- …have Internal Medicine or Internal Medicine/Pediatrics (Med/Peds) Board Certification. In the Medical Director role, you will provide oversight for medical ... staff ensuring timely and consistent responses to members and providers. As a Medical Director you will focus primarily on review appeal cases for denied … 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
- 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)
- **Clinical Operations Associate Medical Director ** **Interventional Pain** **Carelon Medical Benefits Management** **Location:** Alternate locations may be ... of one of our Elevance Health PulsePoint locations. The **Clinical Operations Associate Medical Director ** is responsible for supporting the medical … more
- Elevance Health (Atlanta, GA)
- **Clinical Ops Associate Medical Director ** **Location:** **This is a virtual position. Candidates must reside within 50 miles of an Elevance Health Pulse Point ... analytics to improve the delivery of care. The **Clinical Ops Associate Medical Director ** is responsible for supporting the medical management staff… more
- Humana (Atlanta, GA)
- …a part of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims. The ... Corporate Medical Director works on problems of diverse scope and complexity...and complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation… more
- Devereux Advanced Behavioral Health (Kennesaw, GA)
- …fields? Then consider joining our Devereux Advanced Behavioral Health Team! **Being a Medical Director at Devereux has its Advantages** You will work with ... _Keywords: psychiatrist, child, adolescent, MD, medical services director , medical director , child psychiatry, residential… more
- Centene Corporation (Atlanta, GA)
- …benefits including a fresh perspective on workplace flexibility. **Position Purpose:** The Medical Director works actively to implement and administer medical ... with regulatory agencies. + Supports the Health Plan Chief Medical Officer or Senior Medical Director by effectively implementing the Plan initiatives… more
- Takeda Pharmaceuticals (Atlanta, GA)
- …knowledge. **Job Description** **About the role:** Join Takeda as a Senior Medical Director , Pharmacovigilance in Gastrointestinal and Inflammation (GI2). You ... for presentations to the Takeda Safety Board and similar forums. The Senior Medical Director will be a key player in the preparation and presentation of… more
- Evolent (Atlanta, GA)
- …for the mission. Stay for the culture. **What You'll Be Doing:** As a Field Medical Director , you will be a key member of the utilization management team. ... a timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management process,… more
- Elevance Health (Atlanta, GA)
- **Clinical Ops Associate Medical Director - Ortho** **Location:** **This is a virtual position. Candidates must reside within 50 miles of an Elevance Health ... to improve the delivery of care. The **Clinical Ops Associate Medical Director - Ortho** is responsible for performing pre-authorizations and providing quality… more