- Genesis Healthcare (Santa Fe, NM)
- …balance flexibility (no weekends or on call)! We are seeking a FFS Attending Physician/ Medical Director for our Casa Real Center located in Albuquerque, NM, with ... potential float to nearby centers. This is a Dual Role Attending Physician/ Medical Director . It is clinical in nature. Must be BC/BE Internal Medicine or Family… more
- Humana (Santa Fe, NM)
- **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 (Santa Fe, NM)
- **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 (Santa Fe, NM)
- **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 (Santa Fe, NM)
- **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 (Santa Fe, NM)
- …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
- Parexel (Santa Fe, NM)
- …we are expanding our esteemed Medical Sciences Team and seeking an Associate/ Medical Director to support the growth of our Global Immunology and Inflammation ... Therapeutic Franchise. As an Associate / Medical Director , you will work closely with some of the best and brightest in the industry and assist our clients in… more
- Evolent (Santa Fe, NM)
- …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 (Santa Fe, NM)
- …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
- Humana (Santa Fe, NM)
- **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
- Evolent (Santa Fe, NM)
- …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
- Otsuka America Pharmaceutical Inc. (Santa Fe, NM)
- The Medical Director , Nephrology & Immunology Medical Strategy is a critical role responsible for shaping the strategic processes and planning for assets in ... ability to balance competing priorities. This position reports directly to the Senior Director , Immunology Lead, who in turn reports to the Executive Director ,… more
- Parexel (Santa Fe, NM)
- …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 (Santa Fe, NM)
- …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
- Molina Healthcare (Santa Fe, NM)
- …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 (Santa Fe, NM)
- …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
- Sumitomo Pharma (Santa Fe, NM)
- …a dynamic, highly motivated, and experienced individual for the position of **Associate** ** Medical Director , Clinical Development - Oncology** . The associate ... medical director is responsible for the leadership, development, and management...of the overall product development plan, based on strong medical and scientific principles, knowledge of compliance and regulatory… more
- Highmark Health (Santa Fe, NM)
- …**JOB SUMMARY** This role supports the Medical Policy team by bringing medical director level expertise, experience and knowledge to the team. They support ... the full-cycle ownership of commercial and Medicare Advantage medical policies, both developed internally and by vendors. This...operational guidelines. The incumbent must have an understanding of medical coding (ICD-10, CPT, HCPS) as medical … more
- Molina Healthcare (Santa Fe, NM)
- …reviews behavioral health portions of state contracts. * Assists behavioral health medical director lead trainers in the development of enterprise-wide education ... JOB DESCRIPTION Job SummaryProvides medical oversight and expertise related to behavioral health...and chemical dependency services - working closely with regional medical directors to standardize behavioral health utilization management policies… more
- Sumitomo Pharma (Santa Fe, NM)
- …dynamic, highly motivated, and experienced individual for the position of Senior Medical Director , Clinical Research (Ophthalmology) to join our R&D ... Provides oversight of clinical trial conduct, interacting with CROs, medical monitors, and vendors as required, and working with...and summarization of findings + Serve as the internal medical monitoring for clinical trials + Review and provide… more