- Humana (Salem, OR)
- …Director relies on medical background and reviews health claims and preservice appeals . The Corporate Medical Director works on problems of diverse ... and complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation...experience + Knowledge of the managed care industry including Medicare , Medicaid and or Commercial products + Must be… more
- Humana (Salem, OR)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and ...to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of… more
- CVS Health (Salem, OR)
- …assigned medication utilization reviews (PA) and/or medical necessity appeals for commercial clients, governmental ( Medicare /Medicaid) programs and ... Fortune 4 company, has an outstanding opportunity for a Medical Director - Medical Affairs....medication utilization reviews (PA) and/or medical necessity appeals for commercial clients, governmental ( Medicare /Medicaid) programs… more
- Humana (Salem, OR)
- **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 (Salem, OR)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... reference materials, internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and ...to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all… more
- Humana (Salem, OR)
- **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
- CareOregon (Portland, OR)
- Job Title Medical Director - Clinical Services Department Medical Management Administration Exemption Status Exempt Requisition # 24536 Direct Reports N/A ... Manager Title Sr Medical Director - Clinical Services Pay &...Management activities. + Provide oversight of benefit determinations and appeals for medical and pharmacy as assigned… more
- CareOregon (Portland, OR)
- …a federal contractor and must comply with all federal laws. Job Title Associate Medical Director - Maternal, Child, and Youth Department Medical Management ... Exempt Requisition # 24391 Direct Reports N/A Manager Title Medical Director , CPCCO Pay & Benefits Estimated...Management activities. + Provide oversight of benefit determinations and appeals for medical and pharmacy as assigned… more
- Prime Therapeutics (Salem, OR)
- …of utilization management decisions. + On a requested basis, may function as Medical Director for select health plans or regions, assuming overall accountability ... member of the utilization management team, and provides timely medical review of service requests that do not initially...fax. + Provides clinical rationale for standard and expedited appeals . + Provides assistance and act as a resource… more