- Highmark Health (Atlanta, GA)
- …Inc. **Job Description :** **JOB SUMMARY** This role supports the Medical Policy team by bringing medical director level expertise, experience and ... **ESSENTIAL RESPONSIBILITIES** + Full-cycle ownership of commercial and Medicare Advantage medical policy creation process including writing clinical criteria… more
- Elevance Health (Atlanta, GA)
- …decisions. + Brings to their supervisors attention, any case review decisions that require Medical Director review or policy interpretation. + Determine ... **Clinical Operations Medical Director ** **Carelon MBM** **Virtual:** This...which may include AIM Appropriateness Guidelines, client-specific health plan medical policy , well established evidenced based guidelines,… 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...communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee… more
- Humana (Atlanta, GA)
- **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 ... health, SNF, DME, dual Medicare/Medicaid and Waiver requests. The Medical Director provides medical interpretation...communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee… 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 ... to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of...communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee… 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 ... to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of...communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee… 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 to ... to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all...communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee… more
- Humana (Atlanta, GA)
- **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...value based care in accordance with Medicare and Humana policy . All work occurs within a context of regulatory… more
- Elevance Health (Atlanta, GA)
- …+ Brings to their supervisors attention, any case review decisions that require Medical Director review or policy interpretation. **Minimum Requirements:** + ... **Clinical Operations Medical Director ** ** Medical Oncology**...necessity of requests using guidelines and client-specific health plan medical policy . + Conduct peer-to-peer discussions with… more
- Elevance Health (Atlanta, GA)
- **Appeals Medical Director - Medicare** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person training ... onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable...by law. Alternate locations may be considered. The **Appeals Medical Director ** is responsible for the appeal… more
- ChenMed (Atlanta, GA)
- …We're rapidly expanding and we need great people to join our team. The Regional Medical Director (RMD) is a developmental, pathway role to Market Chief ... Medical Officer which is responsible for aiding in the...operations issues in priority of urgency according to ChenMed policy and FQHC standards. + Advocates wellness for patients… more
- Sumitomo Pharma (Atlanta, GA)
- …seeking a dynamic, highly motivated, and experienced individual for the position of ** Medical Director , Clinical Development - Oncology** . The medical ... of the overall product development plan, based on strong medical and scientific principles, knowledge of compliance and regulatory...in line with your work state. Our robust time-off policy includes flexible paid time off, 11 paid holidays… more
- Sumitomo Pharma (Atlanta, GA)
- …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...in line with your work state. Our robust time-off policy includes flexible paid time off, 11 paid holidays… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …who can contribute to the excellence of our academic community. **Description** Medical Director , Liver Transplant Program Join the dynamic and growing ... packages. Track and rank will be commensurate with experience. Position serves as Medical Director for the Liver Transplant program and oversees the transplant… more
- Highmark Health (Atlanta, GA)
- …most current clinical standards. The incumbent reviews escalated cases electronically and using Medical Policy criteria sets to evaluate the medical ... members **ESSENTIAL RESPONSIBILITIES** + Conduct electronic review of escalated cases against medical policy criteria, which may include telephonic peer to peer… more
- Morehouse School Of Medicine (Atlanta, GA)
- …on charge review workflows; deliver training on operational billing practices ( policy ownership resides with Compliance/Associate Director ). Regulatory & Quality ... Clinical Trials Operations (CTO) Director - Clinical & Operational Implementation Bookmark this...place of distinction, serving as the nation's leading academic medical center for vulnerable populations. It's also a place… more
- Morehouse School Of Medicine (Atlanta, GA)
- Physician Assistant Director of Curriculum Innovation and Evaluation Bookmark this Posting Print Preview | Apply for this Job Please see Special Instructions for ... ) is a place of distinction, serving as the nation's leading academic medical center for vulnerable populations. It's also a place for passionate individuals looking… more
- Morehouse School Of Medicine (Atlanta, GA)
- Sr. Director / Director , Department Administrator Bookmark this Posting Print Preview | Apply for this Job Please see Special Instructions for more details. ... place of distinction, serving as the nation's leading academic medical center for vulnerable populations. It's also a place...at MSM ! Posting Number NONAC3668 Job Title Sr. Director / Director , Department Administrator Position Title Sr. … more
- Otsuka America Pharmaceutical Inc. (Atlanta, GA)
- **Job Summary** **Job Description** The Associate Director (AD), Federal Government Affairs, will assist in the development, communication, and deployment of ... Otsuka's federal strategies, engagement activities and policy priorities that promote access to therapies, preserve patient/provider choice, and generally protect… more
- Humana (Atlanta, GA)
- …initiatives across Pharmacy, Primary Care, Home Solutions, the Office of the Chief Medical Officer, and Integrated Health. The Director and team will provide ... a part of our caring community and help us put health first** The Director , IT Portfolio Management collaborates with the business portfolio team to align the IT… more