- Elevance Health (Richmond, VA)
- ** Director Clinical Quality Management ** **Location:** This position will work a hybrid model (remote and office). Must live within 50 miles/1 hour ... commute of an Elevance Health location. The ** Director Clinical Quality Management ** is responsible for the oversight of day-to-day operations of… more
- BrightSpring Health Services (Colonial Heights, VA)
- …AT Home Care & Hospice Overview MUST HAVE HOSPICE EXPERIENCE RN REQUIRED The Director , Clinical Operations is responsible for the overall direction of hospice ... clinical services. The Director , Clinical ...hospice services that meet and promote the standards of quality and contribute to the total organization and philosophy.… more
- HCA Healthcare (Richmond, VA)
- …developmental activities to prepare you to become a Clinical Resource Director or another key management position within HealthTrust Supply Chain ... integrity. We care like family! Jump-start your career as a(an) Associate Director Clinical Resources today with HealthTrust. **Benefits** HealthTrust, offers a… more
- CenterWell (Richmond, VA)
- …for value-based, senior care model in the primary care network. The Associate Director , Clinical Coding Education (RN) will develop, design, and deploy the ... to managing a team of role-based trainers and training facilitators. The Associate Director , Clinical Coding Education (RN) role will report to the National… more
- ChenMed (Richmond, VA)
- …We're rapidly expanding and we need great people to join our team. The Clinical Director will directly supervise and train primary care providers (PCPs) in ... is accountable for maximizing overall core model execution, including improving clinical quality , efficiency, outcomes, and clinician/patient satisfaction. In… more
- Prime Therapeutics (Richmond, VA)
- … clinical research and analytics that improve medical cost savings and provide clinical quality initiatives + Manages current clients in all Medical Pharmacy ... and drives every decision we make. **Job Posting Title** Director , Specialty Clinical Solutions -RPH/PharmD required- REMOTE...programs such as Fee Schedule Management , Prior Authorization, Post Service Claim Edits, Site of… more
- CVS Health (Richmond, VA)
- …enterprise and provides clinical oversight and mentorship for CVS Health clinical programs, PBM Clinical Quality activities, consultative support to ... in support of Key Clients as assigned. The Medical Director transacts Utilization Management UM activities (prior... clinical oversight and mentorship for CVS Health clinical programs, PBM Clinical Quality … more
- CVS Health (Richmond, VA)
- …of our members' health care and social determinant needs. The Duals Care Management (CM) Medical Director will participate in designing, developing and deploying ... and socioeconomic needs. * Partner closely with the Executive Director of Duals and other Duals Care Management...Collaborates with the Learning and Performance Team to develop clinical training for care management staff. *… more
- Sunrise Senior Living (Richmond, VA)
- …members. Quality Assurance and Regulatory Compliance: + Tracks, trends, and reports clinical quality data to identify risk. + Participates actively as a ... Air **Job ID** 2024-216937 **JOB OVERVIEW** The Resident Care Director (RCD) serves as the nursing clinical ...Quality Assurance and Performance Improvement committee. + Leads clinical quality and process improvement initiatives within… more
- Humana (Richmond, VA)
- …analytic and interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , ... decisions to internal associates, and possible participation in care management . The clinical scenarios predominantly arise from...size of region or line of business. The Medical Director conducts Utilization Management of the care… more
- Humana (Richmond, VA)
- …care, quality metrics, population health, and disease or care management . The Behavioral Health Medical Director may develop procedures, processes, ... analytic and interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management ,… more
- Humana (Richmond, VA)
- …analytic and interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , ... hospitals/ Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management… more
- Humana (Richmond, VA)
- …and interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , and acute inpatient ... is assisted by diverse resources, which may include national clinical guidelines, CMS policies and determinations, clinical ...size of region or line of business. The Medical Director conducts Utilization Management of the care… more
- HealthEdge Software Inc (Richmond, VA)
- **Overview** ** Director , Product Management ** **Position Overview:** We are seeking a highly skilled and experienced Director of Product Management to ... to deliver exceptional value for their stakeholders. As a Director , Product Management , you will lead one...fuel a digital transformation, reduce costs, and improve both clinical outcomes and the member experience. **Your Impact:** +… more
- Highmark Health (Richmond, VA)
- …of care, care plans and through patient centered evaluation and engagement. The medical director will serve as a clinical champion - promoting and representing ... the interdisciplinary team in cooperation with the Executive Medical Director + Evaluate quality assurance and performance...medical education needs in cooperation with the Executive Medical Director + Serve as a clinical champion… more
- HCA Healthcare (Richmond, VA)
- …quality management information. + Aligns with CSG Behavioral Health Director Capital Division on all clinical initiatives (UoD, HBIPS, orientation, ... Department. Plans, coordinates, manages and monitors comprehensive Behavioral Health quality management program. Facilitates the Tucker Pavilion Quality… more
- CVS Health (Richmond, VA)
- …policies, and programs are comprised of utilization management , quality management , network management and clinical coverage and policies. **Primary ... Job Duties & Responsibilities:** Behavioral Health Medical Director + Collaborates with health plan Sr Leadership to...including after-hours consultation as needed. + Leads all major clinical , population health management , and quality… more
- Evolent Health (Richmond, VA)
- …+ Responsible to assist with all types of audits including Interrater, Customer, Clinical quality , and/or confirmation of process changes. + Holds Field Medical ... a scheduled basis. + In conjunction with other leaders, measures Field Medical Director productivity, quality , and telephone statistics + In close partnership… more
- CVS Health (Richmond, VA)
- …involved in local communities and leading the way in health care. The LTSS Director , Clinical Health Services ( Director ), will partner closely with the ... LTSS Executive Director , Market CEO, DSNP Senior Leadership Clinical Health Services, Centers for Medicare and Medicaid Services, and State Agencies to build a… more
- Sunrise Senior Living (Richmond, VA)
- …and promote clinical capabilities of team members. + Track, trend and report clinical quality data to identify risk. Actively participate as a member of the ... department to coordinate care and services that promote resident's quality of life. Direct management of the... Quality Assurance and Performance Improvement committee. Lead clinical quality and process improvement initiatives within… more