- Humana (Providence, RI)
- …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 (Providence, RI)
- **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 (Providence, RI)
- **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 (Providence, RI)
- …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 (Providence, RI)
- **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
- Generations Family Health Center (Putnam, CT)
- Behavioral Health Medical Director / Psychiatrist Job Details Level Management Job Location GEN Putnam - Putnam, CT Remote Type N/A Position Type Full Time ... Undisclosed Job Shift Day Job Category Health Care Description Behavioral Health Medical Director / Psychiatrist (MD/DO) Location: Putnam & Willimantic, CT… more
- Humana (Providence, RI)
- **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
- Elevance Health (Smithfield, RI)
- …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
- Edward M. Kennedy Community Health Center, Inc. (Milford, MA)
- …in helping people live healthier lives. Summary of opportunity: Reporting to the Chief Medical Officer, the Medical Director will provide leadership and ... all aspects of Kennedy Community Health's Milford MA primary care clinic. The Medical Director will spend part of their time overseeing the Provider staff as… more
- CSL Plasma (Warwick, RI)
- …the Quality Assurance Team. Acts as a liaison between the Corporate or Divisional Medical Director and the Center Medical Staff, which includes preparation ... cell immunizations are given. Submits monthly report to Divisional (or Corporate) Medical Director . 12. Determines donor suitability following adverse reactions… more
- Evolent (Providence, RI)
- …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
- South County Hospital (Wakefield, RI)
- South County Hospital is seeking a Medical Director for its Division of Hematology and Oncology. The Medical Director is responsible for the overall ... and patient experience for all patients cared for within the Department. The Medical Director will work in partnership with the system CMO to recruit and retain… more
- Elevance Health (Smithfield, RI)
- **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 (Providence, RI)
- …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
- Takeda Pharmaceuticals (Providence, RI)
- …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
- Family Service Association - Fall River (Fall River, MA)
- We are searching for a Medical Director who can provide guidance, leadership, oversight, and quality assurance to the LTSS Community Partners program in a very ... and Responsibilities : + Collaborate with the Vice President of Care Coordination, Director of Care Coordination, Director and, Clinical Directors of LTSS… more
- Evolent (Providence, RI)
- …Evolent 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 (Smithfield, RI)
- **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
- CVS Health (Providence, RI)
- …a remote based (work at home) based anywhere in the US.** Responsibilities of this Medical Director role are related to Medicare Appeals: * Direct daily work on ... System eg, Clinical Practice or Health Care Industry * Medical License (MD) or (DO) * An Active state... License (MD) or (DO) * An Active state medical license without encumbrances * Board Certified in ABMS… more
- VCA Animal Hospitals (Uxbridge, MA)
- Join us as a Medical Director at VCA Blackstone Valley and you'll quickly discover that you're well supported by world-class medicine, technology, facilities and ... offer competitive compensation along with a comprehensive benefits package, including medical , dental, vision and paid vacation/sick days, 401(k), generous employee… more