- Humana (Nashville, TN)
- …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 (Nashville, TN)
- **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 (Nashville, TN)
- …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 (Nashville, TN)
- **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 (Nashville, TN)
- **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 (Nashville, TN)
- **Medicare Medical Director ** Location: This position will work a hybrid model (remote and office). The ideal candidate will must live within 50 miles of one of ... must be able to work Eastern Time Zone hours. The **Medicare Medical Director ** is responsible for the administration of physical and/or behavioral health … more
- CVS Health (Nashville, TN)
- …have Internal Medicine or Internal Medicine/Pediatrics (Med/Peds) Board Certification. In the Medical Director role, you will provide oversight for medical ... staff ensuring timely and consistent responses to members and providers. As a Medical Director you will focus primarily on review appeal cases for denied … more
- Evolent (Nashville, TN)
- …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
- HCA Healthcare (Nashville, TN)
- …Medicine **Job Summary:** CareNow Urgent Care is recruiting an Urgent Care Area Medical Director with demonstrated leadership qualities to join the management ... As the lead physician for this team under the direction of the Market Medical Director , it is important that the following traits and skills are demonstrated: +… more
- Elevance Health (Nashville, TN)
- **Clinical Operations Associate Medical Director ** **Carelon Medical Benefits Management** **Radiology Benefit** **Management/Utilization** **Review** ... domains, including radiology, cardiology and oncology._ The **Clinical Operations Associate Medical Director ** responsible for supporting the medical … more
- ICON Clinical Research (Brentwood, TN)
- Medical Director (Cardiology), United States, Remote ICON plc is a world-leading healthcare intelligence and clinical research organization. We're proud to ... to shape the future of clinical development. We are currently seeking a ** Medical Director (Cardiology)** to join our diverse and dynamic team. As a Medical… more
- Humana (Nashville, TN)
- …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
- Molina Healthcare (Bowling Green, KY)
- …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... years relevant experience, including: + 2 years previous experience as a Medical Director in a clinical practice. + Current clinical knowledge. + Experience… more
- Evolent (Nashville, TN)
- …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 (Nashville, TN)
- **Clinical Ops Associate Medical Director ** **Orthopedic Surgery** **Location:** This is a virtual position. Candidates must reside within 50 miles of an ... to improve the delivery of care. The **Clinical Ops Associate Medical Director - Ortho** is responsible for performing pre-authorizations and providing quality… more
- HCA Healthcare (Nashville, TN)
- …Intensive Care Consortium (ICC) Healthcare is seeking a Critical Care Intensivist Facility Medical Director to lead the TriStar Skyline Medical Center ... month + Work 12-hour shifts covering 47 beds across Medical and Neuro ICU settings + Support the following...+ Unmatched growth and leadership opportunities **About TriStar Skyline Medical Center:** + TriStar Skyline Medical Center… more
- HCA Healthcare (Mount Juliet, TN)
- …Summary:** Tristar Summit Medical Center is seeking an Emergency Medicine Associate Medical Director to become part of our prestigious practice at Mt. Juliet ... CT + Competitive compensation package + Malpractice and tail coverage + Medical and Dental insurance, 401K, Elective Deferral Plan, and Business Expense… more
- Merck (Nashville, TN)
- **Job Description** The Regional Medical Scientific Director is a credentialed (ie, PhD, PharmD, DNP, MD) therapeutic and disease expert who engages in ... questions about Company products. The work of a Regional Medical Scientific Director is aligned to: Scientific Exchange, Research, Scientific Congress Support,… more
- Merck (Nashville, TN)
- …This person _must_ reside in the territory. **Role Summary** + The Oncology Regional Medical Scientific Director - Head & Neck Cancers/Melanoma is a credentialed ... questions about company products. The work of an Regional Medical Scientific Director is aligned to: Scientific Exchange, Research, Scientific Congress Support,… more
- Merck (Nashville, TN)
- **Job Description** We are seeking a Growth and Improvement minded Regional Medical Scientific Director (AKA Medical Science Liaison / MSL) | in Inflammatory ... our Strategic Operating Priorities. **Summary, Focus and Purpose** The Regional Medical Scientific Director ( Medical Science Liaison) is a credentialed (ie,… more