- Elevance Health (Phoenix, AZ)
- …plans in partnership with blue cross blue shield plans. The Medical Director is responsible for the administration of physical and/or behavioral health medical ... of care opportunities. May serve as a resource to staff including Medical Director Associates. May be responsible for an entire clinical program. **This position… more
- CVS Health (Phoenix, AZ)
- …Internal Medicine / Pediatrics (Med / Peds) Board Certification. In the Medical Director role, you will provide oversight for medical policy implementation. You will ... ensuring timely and consistent responses to members and providers. As a Medical Director you will focus primarily on review appeal cases for denied medical services.… more
- Evolent Health (Phoenix, AZ)
- …Through strong organizational practices and attention to detail the Behavioral Health UM Team supports a range of managed care populations including Medicaid, ... Identifies and refers cases not meeting established clinical criteria to the Medical Director Review. + Identifies and escalates quality of care issues to the… more
- Highmark Health (Phoenix, AZ)
- …in the capacity as a clinical pharmacist the incumbent may also review UM requests; provide consultation into the case and disease management identification process, ... overall efficiencies. + Manage individual projects for timely review with the Director , Clinical Pharmacy. + Participate in Medicare Stars performance measures to… more