- CVS Health (Columbia, SC)
- …continuum of our members' health care and social determinant needs. The Duals Care Management (CM) Medical Director will participate in designing, developing ... and socioeconomic needs. * Partner closely with the Executive Director of Duals and other Duals Care Management...and quality objectives are met. * Consults with plan medical staff regarding adverse determinations, addresses issues related to… more
- HCA Healthcare (Summerville, SC)
- …position is incentive eligible. **Introduction** Do you have the career opportunities as a(an) Director Case Management you want with your current employer? ... have an exciting opportunity for you to join Summerville Medical Center which is part of the nation's leading...of colleagues. Do you want to work as a(an) Director Case Management where your… more
- Humana (Columbia, SC)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members ... caring community and help us put health first** The Medical Director relies on medical ...in teams focusing on quality management , utilization management , case management , discharge planning… more
- Humana (Columbia, SC)
- …relationships, value-based care, quality metrics, population health, and disease or care management . The Behavioral Health Medical Director may develop ... and help us put health first** The Behavioral Health Medical Director is responsible for behavioral health...in teams focusing on quality management , utilization management , case management , discharge planning… more
- Humana (Columbia, SC)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members ... caring community and help us put health first** The Medical Director actively uses their medical...in teams focusing on quality management , utilization management , case management , discharge planning… more
- Humana (Columbia, SC)
- … medical management operational improvements, including those within the medical director area + Participate in call rotation + Develop collaborative ... in teams focusing on quality management , utilization management , case management , discharge planning...on size of region or line of business. The Medical Director conducts Utilization Management … more
- Evolent Health (Columbia, SC)
- …training classes as needed for new hires to educate and train on Utilization management system and Field Medical Director process, standards and resources. ... Evolent for the mission. Stay for the culture. **What You'll Be Doing:** As a Medical Director for the Musculoskeletal department, you will be a key member of… more
- Highmark Health (Columbia, SC)
- **Company :** Endorsed **Job Description :** **GENERAL OVERVIEW** The Medical Director will provide qualified medical direction and consultation for care ... delivery and complex case management for our community-based palliative care...leadership and guidance to the regional interdisciplinary team. The medical director collaborates clinically with the APP… more
- J&J Family of Companies (Columbia, SC)
- Director , Regulatory Medical Writing (1 of 4)...countries. Remote work options may be considered on a case -by- case basis and if approved by the company. ... - 2406211847W **Description** Johnson & Johnson is currently seeking a Director , Regulatory Medical Writing. The primary location for this position is the United… more
- Evolent Health (Columbia, SC)
- …for the mission. Stay for the culture. **What You'll Be Doing:** As a Field Medical Director - Physical Health, you will be a key member of the utilization ... jeans. **Collaboration Opportunities:** Evolent is looking for a Field Medical Director to be a member of...in risk management , claim adjudication, pharmacy utilization management , catastrophic case review, outreach programs, +… more
- Humana (Columbia, SC)
- …our caring community and help us put health first** The Behavioral Health Medical Director responsible for behavioral health care strategy and/or operations. The ... Behavioral Health Medical Director work assignments involve moderately complex...experience post-training providing clinical services + Experience in utilization management review and case management … more
- HCA Healthcare (Walterboro, SC)
- …patient. The CM collaborates with the Rehab Program Director and Facility Case Management Director regarding departmental functions. The CM coordinates ... Registered Nurse + Registered Nurse Diploma + Prior Case Management experience is preferred. Colleton Medical Center (https://colletonmedical.com/) provides… more
- Merck (Columbia, SC)
- **Job Description** The Executive Director , Global Medical and Scientific Affairs (EDMA) GYN Malignancies is accountable for the development and execution of ... scientific & medical affairs Value and Implementation (V&I) plans for their...and Implementation (V&I) plan, in collaboration with the Executive Director of Scientific Affairs (EDSA), that guides TA scientific… more
- CVS Health (Columbia, SC)
- …**Position Summary** Aetna, a CVS Health Company, has an exciting opportunity for a Medical Director (Cardiology) that can be remote based, work from home. This ... can be remote based anywhere in the US. The Medical Director (Cardiology) will be a Subject...will lead all aspects of utilization review/quality assurance, directing case management . In this role you will… more
- CVS Health (Columbia, SC)
- …role and have a current state medical license without encumbrances.** In the Medical Director role you will provide oversight for medical policy ... evaluation of clinical/ medical programs and expand Aetna's medical management programs to address member needs...In addition you will oversee utilization review/quality assurance, directing case management . In this role you'll provide… more
- Highmark Health (Columbia, SC)
- …URAC, CMS, DOH, and DOL regulations, etc.). Ensure that all aspects of the medical management process are consistent with community standards of care. + ... outpatient, or private practice) **Preferred** + 1 year in Medical Management in a Health Insurance Plan;...need. **Preferred** + None **SKILLS** + Critical Thinking + Case Management + Customer Service + Oral… more
- J&J Family of Companies (Columbia, SC)
- …able to thrive in a matrixed environment. Ability to build an effective business case and project management . Track record of successful leadership skills in the ... Director , Global Brand Protection Capabilities & Technology -...stakeholders (internally / externally) to develop an effective business case , strategies, and tactics to address and mitigate brand… more
- J&J Family of Companies (Columbia, SC)
- …processing, reporting and evaluation of adverse events * Understanding in single case medical assessment, post-marketing aggregate adverse event data reviews, ... Associate Director , Signal Detection Scientist - 2406212640W **Description** Johnson...the US or UK may be considered on a case -by- case basis and if approved by the… more
- J&J Family of Companies (Columbia, SC)
- Director , Health Economics and Market Access - Wound...candidates. Remote work options may be considered, on a case -by- case basis and if approved by the ... Healing and Biosurgery - 2406204292W **Description** Johnson & Johnson is recruiting a Director , Health Economics & Market Access (HEMA) for the Johnson & Johnson… more
- J&J Family of Companies (Columbia, SC)
- …to have but not required. * MS Office Tools * Investigations and Intelligence Case Management Systems experience * Fluency in English * Strong executive ... Director , Product Security Investigations & Intelligence - 2406207568W...security investigations and intelligence strategy, value recovery targets, ensure case and intelligence management systems effectiveness, and… more