- Daiichi Sankyo, Inc. (Boston, MA)
- …pharmaceutical therapies to improve standards of care and address diversified, unmet medical needs of people globally by leveraging our world-class science and ... around rare diseases and immune disorders. Summary: The Associate Director Field Reimbursement (ADFR) is a critical front-line member...member of the DSI oncology Field Reimbursement team. The primary purpose of this role is to serve as… more
- Daiichi Sankyo, Inc. (Seattle, WA)
- …pharmaceutical therapies to improve standards of care and address diversified, unmet medical needs of people globally by leveraging our world-class science and ... around rare diseases and immune disorders. Summary: The Associate Director , Field Reimbursement (ADFR) is a critical front-line member...member of the DSI oncology Field Reimbursement team. The primary purpose of this role is to serve as… more
- Elevance Health (Atlanta, GA)
- ** Medical Director - Appeals ( Primary Care-IM or FM)** **Location: This is a hybrid position. Candidates must live within 50 miles of an Elevance Health ... opportunities. May serve as a resource to staff including Medical Director Associates. May be responsible for...the United States when conducting utilization review or an appeals consideration and cannot be located on a US… more
- Elevance Health (Los Angeles, CA)
- …prospective, inpatient, or retrospective medical records. + Extrapolates and summarizes medical information for medical director , consultants and other ... **Nurse Appeals (Quality) - California candidates only** **Location: This...Prepares recommendations to assign appropriate level or forwards to Medical Director for decision. + Ensures that… more
- The Mount Sinai Health System (New York, NY)
- …years administrative or medical office experience required , 416 - HSO Appeals Management - MSH, Mount Sinai Hospital **REQUIRED SKILLS** MS Excel MS Word ... operational details. This individual typically reports to a manager, director or division head. **RESPONSIBILITIES** 1. Serves as an...Sinai Health System is one of the largest academic medical systems in the New York metro area, with… more
- CVS Health (Columbus, OH)
- …**Position Summary** CVS Health, a Fortune 4 company, has an outstanding opportunity for a Medical Director - Medical Affairs. We need a Board Certified ... clinical product development, Enterprise Analytics, Compliance, Legal, Accreditation) and clients. The Medical Director ( Medical Affairs) will report into… more
- Evolent Health (Columbus, OH)
- …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 ... complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of...questions. + Reviews statistical sample of cases for Field Medical Director audits and makes recommendations into… more
- Molina Healthcare (Starkville, MS)
- …regulatory requirements affecting the medical and clinical staff. + Part Time Perinatal Medical Director , Based in MS **Job Duties** + Provides medical ... **JOB DESCRIPTION** **Job Summary** Responsible for serving as the primary liaison between administration and medical staff....activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. +… more
- Lancaster General Health (Lancaster, PA)
- **Summary** **Job Description** **POSITION SUMMARY:** The Associate Medical Director , Hospitalist Services is responsible for assisting the Medical ... The Associate director will report to LGHP Medical Director and have a reporting relationship...with the administrative and clinical staff of LRH. The primary function of the Associate director is… more
- AmeriHealth Caritas (Newark, DE)
- ** Medical Director , LTSS (must reside in DE)** Location: Newark, DE Primary Job Function: Medical Management ID**: 34195 **Job Brief** Qualified ... and related policy and practice initiatives in collaboration with the Corporate Medical Director (s), Senior Medical Directors, Utilization Management and… more
- State of Colorado (Denver, CO)
- …Code of Regulations (CCR) 801-1, State Personnel Board Rules and Personnel Director 's Administrative Procedures, Chapter 8, Resolution of Appeals and Disputes, ... This position is open only to Colorado state residents. Primary Physical Work Address 710 S. Ash Street, Unit...knowledge of the action: Colorado State Personnel Board/State Personnel Director , Attn: Appeals Processing, 1525 Sherman Street,… more
- Magellan Health Services (Albuquerque, NM)
- …Commercial) and implements and manages programs to support this vision. The Senior Medical Director ensures the delivery of appropriate health care by overseeing ... staff and physician advisors. Ensures adequate physician resources. Develops and manages medical director and physician advisor budgets, travel budgets, and… more
- City and County of San Francisco (San Francisco, CA)
- …reason(s) why the cited item(s) constitute(s) abuse of discretion by the Human Resources Director . Appeals must be submitted directly to the Executive Officer of ... (ZSFG), Laguna Honda Hospital and Rehabilitation Center (LHH), and over 15 primary care health centers. The Population Health Division (PHD) provides core public… more
- City and County of San Francisco (San Francisco, CA)
- …reason(s) why the cited item(s) constitute(s) abuse of discretion by the Human Resources Director . Appeals must be submitted directly to the Executive Officer of ... Trauma Center, Laguna Honda Hospital and Rehabilitation Center, and over 15 primary care health centers. The Population Health Division (PHD) provides core public… more
- State of Colorado (CO)
- …in building a brighter future for Colorado students! This role is internally titled Director of Field Services Primary Duties and Responsibilities: + Directs and ... of notice or knowledge of the action: Colorado State Personnel Board/State Personnel Director , Attn: Appeals Processing, 1525 Sherman Street, 4th Floor, Denver,… more
- State of Colorado (Denver, CO)
- RAC Program Medical Director (PART-TIME) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4658063) Apply RAC Program Medical ... abilities. We are looking for a Part-Time RAC Program Medical Director to join our Cost Control...Regulations (CCR) 801-1, State Personnel Board Rules and Personnel Director 's Administrative Procedures, Chapter 8, Resolution of Appeals… more
- Magellan Health Services (Dallas, TX)
- …quality improvement activity (QIA) in collaboration with the clinical lead senior medical director , and quality improvement staff. May participate in various ... + Participates in and maintains the integrity of the appeals process, both internally and externally. Responsible for the...committees or project teams as directed by the senior medical director or vice-president. + Supports senior… more
- City and County of San Francisco (San Francisco, CA)
- …and payment reform across the Medi-Cal program. Under the direction of the SFHN Chief Medical Officer, the CalAIM Director will manage all aspects of the CalAIM ... Laguna Honda Hospital and Rehabilitation Center, and over 15 primary care health centers. CalAIM is a multi-year initiative...item(s) constitute(s) abuse of discretion by the Human Resources Director . Appeals must be submitted directly to… more
- AdventHealth (Maitland, FL)
- …Site position** **The role you'll contribute:** As the physician advisor, the Executive Medical Director of Revenue Cycle educates, informs, and advises members ... related to denial prevention measures for our contracted managed care payers. The Medical Director is responsible for providing physician review of utilization,… more
- CareOregon (Portland, OR)
- …a federal contractor and must comply with all federal laws. Job Title Associate Medical Director - Maternal, Child, and Youth Department Medical Management ... Exempt Requisition # 24391 Direct Reports N/A Manager Title Medical Director , CPCCO Pay & Benefits Estimated...Management activities. + Provide oversight of benefit determinations and appeals for medical and pharmacy as assigned… more
