- CVS Health (Richmond, VA)
- …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
- Humana (Richmond, VA)
- … 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 (Richmond, VA)
- …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 (Richmond, VA)
- … 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
- HCA Healthcare (Dulles, VA)
- …patient. The CM collaborates with the Rehab Program Director and Facility Case Management Director regarding departmental functions. The CM coordinates ... you have the PRN career opportunities as a RN Case Management PRN you want with your...colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no… more
- Humana (Richmond, VA)
- … 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 (Richmond, VA)
- …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 (Richmond, VA)
- **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 (Richmond, VA)
- 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
- Elevance Health (Roanoke, VA)
- …Operations Associate Medical Director ** is responsible for supporting the medical management staff ensuring timely and consistent medical decisions ... member of the Elevance Health family of companies, Carelon Medical Benefits Management , formerly AIM Specialty Health,...attention, any case review decisions that require Medical Director review or policy interpretation. **Minimum… more
- Humana (Richmond, VA)
- …risks. + Develops and achieves performance metrics for a fast-paced comprehensive case management environment. + Assures contractual compliance with mandated and ... corporate policies regarding other departmental areas such as medical management , utilization management , population health and quality. + May require cross… more
- ACI Federal (Norfolk, VA)
- …REQUIREMENTS: Knowledge: * State Licensure Requirements * Consumer Rights Regulations * Case Management Components * Available community resources * Psychotropic ... services field related to the area of assignment, to include work in case management . Some assignments also require specific experience working with various… more
- Evolent Health (Richmond, VA)
- …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
- Parsons Corporation (Springfield, VA)
- …contractors within the Intelligence Reform and Terrorism Prevention Act (IRTPA) and Director of National Intelligence (DNI) mandated timelines. + Monitor all case ... + Ensure no errors are detected and that all case data entry is current and accurate in the...status reports on mandated timelines. + Accurately create the Director of National Intelligence (DNI) Quarterly Metrics reports and… more
- Humana (Richmond, VA)
- …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
- ChenMed (Hampton, VA)
- …treatment, development of the plan of care, health education, specialty referrals, case management referrals, follow-up and clear documentation according to ... teams in quality and performance improvement initiatives + Must successfully complete full medical director training prior to promotion to Senior Medical … more
- Merck (Richmond, VA)
- **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 (Richmond, VA)
- …**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
- Fairfax County Sheriff's Office (Fairfax, VA)
- …Program, Facility Management , and Emergency and Continuity of Operations Planning. Case management includes management of a Pretrial Evaluation Program, ... the administrative direction of the Deputy County Executive, the Director is responsible for the overall management ...legal requirements and best practices in the areas of case management , including pretrial supervision (both incarcerated… more
- CVS Health (Richmond, VA)
- …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