- CVS Health (Trenton, NJ)
- …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 (Trenton, NJ)
- … 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 (Trenton, NJ)
- …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 (Trenton, NJ)
- … 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 (Trenton, NJ)
- … 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 (Trenton, NJ)
- …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
- J&J Family of Companies (Spring House, PA)
- 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
- Highmark Health (Trenton, NJ)
- **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
- Spectrum Health Services (Philadelphia, PA)
- …+ Nurse Practitioner + Three years minimum managerial experience + FQHC experience preferred Keyword: Senior Medical Director From: Spectrum Health Services, Inc ... Director under the direction of the Chief Medical Officer and in collaboration with the Chief Operating...out of care. This requires working closely with the Director of Integrated Services, Case Managers, Clinicians,… more
- J&J Family of Companies (Horsham, PA)
- Director , Medical Safety Officer (Neurovascular) - 2406209070W **Description** **Johnson & Johnson, is recruiting for a Director , Medical Safety Officer ... considered. Remote work options may be considered on a case -by- case basis and if approved by the...Duties & Responsibilities:** + Assess product risk-benefit and offer medical input/review to: Risk Management Reports, Product… more
- Evolent Health (Trenton, NJ)
- …the mission. Stay for the culture. **What You'll Be Doing:** As a Behavioral Health Field Medical Director will be a key member of the utilization management ... Opportunities:** Evolent Health is looking for a Behavioral Health Medical Director to be a member of...in risk management , claim adjudication, pharmacy utilization management , catastrophic case review, outreach programs, +… more
- Humana (Trenton, NJ)
- …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
- BluePearl (Conshohocken, PA)
- …clinical experience to lead our team of emergency and specialty clinicians in the role of ** Medical Director ** . As Medical Director you will partner in ... offer a competitive salary and relocation assistance. Your primary responsibilities as Medical Director include **upholding medical quality standards**… more
- Merck (Upper Gwynedd, PA)
- **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 (Trenton, NJ)
- …**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
- NJM Insurance (Trenton, NJ)
- …This position will require some travel. The official NJM job title is Medical Management Coordinator/Field Nurse Case Manager. Job Responsibilities: + ... is results-oriented and will perform all aspects of utilization management : case management intervention, precertification,...evidence. Refer cases that don't meet established guidelines for medical necessity to Medical Director … more
- CVS Health (Trenton, NJ)
- …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 (Trenton, NJ)
- …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
- Merck (North Wales, PA)
- **Job Description** **Position Description:** **Associate Director , Policy Advocacy** The Associate Director , Policy Advocacy serves as the senior expert in the ... policy change in support of the company's business objectives. The Associate Director will proactively research and stay abreast of new strategies and tactics… more
- J&J Family of Companies (Trenton, NJ)
- …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