- Prime Therapeutics (Hartford, CT)
- …It fuels our passion and drives every decision we make. **Job Posting Title** Senior Director Clinical Account Management - Remote **Job Description** The Sr ... Director of Clinical Account Management is responsible for providing...new ideas and work collaboratively to provide the highest quality of care and service to our members. If… more
- Northeast Family Services (West Springfield, MA)
- …developed and assigned within the state of Massachusetts. The Clinical Director is responsible for the effective management of services including oversight ... management responsibilities over behavioral health options. The Clinical Director is a data-driven leader who...a strong emphasis on, and an understanding of, financial management , strategic planning, client care, quality assessment… more
- Merck (Hartford, CT)
- …with all groups within GCTO, especially with Clinical Sciences and Study Management (CSSM), Clinical Quality Managers (CQMs) and Regional Operations ... **Job Description** The Clinical Research Director (CRD) is the...ensure appropriate scientific and operational training for staff members. ** Clinical Operation Management :** + Ensures a single… more
- Humana (Hartford, CT)
- …analytic and interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , ... decisions to internal associates, and possible participation in care management . The clinical scenarios predominantly arise from...size of region or line of business. The Medical Director conducts Utilization Management of the care… more
- Hartford HealthCare (Hartford, CT)
- …to the Regional VP, Medical Affairs and in collaboration with the System Chief Quality Officer, the Medical Director is a member of the Regional Executive ... Leadership Team. As part of the regional Quality leadership dyad with the Director ...requirements, and accreditation standards. * Advanced degree in healthcare management , quality improvement, or a related field.… more
- Humana (Hartford, CT)
- …analytic and interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , ... decisions to internal associates, and possible participation in care management . The clinical scenarios arise from outpatient,...Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of the care… more
- Humana (Hartford, CT)
- …analysis and interpretation skills with 5+ years of experience focusing on quality management , utilization management , discharge planning, rehabilitation ... Integration, Long Term Services & Supports, and Case Management . The Medical Director , as indicated, could...10 weekends per year. **Additional Information** + The Medical Director conducts clinical reviews of the care… more
- Evolent (Hartford, CT)
- …impact on patient care in a non- clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your ... discussions with treating providers to ensure appropriate, high-value care aligned with clinical guidelines. + Collaborate with leadership, management , and … more
- Humana (Hartford, CT)
- …as an MBA, MHA, MPH + Prior experience participating in teams focusing on quality management or utilization management . **Additional Information** Reports to ... hospitals/ Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Prefer Medical...a Lead Medical Director . The Medical Director conducts Utilization Management of the care… more
- Humana (Hartford, CT)
- …analytic and interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , ... hospitals/ Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization ...size of region or line of business. The Medical Director conducts Utilization Management of the care… more
- Humana (Hartford, CT)
- …communication of decisions to internal associates, and possible participation in care management , with clinical scenarios arising from outpatient or inpatient ... license, if required . At least five years of experience post-training providing clinical services . Experience in utilization management review and case … more
- Evolent (Hartford, CT)
- … Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + On a requested ... **What You'll Be Doing:** As a Cardiology, Field Medical Director you will be a key member of the...Vascular Surgery or Adult Congenital Heart Disease + Strong clinical , management , communication, and organizational skills +… more
- Merck (Hartford, CT)
- **Job Description** The Executive Director (ED) for Field Medical Affairs in the US understands our Company's corporate and products/portfolio strategies and work ... and successfully in a highly matrixed environment is critical. The Executive Director provides strategic and tactical direction to the field Regional Medical… more
- Evolent (Hartford, CT)
- … and next generation idea and value creation. + Provide ** clinical ** **expertise** **in** **utilization** ** management (UM),** ensuring high-value care ... policies and regulatory requirements. + Collaborate with cross-functional teams, including ** clinical reviewers, management , and senior leadership,** to improve… more
- CVS Health (Hartford, CT)
- …Leads all aspects of utilization review/ quality assurance, directing case management Provides clinical expertise and business direction in support of ... transparent and consumer-focused, and it recognizes physicians for their clinical quality and effective use of health...medical management programs through participation in clinical team… more
- CSL Plasma (Manchester, CT)
- …as or delegates to another appropriate physician the duties of "laboratory director ", "technical consultant", or " clinical consultant" as prescribed by the ... as the primary center physician registered as the Laboratory Director with the Food and Drug Administration (FDA). **Job...that cGMPs are adhered to through involvement with center management , center quality unit, and overall center… more
- Evolent (Hartford, CT)
- … Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + Participates in ... culture. **What You'll Be Doing:** As a Field Medical Director you will be a key member of the...needs + Active Board Certification in Pulmonology + Strong clinical , management , communication, and organizational skills +… more
- The Cigna Group (Bloomfield, CT)
- …in a post-acute care facility, focusing on discharge planning, complex medical care management , quality of care, appropriate level of care, and appropriate ... **Summary:** The Medical Director provides timely expert medical review of medical...timely expert medical review of medical necessity requests for clinical services that do not meet utilization review criteria… more
- The Cigna Group (Bloomfield, CT)
- Medical Director - Pediatric Surgery- Evicore- Remote **We have both full-time and part-time opportunities available.** Do you crave an intellectually stimulating ... job that allows you to leverage your clinical expertise while developing new skills and improving the...Then look no further! As a Pediatric Surgery Medical Director at Evicore part of Evernorth Health Services, a… more
- Molina Healthcare (Springfield, MA)
- …education outreach programs and interventions align with our population health and quality strategies. The Director uses risk stratification and segmentation of ... **JOB DESCRIPTION** **Job Summary** The Director , Health Equity and Cultural Competency is accountable...focus on integrated care, wellness and prevention, chronic condition management , resource navigation, and SDOH, and are supported by… more