Medical Director: Care, Utilization & Policy Leader
100 Horizon Healthcare Services, Inc
100 Horizon Healthcare Services, Inc is seeking a Medical Director to act as a medical spokesperson and provide leadership for the provider network across New Jersey. Responsibilities include managing clinical activities, supporting the development of medical policy, and enhancing collaborative relationships with healthcare providers. The ideal candidate will possess a Board Certification, an MD or DO license, and 5-7 years of clinical experience. The role includes comprehensive health benefits and significant growth opportunities. #J-18808-Ljbffr 100 Horizon Healthcare Services, Inc
- ...Physician Medical Director Location: Hopewell, NJ 08560 Contract Duration: Two (2) Years... ...compliant, and patient-centered medical care for incarcerated individuals while... ...leadership input for operational planning and policy development. Support reporting...PolicyHourly payFull timeContract workMonday to Friday
- ...highest level of care to patients, conducting... ...educating future leaders in the field of... ...leading academic medical center means collaboration... ...? The Medical Director of the Princeton... ...coordination, utilization management, and nursing... ...organizational policies, procedures, and...Policy
$298k - $409.8k
...Become a part of our caring community The National Physician Leader relies on medical background and reviews... ...and post-acute utilization management, while also... ...post-acute medical director team for home health,... ...Employer It is the policy of Humana not to discriminate...PolicyFull timeTemporary workRemote workShift work- ...Provides high quality patient care to patients. Provides oversight of medical quality, delivery of medical care... ...monitoring ongoing compliance with policies and procedures f. Promote resident... ...: Supervisory and/or Medical Director experience highly desirable License...PolicyHourly pay
$95 - $100 per hour
...specialties and primary care, we seek to connect... ...be a key member of the utilization management team. We can... ...meet the applicable medical necessity guidelines,... ...compliance with SBU`s policies/procedures, as well as... ...assist the Senior Medical Director in research activities...PolicyPart timeWork at officeImmediate start$214.1k - $297.89k
About the Role The Medical Director is a medical spokesperson for Horizon Blue Cross Blue... ...activities include, but are not limited to, utilization management, care management, disease management,... ...medical management program. Medical Policy and HPIRIT only: The position has...PolicyContract workLive inLocal area- ...Facility in Trenton, NJ is seeking a Full Time Medical Director. The MD is a psychiatrist whose functions are diverse and ranges from direct... ...in regard to planning for individual clients or formulating policies. Great salary and benefits 90% adult population. Current New...PolicyPermanent employmentFull timeMonday to Friday
- ...Health is the region's leader in providing progressive, quality patient care with significant investments... .... Capital Health Medical Group is made up of more... ...2,142.00 The Medical Director of Maternal–Fetal Medicine... ...updates departmental policies, clinical pathways, and...PolicyFull timeTemporary workPart timeFlexible hours
$79.1k - $105.95k
...Jersey's health solutions leader driving innovations that improve health care quality, affordability,... ...of the patient are medically appropriate for inpatient... ...to coordinate resource utilization and evaluation of... ...and current organization policies. Interacts and communicates...PolicyLive inLocal areaMonday to FridayWeekend work- ...innovative and high-quality patient care, significantly investing in... ...operate two hospitals. Our medical group consists of over 250... ...$1,042,142.00 The Medical Director of Maternal-Fetal Medicine is... ...Develop and revise departmental policies, clinical pathways, and...PolicyFull timeTemporary workPart timeFlexible hours
$200k - $240k
...The Group Medical Director (GMD) is a key medical leader responsible for driving high-quality veterinary care, patient safety, and clinical excellence across multiple VCA hospitals. In this role, you will lead and mentor Medical Directors and veterinary teams, ensuring...Full time- ...providing the highest level of care to patients, conducting... ..., and educating future leaders in the field of... ...this leading academic medical center means collaboration... ...communication and/or policy changes and solicits proactive... ...weekly review overtime utilization and manage...PolicyFull timeWork at officeLocal areaImmediate start
- ...Health is the region's leader in providing progressive, quality patient care with significant investments... ...care. Capital Health Medical Group is made up of... ...,142.00 The Medical Director of Maternal-Fetal Medicine... ...updates departmental policies, clinical pathways, and...PolicyFull timeTemporary workPart timeFlexible hours
$170 - $175 per hour
...Medical Director Req number: R7707 Employment type: Full time... ...Medical Director to ensure utilization management responsibilities... ...escalated cases against medical policy criteria, which may include... ...with community standards of care Participate as a member...PolicyHourly payFull timePrivate practiceWork at officeLocal areaRemote workWorldwide$45 per hour
...your job look like? The Medical Director will provide clinical... ...Medicaid experience, expertise in utilization review, and a collaborative... ...approach to improving access to care. This position is... ...Review and approve medical policies related to transportation eligibility...PolicyContract workCasual workLocal area$223.8k - $313.1k
...Become a part of our caring community The Medical Director relies on fundamentals of CMS Medicare Guidance... ...guidelines, CMS requirements, Humana policies, clinical standards, and applicable... ...~ Intermediate to advanced skills utilizing Microsoft Office and Internet navigation...PolicyFull timeTemporary workApprenticeshipWork at officeRemote workWork from homeHome officeMonday to Friday$227.6k
...part of a physician team, ensures that utilization management responsibilities are performed... ...cases electronically and using Medical Policy criteria sets to evaluate the medical necessity... ...to help support and improve the care of our members ESSENTIAL RESPONSIBILITIES...PolicyFor contractorsPrivate practiceWork at officeLocal area$223.8k - $313.1k
...Become a part of our caring community The Medical Director uses their medical background, experience, and judgement... ...national clinical guidelines, CMS policies and determinations, clinical... ...structured and mentored training programs; utilize ongoing team support during daily...PolicyBi-weekly payFull timeTemporary workApprenticeshipRemote workWork from homeHome office$39.4 - $51.47 per hour
...Health is the region's leader in providing progressive, quality patient care with significant investments... ...care. Capital Health Medical Group is made up of... ...conduct continued stay utilization review activities with... ...applicable regulations, policies and timelines. Adheres...PolicyFull timeTemporary workPart timeWork at officeLocal areaImmediate startFlexible hoursNight shiftWeekend workDay shift$340.87k - $413.05k
...Clinical Development Team Leader sits within Clinical... ...Development, Regulatory, Medical, Commercial and other... ...pharmacy, dental, and vision care. Wellbeing Support:... ...data privacy policies and regulations. If... ...R1601919 : Executive Director, Clinical Development Team...PolicyHourly payFull timeTemporary workPart timeFor contractorsSummer workLive inWork at officeLocal areaRemote workFlexible hoursShift work$223.8k - $313.1k
...Become a part of our caring community The Medical Director relies on medical background and reviews health... ...Medicine, or those experienced in Utilization Review are encouraged to apply.... ...guidelines, CMS regulations, Humana policies, and recognized clinical standards...PolicyBi-weekly payFull timeTemporary workApprenticeshipWork at officeLocal areaRemote workWork from homeHome officeMonday to FridayWeekend work$85k - $143k
...regulatory and FMS policy requirements.... ...of quality patient care while maintaining... ...policies as the clinical leader, has the authority... ...integrity of medical records and other... ...collaboration with the Director. Plans,... ...Responsible for efficient utilization of medication,...PolicyFull timeTemporary workWork experience placementLocal areaImmediate startRelocation package$87.3k - $119.07k
...health solutions leader driving innovations... ...that improve health care quality,... ...customer and contain medical claims cost. This... ...consistent with Horizon's policies and procedures and... ...between Medical Directors, Management leadership... ...knowledge of Utilization Management (UM) and...PolicyFull timeLive inLocal areaRemote work- ...Statewide Associate Medical Director UCHC Administration... ...University Correctional Health Care (UCHC), operating... ...committed to being a leader in the delivery of effective... ...Equipment Utilized Physical Demands and... ...Requirements Under Policy 100.3.1 Immunization Policy...PolicyFull timeSeasonal workFlexible hoursShift work
$79.1k - $158.2k
...decisions and better patient care. We want people just as dedicated... ...on customer success in utilizing Oracle's solutions. Using... ...and organizational security policies and procedures, understand personal... ...includes the following: # Medical, dental, and vision insurance...PolicyTemporary workWork experience placementLocal areaRemote workFlexible hours$120 - $135 per hour
...across specialties and primary care, we seek to connect the pieces of... ...Doing: As a Cardiology, Field Medical Director you will be a key member of the utilization management team. We can offer... ...utilization and compliance with SBU`s policies/procedures, as well as...PolicyWork at officeImmediate start- ...for an outstanding opportunity?NOW HIRING: Medical Director ResponsibilitiesWork directly with providers to educate them on our care process and determine what can be done to... ...clinical services such as cost management, utilization review, quality assurance, and medical...Permanent employmentImmediate start
$30k
...Health Care Director A certified Great Place To Work (voted by associates) 7 years in a row... ...performance) ~ Mileage reimbursement ~ Medical, Dental, Vision offerings) ~ Company... ...accepted on an ongoing basis. It is the policy of Legend Senior Living to provide equal...PolicyLocal areaWeekend workAfternoon shift$230.9k - $384.8k
...Oncology Field Medical, Director (MD), Solid Tumors and Early Pipeline... ...applicable Pfizer guidelines, policies, and procedures Leads advisory... ...evolving external health care environment Demonstrate change... ...skills Rapidly adopt and utilize new digital technology and...PolicyPermanent employmentH1bLocal areaRemote workVisa sponsorshipWork visaRelocation packageFlexible hours- ...Registered Nurse-Utilization Review One of our direct client is looking... ...Emergency room or intensive care units. We get a variety of... ...pediatric members with various medical conditions and will process... ...practice and current organization policies. Interacts and...PolicyLocal area
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