Inpatient Medical Director: Utilization Review Expert
Humana
A leading healthcare company seeking a Medical Director to conduct clinical reviews and evaluate health claims. This role requires a physician with significant clinical experience and strong analytical skills. Responsibilities include reviewing inpatient medical records and ensuring compliance with healthcare standards. The position offers opportunities for impactful contributions to patient care without the demands of regular bedside duties. Excellent benefits and a supportive work environment are provided. #J-18808-Ljbffr
$223.8k - $313.1k
...caring community The Medical Director relies on medical background and reviews health claims. The... ...advancing the quality of inpatient care through clinical... ...those experienced in Utilization Review are encouraged... ...Role Overview Perform expert clinical review of...SuggestedBi-weekly payFull timeTemporary workApprenticeshipWork at officeLocal areaRemote workWork from homeHome officeMonday to FridayWeekend work- ...seeking an enthusiastic and highly skilled Medical Director to join our growing team. This... ...responsible for overseeing and performing utilization reviews, prior authorizations, and making... ...Director will serve as a key clinical expert, ensuring appropriate resource...SuggestedFull timeRemote workFlexible hours
- A health insurance startup is looking for an experienced Medical Director to oversee utilization reviews and prior authorizations. This remote position demands a strong clinical background with a doctorate in medicine and board certification. The ideal candidate will have...SuggestedRemote jobFlexible hours
- A healthcare company is seeking an experienced Inpatient Medical Facility Coder to join their team in Temple, TX. You will be responsible for reviewing and coding inpatient medical records, ensuring accurate billing and compliance with regulations. Ideal candidates will...Suggested
- ...APRN or PA with hematology/oncology experience to provide specialized care at Dell Children's Medical Center in Austin, Texas. Responsibilities include delivering inpatient care, coordinating support for families, and ensuring accurate documentation. Ideal candidates...SuggestedFull time
- Job Summary The Medical Director of Integrated Psychiatry is a senior clinical leader... ..., supervision, and case review with psychiatric providers, primary... ...emphasis on: Reducing avoidable inpatient and emergency department utilization Improving engagement, continuity...Work at officeLocal areaShift work
$234k
...the state. Read more about THA here: Medical Director is a licensed Physician who provides clinical... ...patient examinations: medical history reviews, physical assessments, and diagnostic... ...participating in resource and utilization management. This may include but is not...Temporary workRelocation packageWeekend work- DESCRIPTION We are seeking an HBM/DDRx PHY expert for Annapurna Labs, part of the AWS Utility Computing organization. The role focuses on the definition, design... ...collect data across the fleet. Participate in code reviews, design discussions, team planning, and metrics/COE...
- UnitedHealth Group is looking for a Behavioral Medical Director to lead the Utilization Management Program. This role includes managing peer reviews and interacting with clinical professionals to enhance care quality. The position supports the development of evidence-based...Remote job
- The Behavioral Medical Director position is responsible for providing oversight to and direction of the Utilization Management Program and performing peer reviews as necessary. This individual will interact directly with Psychiatrists, Behavioral Health Providers, and other...Remote jobMinimum wageWork experience placementLocal area
- Britt Medical is actively searching for a BC Physiatry Medical Director to join our physician-led group based in Austin, Texas. This role offers flexibility as an independent contractor (1099) or employed (W2) with a comprehensive benefits package including malpractice...For contractors
- ...Hospice Medical Director Expand Access. Build Partnerships. Transform... ...leadership team and provide expert clinical oversight to our hospice... ...and support regulatory reviews. Participate actively in... ...management. Monitor pharmacy utilization, ensuring appropriate...Daily paidFull timePart timeLocal area
- ...are seeking a dedicated Hospice Medical Director to join our leadership team and provide expert clinical oversight to our... ...documentation and support regulatory reviews. Participate actively in... ...management. Monitor pharmacy utilization, ensuring appropriate medication...Daily paidFull timePart timeLocal area
- ...seeking a highly skilled and experienced Expert Workfront Architect (Adobe Practice) to... ...best practices and business requirements, utilizing features like scenarios, modules, and... ...platform’s effectiveness. Conduct regular reviews and assessments to ensure the platform...Work experience placementLocal areaRemote work
- ...Consumer Complaints Investigator (Investigator III).The Public Utility Commission of Texas (PUCT) has an opportunity for a motivated professional... ...surrounding communities.If... Show more Permanent This is a Review Appraiser position with USACE, Southwestern Division (SWD), Ft...Permanent employmentFull timeFor contractors
- ...PMO Leaders - Subject Matter Expert About Prolific Prolific is... ...Professional Experience: Director-level or above experience in... ...Services, Financial Services, Utilities, or Government. Domain Knowledge... ...processes. Scenario Review: apply your real-world experience...Hourly payWork from homeFlexible hours
- A leading addiction treatment facility in Texas is seeking an experienced Compliance Manager. This role involves overseeing regulatory compliance, conducting audits, and providing staff training to ensure adherence to federal, state, and accreditation standards. Candidates...
$188.5k - $235.6k
...gynecologic oncology as an Associate Medical Director at Natera. In this clinical... ...that demonstrate clinical utility in gynecologic oncology,... ...relationships with external experts, clinical investigators,... ..., data interpretation, peer-reviewed publications, and congress submissions...Immediate startWorldwide- ...Job Description The Medical Director will lead and manage critical care Physicians as well as serve Physicians and allied health professionals... ...Ascension Seton Medical Center Austin Critical Care and Inpatient Pulmonary MICU Daily Volume: 55 Inpatient Consult...
- ...Senior Market Medical Director Landmark Health, part of the Optum and UnitedHealth Group family... ...and present at quarterly business reviews Other duties as assigned by the Regional... ..., and environment to most effectively utilize the resources that are available to...Work at officeLocal area
- ..., and drive lasting results on the P&L. Role Overview: Reviewing AI training problems and research environments built for a frontier... ...: ~ Engagement type : Contractor assignment/freelancer (no medical/paid leave) Interested? Complete this quick application...Contract workFor contractorsFreelanceImmediate startRemote work
- ...Sales And Service Expert The Sales and Service Expert (SSE) delivers an outstanding and well-rounded sales and service experience to... ...expected to perform other duties as assigned. This job may be reviewed as duties and responsibilities change with business necessity....Work experience placementWork at officeLocal area
$8 - $65 per unit
...Prolific is seeking Mental Health Professionals to train AI models. Join our Expert Network for flexible hours and competitive pay ranging from $8 to $65 per task. Responsibilities include reviewing AI responses, analyzing content, and providing feedback to improve AI...Remote workWork from homeFlexible hours- ...is seeking a board‑certified Physiatrist (PM&R) to serve as Medical Director , providing clinical oversight and leadership across our post... ...across assigned facilities. Conduct structured remote chart reviews, documentation oversight, and compliance audits. Review and co...Full timePart timeRemote workFlexible hours
- ...dynamic alignments) to assure function, medical efficacy, and quality of work are appropriate... ..., and other Clinicians, as appropriate. Utilizes effective materials management, quality,... ...managers and other referral sources to review services and capabilities; develop and enhance...Temporary workWork at officeLocal areaFlexible hours
- ...Your Healing Mission Matters As a Medical Director with Central Texas Rehabilitation Hospital you will be inspired by the community you... ...is seeking a Medical Director to provide care at our 50 bed inpatient rehabilitation facility that serves patients in need of comprehensive...For contractorsLive inLocal areaFlexible hours
$230.9k - $384.8k
...SUMMARY The Specialty Care Field Medical, Director is responsible for providing... ...required Subject matter expert recognized across internal... ...technical skills Rapidly adopt and utilize new digital technology and... .... Subject to further legal review and statutory or regulatory...Permanent employmentH1bLocal areaRemote workVisa sponsorshipWork visaRelocation packageFlexible hours$86.8k - $173k
...FirstNet Authority. Required Qualifications Expert in the data and AI management field with... ...network architecture critical design reviews. Knowledge of wireless network coverage... ...disability, pregnancy/childbirth and related medical conditions, veteran or military status,...Full timeContract workPart timeLocal area- Job Title Haitian Creole Bilingual Expert Job Type Contract (Full-time or Part-time) Location Remote Job Summary Join our customer... ...transcription, linguistic analysis, and nuanced communication reviews. Key Responsibilities Transcribe and translate video content...Full timeContract workPart timeRemote work
- ...play a crucial role in patient care and collaboration with a growing team at Dell Children's Medical Center. Your responsibilities will include outpatient clinics, inpatient consultations, and supervising advanced practice providers. Join a team dedicated to exceptional...Full time
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