Medicare Medical Director — Utilization & Care Oversight
Humana Inc
Humana Inc is seeking a Medical Director in Phoenix, AZ, who will leverage their medical expertise to evaluate preauthorization requests for services. The role involves overseeing clinical operations, making complex medical determinations, and ensuring compliance with regulations. The ideal candidate will have extensive clinical experience, strong analytical skills, and the ability to communicate with various stakeholders, including external physicians. In addition to a competitive salary, we offer comprehensive benefits including health coverage and a supportive work environment. #J-18808-Ljbffr Humana Inc
Vacancy posted 1 day ago
Similar jobs that could be interesting for youBased on the Medicare Medical Director — Utilization & Care Oversight in Phoenix, AZ vacancy
$174.07k - $374.92k
Medical Director - Mercy Care page is loaded## Medical Director - Mercy Careremote type: Remotelocations... ...Director role you will provide oversight for medical policy implementation.*... ...will focus primarily on overseeing utilization review and quality assurance while being...SuggestedHourly payFull timeTemporary workLocal areaRemote workWork from homeNight shiftWeekend work$210k
...Bi-Lingual Medical Director Vamos Health is a Primary Care clinic offering services in both English and Spanish... ...0 per week). Provide medical oversight and guidance for clinical staff,... ...insight with COO for peer review, utilization management, and provider...Suggested- ...Description The Regional Medical Director for Musculoskeletal Value-Based Care (VBC) is responsible... ...leadership and clinical oversight for all MSK value-based... ...’s goals for quality, utilization, and cost management.... ...environment (such as ACO, Medicare Advantage, risk-bearing...SuggestedContract workLocal area
HOPCo
Phoenix, AZa month ago $269.5k - $425.5k
...Primary Care Medical Director Optum Arizona is seeking a Primary Care Medical Director to join... ...Responsibilities: Provide clinical oversight and leadership to the primary care... ...value-based care models. Analyze and utilize data to drive decision-making and improve...SuggestedMinimum wageWork experience placementLocal areaWork from homeRelocationUMR
Phoenix, AZ14 days ago- ...Inc. is seeking a Jail Intake Associate Medical Director in Phoenix, AZ. This leadership role provides clinical and administrative oversight in a fast-paced correctional health environment... ...populations, ensuring high-quality care, supporting quality improvement initiatives...Suggested
$137 - $145 per hour
TEEMA is seeking a Behavioral Health Medical Director for a fully remote, temp‑to‑perm opportunity with a nationally... .... The ideal candidate will provide clinical oversight and behavioral health consultation in a managed care environment while residing in an approved state...Remote jobPermanent employmentTemporary work$223.8k - $313.1k
...Overview Become a part of our caring community and help us put health first The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing Home Health... ...Intermediate to advanced skills utilizing Microsoft Office and Internet navigation...Full timeTemporary workApprenticeshipWork at officeRemote workWork from homeMonday to FridayHumana
Phoenix, AZ1 day ago- ...SafetyCall International is seeking a Medical Director to oversee clinical operations and ensure effective care delivery. This role involves conducting coverage reviews and collaborating with providers across various health services. The ideal candidate will have extensive...Remote work
SafetyCall International PLLC
Phoenix, AZ3 days ago $223.8k - $313.1k
...A leading healthcare company in Arizona is seeking a Medical Director to conduct clinical reviews of inpatient records and support decision-making for patient care. The role requires an MD or DO with over five years of clinical experience and strong analytical and communication...Remote workMonday to FridayHumana
Phoenix, AZ2 days ago$223.8k - $313.1k
...Become a part of our caring community The Medical Director uses their medical background, experience, and judgement... .... Medical Directors will learn Medicare and Medicare Advantage requirements... ...and mentored training programs; utilize ongoing team support during daily work...Bi-weekly payFull timeTemporary workApprenticeshipRemote workWork from homeHome officeHumana
Phoenix, AZ5 days ago$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.... ...utilization management or inpatient review (Medicare Advantage, Managed Medicaid, or...Bi-weekly payFull timeTemporary workApprenticeshipWork at officeLocal areaRemote workWork from homeHome officeMonday to FridayWeekend workHumana
Phoenix, AZ5 days ago- The CORE Institute is seeking a Regional Medical Director for Value Based Care in Phoenix, Arizona. This leadership role focuses on the oversight of musculoskeletal value-based care initiatives, aiming to improve quality, outcomes, and patient experience. The candidate...
- ...lead and provide professional oversight for medical management activities related to utilization management, case management, disease... ...to drive value and quality of care. Work collaboratively with... ...Credentialing Committee, Medical Directors Committee, and Medical...Work at officeRemote work1 day per week
- Job Purpose The Medical Director - Primary Care provides clinical and administrative leadership for Denova’s Primary Care services through a dyad... ...meet federal, state, and regulatory standards (including Medicare/Medicaid compliance). Develop, review, and approve Primary...Full timeTemporary work
- Medical Director (IM / FM / Geriatrics) - Post-Acute Care - Northern AZ Opportunity Highlights Full-time 4-5 days/week post-acute care leadership role Skilled nursing facility / rehab setting with strong autonomy Established clinical and administrative support team...Full timeLocal areaFlexible hoursWeekday work
- Necnic Group Healthcare Recruitment is seeking a Medical Director for a full-time leadership role in post-acute care located in Northern Arizona. The position in a skilled nursing facility includes responsibilities for patient assessments, care management, and leading quality...Full timeFlexible hours
- ...divh2Medical Director, Behavioral Health/h2pLocation... ...DC, WA, WI, WY)/ppThe Medical Director, Behavioral Health... ...provides clinical oversight for behavioral health... ..., ensuring quality of care, and supporting integrated... .../liliAdvise utilization management, quality management...Immediate startRemote work
- ...Clinical Laboratory Medical Director TGen, the Translational Genomics... ...TGen is our belief that by utilizing the latest technologies and... ...for improvements in patient care. In short, our science-led business... ...Medical Director to provide oversight for the overall operation...
The Translational Genomics Research Institute
Phoenix, AZ5 days ago - ...Senior Regional Medical Director Phoenix, Arizona, United States Position... ...) is responsible for the oversight of all Medical Staff within... ...cost-effective endovascular care across all service lines.... ...conversion, modality mix and utilization. Monitor and improve clinical...Work at officeRelocation package
United Vein & Vascular Centers
Phoenix, AZ4 days ago $205k - $325k
...As our Jail Intake Associate Medical Director, you will provide clinical and administrative oversight for physicians and advanced practice... ...high-quality, evidence-based care for a diverse and complex... ...Us It's time for you to utilize and perfect your talents. Correctional...Shift workNight shiftDay shiftMaricopa County
Phoenix, AZ24 days ago- ...Specialist in the Office of the Medical Center Director reports to a senior member... ...Health Systems Specialist utilizes specialized knowledge of... ...problems arising from quality of care issues and consumer... ...or she is assigned); and 3) Oversight by an experienced health system...Permanent employmentFull timePart timeSeasonal workWork at officeTrial periodRelocation packageMonday to Friday
VETERANS HEALTH ADMINISTRATION
Phoenix, AZ2 days ago - ...Summary Advise clients on network strategy, utilization performance, and provider market... ...Understanding of service line strategy and site-of-care optimization (ASC vs HOPD, home-based... ...competitive suite of benefits including medical, dental, vision, life, and long-term...Live inWork at officeLocal areaWork from home
Accenture
Scottsdale, AZ3 days ago - ...exciting opportunity for an Associate Medical Director to join a young, national group in... ...the senior patients in a Value Based Care model. Care for 12-14 patients per day... ...medical operations, ensuring compliance with Medicare and other healthcare regulations....Full time
Provenir Healthcare
Phoenix, AZ3 days ago $60.52k - $129.62k
...time Clinical Case Manager for Behavioral Health, located in Maricopa County, Arizona. This telework role involves utilizing clinical skills to coordinate care for members, including evaluation and documentation processes. Candidates should possess an active Arizona...Remote jobFull time- ...Job Description Job Description Medical Director, Adult Congenital Heart Disease (ACHD)... ...delivering exceptional, patient-focused care and is eager to enhance the lives of adults... ...strategic vision and clinical oversight. Drive initiatives for program expansion...
Phoenix Children's
Phoenix, AZ11 days ago - ...the Valley is a national leader in hospice care and has been serving the Phoenix... ...Creates timely and accurate documentation. Utilizes resources effectively and efficiently.... ...Minimum one year of recent experience in medical, surgical or critical care as a professional...Flexible hours
Hospice of the Valley
Peoria, AZ4 days ago $113k - $132k
...lead the design and configuration of clinical workflows, impacting care management operations in healthcare payer organizations. The... ...comprehensive salary range of $113K-$132K and includes benefits like medical insurance, paid time off, and a 401(k) plan. #J-18808-Ljbffr...Remote job- ...Note: Phoenix Children's is seeking a Medical Director of Adult Congenital Heart Disease (ACHD... ...passionate about high-quality, patient-centered care and dedicated to advancing the lives of... ...with strategic vision and clinical oversight. • Lead program growth initiatives,...Full timeTraineeshipShift workNight shift
Phoenix Children's Hospital
Phoenix, AZ2 days ago - ...Genetics/Genomics Clinical Director to join our growing... ...for a laboratory health care system. The Clinical Director provides medical, scientific and... ...correlates clinical data utilizing standard laboratory procedures... ...as well. 6. Provides oversight and guidance to...Shift work
Sonora Quest Laboratories
Phoenix, AZ3 days ago - ...Medical Director- Remote (Must Reside in AZ) Medical Director- Remote (Must Reside in AZ) 1 week... ...first 25 applicants Prisma Community Care is committed to delivering inclusive, compassionate... ...Medical Director will ensure clinical oversight, support provider education, and...Full timePart timeRemote work
Prisma Community Care
Phoenix, AZ2 days ago
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Medicare Medical Director — Utilization & Care Oversight. Be the first to apply!
Related searches
- healthcare consulting manager Phoenix, AZ
- hospital supervisor Phoenix, AZ
- entry level healthcare project manager Phoenix, AZ
- healthcare supervisor Phoenix, AZ
- senior manager clinical operations Phoenix, AZ
- medical operations manager Phoenix, AZ
- clinical account manager Phoenix, AZ
- health services director Phoenix, AZ
- part time medical director Phoenix, AZ
- health insurance manager Phoenix, AZ