Medicare Medical Director Utilization & Care Oversight
$223.8k - $313.1kHumana
Humana Inc is seeking a Medical Director to utilize clinical expertise in reviewing preauthorization requests for services. This role involves determining authorization for services, performing compliance reviews, and engaging with external physicians. The ideal candidate will have at least 5 years of clinical experience and an MD or DO degree. The position entails a virtual workplace with occasional travel for training. Competitive benefits and a salary range from $223,800 to $313,100 per year are offered. #J-18808-Ljbffr
- ...Humana Inc. is seeking a Medical Director for a remote position based in the United States. This role involves utilizing medical expertise to authorize rehabilitation services, collaborating... ...in utilization management and the managed care industry is essential. The position offers...SuggestedRemote work
- ...Job Type Contract Description As a Medical Director for Access Medical Clinics (AMC), you will provide clinical leadership and oversight for medical care services within the long-term care facility. The Medical Director collaborates with administration,...SuggestedContract 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.... ...utilization management or inpatient review (Medicare Advantage, Managed Medicaid, or...SuggestedBi-weekly payFull timeTemporary workApprenticeshipWork at officeLocal areaRemote workWork from homeHome officeMonday to FridayWeekend work$223.8k - $313.1k
...Become a part of our caring community The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing Home Health, SNF, DME, dual Medicare... ...~ Intermediate to advanced skills utilizing Microsoft Office and Internet navigation ~...SuggestedFull timeTemporary workApprenticeshipWork at officeRemote workWork from homeHome officeMonday to Friday$223.8k - $313.1k
...Become a part of our caring community The Medical Director uses their medical background, experience, and... ...reference sources. You will learn Medicare, Medicaid, and Medicare Advantage... ...teams focusing on quality management, utilization management, case management,...SuggestedBi-weekly payFull timeTemporary workApprenticeshipWork at officeRemote workWork from homeHome office- ...A leading healthcare company is seeking a Medical Director to perform expert clinical reviews of inpatient medical records and support high-... ...competitive compensation and benefits without the demands of bedside care, fostering a structured team-oriented environment. #J-18808-...Remote work
- ...A healthcare organization in Arkansas seeks a Site Medical Director to oversee medical care at their facility. You will provide direct patient care, supervise staff, and collaborate on quality improvement initiatives. The ideal candidate has a medical degree, experience...
$170 - $175 per hour
...Medical Director Req number: R7707 Employment type: Full time Worksite flexibility... ...for a Medical Director to ensure utilization management responsibilities are performed... ...consistent with community standards of care Participate as a member of the CMDM...Hourly payFull timePrivate practiceWork at officeLocal areaRemote workWorldwide$227.6k
...part of a physician team, ensures that utilization management responsibilities are performed... ...escalated cases electronically and using Medical Policy criteria sets to evaluate the... ...projects to help support and improve the care of our members ESSENTIAL RESPONSIBILITIES...For contractorsPrivate practiceWork at officeLocal area$270k - $340k
...across specialties and primary care, we seek to connect the... ...cancer. As a Performance Suite Medical Director in Medical Oncology, you... ...throughput, this position integrates utilization management with... ...sanction or exclusion from Medicare/Medicaid programs. To ensure...Immediate start$191.15k - $305.85k
...Job Description The Medical Director brings a unique set of knowledge and skills to the business... ...groups, and members as needed. Utilizes clinical knowledge and experience to support... ...of high quality and cost-effective care for members. The application of a Medical...Local areaRemote work- ...Type of Position: Clinical Staff - Medical Services Job Type: Regular Work... ...We champion being a collaborative health care organization, focused on improving patient... ...will also collaborate with the Medical Director, Residency Director, physicians, and leadership...Work at officeVisa sponsorshipShift workDay shift
- ...social needs. The role requires a minimum of 2 years in long-term nursing care and an active Arkansas nursing license. Key responsibilities include observing resident needs, administering medications, and consulting with physicians. Strong communication and leadership...
$25k
...Become a part of our caring community As a Clinical... ...to the Branch Director, you will lead and support... ...audits, and billing meet Medicare, payer, and company... ...documentation review, utilization review findings, and performance... ..., Humana provides medical, dental and vision...Full timeTemporary workApprenticeshipWork at office$79.1k - $158.2k
...lifesaving decisions and better patient care. We want people just as dedicated as we... ...electronic health record across services. Utilizing effective consulting skills during... ...package which includes the following: # Medical, dental, and vision insurance, including...Contract workTemporary workWork experience placementLocal areaRemote workFlexible hours$79.1k - $158.2k
...expertise focusing on client success in utilizing Oracle's solutions. Through the use of Oracle... ...which includes the following: Medical, dental, and vision insurance, including... ...insurance (Employee/Spouse/Child) Health care and dependent care Flexible Spending Accounts...Temporary workFlexible hours$130 - $140 per hour
...conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health... ...What You’ll Be Doing: As a Vascular Surgery, Field Medical Director you will be a key member of the utilization management team. We can offer you a meaningful way...Full timePart timeWork at officeImmediate start- Company Description Medical Director | Bellevue Animal Clinic | Little Rock, AR | Signing Bonus starting at $50,000 | Are you ready to lead a... ...served pets and their families with compassionate, comprehensive care for years. Our hospital offers a wide range of services...Full timeLocal areaRelocation packageFlexible hours
- ...Summary: Provides quality management oversight in the areas of access, financial performance... ...operations and maximum quality patient care. Other information: • Bachelors in... ...operations such as billing/coding, accounting and medical software systems. This job will be...Shift work
- ...the organization. The Director is responsible for developing... ...governance, financial oversight, compliance, and... ...and research systems utilization. # Ensures regulatory... ...state dedicated to caring for children, which enables... ...the world class medical care to the Children of...Full timeWork experience placementWork at officeLocal areaShift work
- ...A pediatric healthcare provider in Little Rock seeks a Patient Care Manager for the burn unit. This full-time role includes overseeing daily nursing operations, ensuring high-quality patient care, and leading performance initiatives. Candidates need a Bachelor’s in Nursing...Full timeDay shift
$81k - $115k
...Chicago, Boston, or South Bend) Travel: Up to 25% Overview Health care organizations with highly engaged workforces deliver better... ...milestonespecific feedback across onboarding and exit. Employee Crowdsourcing: Utilize front-line wisdom to generate ideas, solve challenges, and spark...For contractorsWork at officeLocal areaRemote workFlexible hours$97.5k - $199.5k
...lifesaving decisions and better patient care. We want people just as dedicated as we are... ...will support the ongoing operational oversight for the various solutions and service areas... ...package which includes the following: # Medical, dental, and vision insurance, including...Contract workTemporary workLocal areaRemote workFlexible hours- ...Arkansas to deliver holistic support to patients in their homes. The ideal candidate will be responsible for developing personalized care plans, ensuring symptom management, and leading meaningful end-of-life conversations. Applicants should have 1+ years of acute care...Full time
- ...Registered Nurse Case Manager (RNCM) to provide high-quality end-of-life care to patients in their homes. Responsibilities include managing a caseload of patients, performing assessments, administering medications, and coordinating care with the interdisciplinary team. The...
- ...Springs, AR location. You will provide expert, patient-centered care in a supportive environment while assessing patient needs and creating... ...focus on hospice care. We offer competitive benefits including medical, dental, vision insurance, and generous PTO, along with...
- ...BHMC-Little Rock is seeking an RN Case Manager to provide, manage, and coordinate care for a caseload of patients. This role requires a graduation from an approved Nursing program and a current Arkansas RN License. Applicants should have a current Arkansas Driver's License...
$128.4k - $235.3k
...systems, physician practices and academic medical centers, to assess and redesign clinical... ...financial statements and contract terms, utilize complex financial models, experience with... ...Holidays, Winter/Summer breaks, Personal/Family Care, and other leaves of absence when needed...Contract workWork experience placementSummer holidayFlexible hours$115 per hour
...Maximus is currently hiring for a Part-Time Medical Director to join our State East team. This is a part-time, fully remote opportunity. The... ...Complete clinical reviews with regards to denials and level of care on various contracts. Fulfill client's requests for educational...Full timePart timeCurrently hiringRemote workHome officeMonday to Friday$68.97k - $113.31k
...for the investigation and assessment of medical information regarding disability by providing... ...assist individuals to obtain appropriate care and ensure optimal treatment outcomes and... ..., to enhance the customer experience. Utilize independent vendors to perform independent...Full timeTemporary workWork at officeFlexible hours
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