Medicare Medical Director — Utilization & Care Oversight
$223.8k - $313.1kHumana Inc
Humana Inc is looking for a Medical Director National OP Medicare in Saint Paul, Minnesota. You will utilize your clinical expertise and judgment to determine medical service authorizations and ensure compliance with Medicare regulations. The role involves communication with internal teams and external physicians on clinical determinations, with a focus on patient outcomes. This full-time position offers a competitive salary range of $223,800 - $313,100 per year along with a bonus incentive. Join Humana to innovate in healthcare delivery! #J-18808-Ljbffr Humana Inc
- ...Medical Director, Primary Care Fairview is seeking a full time Medical Director, Primary Care to provide... .../.50 Clinical) ~ Administrative oversight for clinics located in Blaine,... ...plans ~ Monitor clinic capacity and utilization to ensure access and meet community...SuggestedPrice workFull timeTemporary work
$223.8k - $313.1k
Become a part of our caring community The Medical Director National OP Medicare relies on medical background and reviews... ...Advantage requirements in daily utilization management and coverage determination... ...resource utilization. Provide oversight or input, as applicable,...SuggestedBi-weekly payFull timeTemporary workApprenticeshipRemote workWork from homeHome office$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. Role... ...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- Summary St. Cloud VA Health Care System is seeking a... ...Community (ICC) Director in St. Cloud - MN. The... ...accrediting bodies for graduate medical education - the... ...program responsibility and oversight includes a 225 bed... .../ Quality Improvement/Utilization Management activities...SuggestedDaily paidFull timeContract workFreelanceWork at officeLocal areaRelocation packageMonday to Friday
$33.13 - $54.66 per hour
...Shield of Minnesota Position Title: Care Manager PreService & Retrospective - Behavioral... ...Have Reviews and evaluates requested medical or behavioral health service claims by... ...care experience (e.g. case management, utilization management and/or auditing experience)....SuggestedHourly payFull timeFor contractorsRemote workFlexible hoursShift work$248.5k - $373k
...organization that delivers care, aided by technology to help... ...part, as a member of a team of medical directors, for the overall quality,... ...services. Additionally, performs Utilization Management reviews and... ...assists in the direction and oversight in the development and implementation...Minimum wageWork experience placementLocal areaRemote workWeekend work$223.8k - $313.1k
...A leading healthcare company is seeking a Medical Director to conduct clinical reviews and assess medical necessity in a remote role. The ideal candidate will have a medical degree, extensive clinical experience, and strong analytical skills. Responsibilities include...Remote work- ...SafetyCall International is seeking a Medical Director Oncology to oversee utilization review determinations and support teams for optimal clinical outcomes. Responsibilities include engaging providers, enhancing clinical expertise through education, and collaborating...
$258k - $423k
...global organization that delivers care, aided by technology to help... ...Growing together.The Behavioral Medical Director position is responsible for providing oversight to and direction of the... ...servicesLevel of Care guidelines and utilization management protocolsOversight and...Minimum wageWork experience placementLocal areaRemote work- ...Medical Director, Medical Safety (MDMS) - Neuromodulation Work mode: Remote in Country Onsite... ...US-TX-Austin Diversity - Innovation - Caring - Global Collaboration - Winning Spirit... ...development to ensure comprehensive safety oversight. Engage on behalf of Boston Scientific...Work at officeRemote workWork from homeRelocation
$270.8k - $378.8k
...Become a part of our caring community The National Medical Director of Clinical Excellence & Safety is a pivotal leadership position within CenterWell... ...primary care network. Patient Safety Provide oversight for patient safety activities, including policy management...Full timeTemporary workApprenticeshipWork at officeRemote work$300k
An established industry player is seeking a Medical Director to join a thriving adult primary care group in Minneapolis. This role offers the chance to work with a dedicated team of seven physicians and 27 advanced practice providers, ensuring excellent support and collaboration...Monday to Friday- ...The client is seeking a Director of Perioperative Services and Clinical Care for a facility located in O'Fallon, Missouri. Find out more about this role by reading the information below, then apply to be considered. The facility is equipped with 42 beds and 3 operating...
- ...is a not-for-profit health system that cares for individuals, families and communities... ...: Job Description: The BMT & CT Medical Director will lead all aspects of the Cellular... ...transplantation capacities. Provides oversight and leadership to staff in respect to all...Full timeContract workTemporary workLive inRelocation packageShift workNight shiftWeekend workAfternoon shift
- Highmark Health is looking for a Product Manager for Behavioral Health & Wellness, responsible for shaping product offerings within the Utilization Management function. You will develop the product vision, create execution plans, and work closely with stakeholders through the...Work at officeRemote work
$75k - $90k
...involves implementing strategic selling initiatives and maintaining relationships with key accounts in the Ostomy, Continence and Critical Care markets. Ideal candidates should have a Bachelor's degree, 2-5 years of experience in sales, and strong clinical knowledge. The...Remote job$70k - $150k
Senior Care Advisor & Healthcare Liaison Twin Cities, MN | Full-Time | Remote but must be located in the Twin Cities area This is not... ...reach between $70,000 - $150,000 in your first year Full benefits: medical, dental, vision, 401(k), and flexible PTO A defined market...Full timeLocal areaRemote workFlexible hours$135 - $150 per hour
...across specialties and primary care, we seek to connect the pieces... ...'ll Be Doing: As a Field Medical Director, MSK Surgery you will be a key member of the utilization management team. We can offer... ...health care program, including Medicare or Medicaid, and is not identified...Work at officeImmediate start$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$80k - $85k
...Behavioral Health Care Team Manager Care Team Manager - Behavioral... ...Reports To: Assistant Director of Care Team Operations Salary... ...trauma-informed approach. Utilize text messaging, phone calls, home... ...Salary and Equity Package ~ Medical, Dental, and Vision Insurance...Full timeLocal areaRemote workMonday to FridayFlexible hoursAfternoon shift- ...Emergency Department team. This clinical leader will influence patient care, coordinate complex care, and embed evidence into practice... .... A competitive benefits package is offered, including medical insurance and 401K with match. #J-18808-Ljbffr Regions Hospital
$80k - $100k
...company that supports patients at risk for, or living with, chronic kidney disease (CKD), and we’re looking for Registered Nurse (RN) Care Managers to join their team. This is a fully remote, full‑time opportunity for nurses passionate about coaching, patient education,...Full timeImmediate startRemote workMonday to FridayFlexible hoursShift workNight shift- ...Supervisor to oversee a team providing outpatient and inpatient wound care. This full-time role requires 80% direct patient care and 20%... ...in Minnesota. There are numerous benefits included such as medical and dental insurance, retirement programs, and tuition reimbursement...Full time
$238k - $357.5k
...Optum is a global organization that delivers care, aided by technology to help millions of people live healthier... ...us to start Caring. Connecting. Growing together.The Medical Director Oncology will provide utilization review determinations and support case and disease...Full timeWork experience placementLocal areaRemote work$116.5k - $251.6k
...decision impacts. You will provide solution oversight, direction and expertise to stakeholders.... ...which includes the following: # Medical, dental, and vision insurance, including... ...insurance (Employee/Spouse/Child) # Health care and dependent care Flexible Spending Accounts...Temporary workWork experience placementLocal areaFlexible hours$248.5k - $373k
...is a global organization that delivers care, aided by technology to help millions of... ...the Fertility Solutions Programs, the Medical Director guides members through the fertility landscape... ...treatment at the right time, performs Utilization Management for requested services,...Minimum wagePart timeWork experience placementLocal areaRemote workFlexible hours$269.5k - $425.5k
...Overview Medical Director - Clinical Review / DRG - Remote. Optum is a global organization that delivers care, aided by technology, to help millions of people live healthier lives... ...success in collaboration with hospital utilization management and claims adjudication teams...Minimum wageFull timeWork experience placementLocal areaRemote work$160k - $219k
...experience in environmental services or water utility and/or consulting industry is required.... ..., performance, and success, including medical, dental, vision, short- and long-term disability... ..., pet insurance, and long-term care insurance. See our full list of benefits....Temporary work$238k - $357.5k
...Stryker Corporation is seeking a Medical Director of Oncology in Minneapolis, Minnesota, to lead utilization reviews and support case management teams for optimal clinical... ...teams, and evaluate clinical data to improve care processes. A comprehensive benefits package is...Remote work- ...Job Description Job Description Position Summary: The Medical Director serves as a vital member of the Open Cities Health Center (OCHC... ...Chief Clinical Officer to ensure the delivery of quality patient care and efficient clinical operations. The Medical Director leads...Local area
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