Medicare Medical Director — Utilization & Care Oversight
$223.8k - $313.1kHumana Inc
Humana Inc. is hiring a Medical Director to manage Medicare service authorizations in Boise, Idaho. The role involves reviewing clinical cases to determine the necessity of services while adhering to regulatory standards. Qualified candidates will have an MD or DO degree, strong clinical experience, and excellent communication skills. The position offers a competitive salary in the range of $223,800 to $313,100 annually, along with bonus incentives and comprehensive benefits. #J-18808-Ljbffr Humana Inc
- ...Highlights: Saint Alphonsus Medical Group (SAMG) is a... ...Control as the Medical Director for that specialty.... ...excellent support staff. We utilize EPIC for our EHR.... ...on physician's plan of care; order & interpret appropriate... ...diseases; provides oversight of surveillance for healthcare...SuggestedRelocation
- ...Job Description Saint Alphonsus Medical Group (SAMG) is a 650+ provider multispecialty... ...-disciplinary team approach to patient care in an Urgent Care (UC) setting. Clinical... ...Additionally, the Urgent Care Medical Director is the leader of the Urgent Care provider...SuggestedFull timeRelocationShift work
- ...the design and configuration of clinical workflows supporting care management operations. This remote position requires 4-7 years... ...consulting experience, with expertise in care management processes like Utilization Management and Case Management. The ideal candidate will...SuggestedRemote job
$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- ...A leading healthcare provider is seeking a Medical Director to conduct inpatient medical necessity reviews. This role requires an MD or DO with... ...a multidisciplinary team to uphold high standards of patient care and support continuous improvement. This remote position...SuggestedRemote 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 Friday$223.8k - $313.1k
Humana Inc is seeking a Medical Director for a remote position based in the United States. The Medical Director will leverage their medical... ...authoritative decisions on service authorizations in line with Medicare requirements and clinical guidelines. Responsibilities...Remote job- Infection Prevention Medical Director / Infectious Disease Provider - FT... ...excellent support staff. We utilize EPIC for our EHR. Specific duties... ...on physician's plan of care; order & interpret appropriate... ...diseases; provides oversight of surveillance for healthcare...
- ...seeks a System Service Line Medical Director (SMD) who reports to the President... ...The SMD is responsible for oversight, supporting, and innovating... ...at the lowest total cost of care and for facilitating... ...accountable for Supply Chain and drug utilization performance improvement...Part time
- ...Description Saint Alphonsus Medical Group (SAMG) is a 650+... ...provide Physician leadership and oversight for our Maternal Fetal... ...4-hr comprehensive specialty care for premature and high-risk infants... ...Medicine program. The Medical Director will be responsible and...RelocationShift work
- ...seeks a System Service Line Medical Director (SMD) who reports to the President... ...The SMD is responsible for oversight, supporting, and innovating... ...at the lowest total cost of care and for facilitating... ...accountable for Supply Chain and drug utilization performance improvement...Part time
$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- ...A healthcare organization is seeking a Medical Director to ensure healthcare services align with... ...requires reviewing clinical cases for Medicare and Medicaid members, ensuring compliance... ...experience in clinical patient care. This position is remote with a focus on...Remote work
- ...Job Description Saint Alphonsus Medical Group (SAMG) is a physician led and accountable... ..., culturally responsive and equitable care for all families in the Treasure Valley.... ...have come from around the globe. The clinic utilizes several programs to help reduce current...Full timeRelocation
- Humana Inc is seeking a Behavioral Health Medical Director to oversee behavioral health care strategy and operations. This role includes responsibilities such as developing educational seminars, participating in quality management, and ensuring regulatory compliance. Candidates...Remote job
- A leading health system in Boise, Idaho, seeks a Palliative Care-Oncology Physician to deliver exceptional care in outpatient settings. Join a dedicated team focused on patient needs, develop care plans, and engage in program improvements. Enjoy a competitive salary, generous...
- ...Job Description Saint Alphonsus Medical Group (SAMG) is a physician led and accountable... ...-disciplinary team approach to patient care and who is willing to support the growth... ...regulations is strongly desired. Medical Director Experience Preferred RECRUITMENT...Full timeLocal areaRelocation
$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$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- About this Position The Hospitalist Medical Director provides strategic, clinical, and operational... ..., efficient, and patient-centered care while aligning with institutional goals... ...communication, and organizational skills. Clinical Oversight: Ensure adequate provider coverage and...
$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$27 - $30 per hour
...Paramedic to manage an occupational health clinic in Caldwell, ID. Responsibilities include overseeing clinic workflows, providing patient care, and ensuring efficient operations. Suitable candidates will have a valid license, CPR/BLS certification, and strong communication...Hourly payFull time$100k - $140k
...education and personal growth. Strong emphasis on feline-only care, including dentistry. Recently expanded services to include... ...NVA! NVA offers a comprehensive benefits program including medical, dental, vision, a 401k with employer match, and paid time off (...Full timeLocal areaRelocation package3 days per week- A leading long-term care pharmacy provider in Boise, Idaho is seeking a team member to engage with clients and resolve problems, ensuring... .... The role promises competitive pay and comprehensive benefits including medical and retirement plans. #J-18808-Ljbffr Guardian Pharmacy
$125k
...It's time for A New Approach to Physical Therapy...Patient care focused on Health, Wellness, and Prevention! Tired of seeing... ...services within PT, Nutrition, and Behavioral Health Operational Oversight: Ensure scheduling efficiency while protecting 1-on-1 care...Full timeLocal areaRelocation packageFlexible hours- BEST Physical Therapy in Boise, Idaho is seeking a motivated Physical Therapist for a full-time role. The position involves providing 1-on-1 treatments with a focus on outpatient musculoskeletal injuries and sports performance. Candidates must hold a Doctor of Physical ...Full time
$92.6k - $127.4k
Become a part of our caring community and help us put... ...to the Branch Director of the Portland/Lake Oswego... ...and in compliance with Medicare regulations. Coordinate... ...recommendations by Utilization Review staff. Upon completion... ..., Humana provides medical, dental and vision...Full timeTemporary workApprenticeshipImmediate startRelocation packageFlexible hours- ...helping others. We offer a fun and caring work environment, competitive... .... Responsible for meeting utilization and schedule metrics while... ...accordance with Patient Centered Medical Home concepts. Establishes... .... This includes knowledge of Medicare, Medicaid, and major...Work at officeLocal area
- Clinical Director (EX) page is loaded## Clinical Director (EX)locations: Boise, Idahotime type... ...and function. The Clinical Director utilizes sound leadership principles to maintain a... ...to the Wellness team, residents’ primary care providers and other health services providers...Contract workLocal areaImmediate start
$50.97 - $78.69 per hour
...creation through cost optimization, product, equipment and services utilization, and rationalization aligned with best-in-class clinical... ...make recommendations. Interaction with clinical teams at the care sites and system clinical teams in conjunction with Category Managers...Hourly payContract workWork at office
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