Medicare Medical Director — Policy, Review & Strategy
WPS—A health solutions company
WPS Health Solutions seeks a Contractor Medical Director to lead clinical evidence reviews, develop LCDs, and support medical review and policy initiatives for Medicare. The CMD collaborates with CMS and other contractors, guides education, and helps ensure accurate, timely medical decision-making while protecting program integrity and high‑quality care. The role involves working with multi-disciplinary teams, interfacing with medical societies, and participating in administrative law judge #J-18808-Ljbffr WPS—A health solutions company
- ...of the Chief of Medicine the Medical Director will serve as an enterprise... ...rate Responsible for chart review and peer review following the... ...guidelines established by the Policies and Procedures Committee.... ...and consistent business model strategy across the organization...Policy
- ...insurance Position Summary The Medical Director is first and foremost a... ...protocols Oversee peer review processes and implement corrective... ...HIPAA, OSHA, and Medicaid/Medicare requirements Support... ...Collaboration Implement clinical strategies, policies, and initiatives as...PolicyWork at officeLocal area
- Overview The Contractor Medical Director (CMD) is responsible for researching and reviewing clinical evidence in... ...collaborates with CMS and other Medicare Administrative... ...on coverage and MR policy issues and interact with... ...to develop our MR strategy and provide clinical expertise...PolicyContract workFor contractorsLive inLocal areaImmediate startRemote work2 days per week
- ...DescriptionThis role is key for medical supervision and... ...D. The Clinical Study Director (CSD) is the medical... ...for medical review and will collaborate and... ...expertise for operational strategy within the CSO for study... ...respect with communication policies (e.g. study results,...PolicyWork at officeLocal areaImmediate start
- ...Clinical Development Executive Medical Director The Clinical Development... ...clinical development strategy in line with regulatory requirements... ...products, including review and analysis of safety data... ...compliance with applicable policies and regulations. Establish...PolicyContract work
- ...through patient/family interviews and chart reviews; assessing presenting illness, risk... ...treatment plan by prescribing/dispensing medications and/or injections in compliance with medical... ...compliance with standards, regulations, policies, and procedures. Acts as consultant/...PolicyFull timeShift workWeekend workDay shift
$350 per month
...National Services (VOANS) is seeking a Medical Director. The Medical Director Provide direction... ...expertise in the development of medical policies, procedures and guidelines. Responsible... .... Provides oversight of the QI Plan. Reviews all quality of care issues and oversees...PolicyContract workTemporary workMonday to Friday- ...compliance with contracts, agency policies and procedures, regulatory... ...documents to obtain/retain Medicare UPIN credential and Managed Care... ...staff in the preparation and review of individual treatment plans... ...and the implementation of strategies to assure that programs may obtain...PolicyWork at officeAll shifts
- ...includes but is not limited to, policy and program development,... ...diversion decisions.3. Devises strategy and interacts with CMOS, CNOs... ...multidisciplinary huddles, to review and expedite patient movement... ...charts and works with MSHS Medical, Nursing, Infection Prevention...PolicyLocal areaShift workNight shiftWeekend work
- ...designated nursing staff within the Medical Center. This individual... ...and departmental policies and in accordance with any government... ...procedures. Communicates values, strategies, and objectives of department... ...procedures. Regularly reviews policies and procedures and makes...PolicyTemporary workTraineeshipLocal area
$25k
...reporting to the Branch Director, you will lead and... ...working onsite in-office. Review referrals, determine admission... ..., and billing meet Medicare, payer, and company... ...benefits, Humana provides medical, dental and vision... ...Opportunity Employer It is the policy of Humana not to...PolicyTemporary workApprenticeshipWork at officeWeekend work$23 - $26.37 per hour
...support to clients with chronic medical and behavioral health... ...individualized care plans. Reviews patient intake assessments and... ...plan, self-management goals and strategies. In conjunction with the patient... ...in accordance with agency policy. Ensures that patients and...PolicyHourly payFull time- ...Health, Patient Care Director The Behavioral Health... .... Provides patient reviews that are coordinated to... ...engagement and retention strategies in accordance with... ...compliance with all hospital policies and procedures.... ...and receive an approved medical exemption. We are an...PolicyHourly payLocal area
- ...Sinai Adolescent Health Center seeks a Medical Director for its School Based Health Centers.... ...delivered in accordance with Mount Sinai's policies and procedures, New York State... ...conduct informal performance evaluation and review of charts on a regular basis; In concert...PolicyFull timeTraineeshipFlexible hours
$73.78k - $77.64k
...and potential reforms to criminal justice policy in New York City. CJA's programs operate... ...Case Manager's functions include: Reviewing with participants the conditions of... ...solving that evaluates different methods and strategies for alternatives to detention....PolicyWork at officeRemote workMonday to FridayNight shiftWeekend workAfternoon shift$191.15k - $305.85k
Job Description The Medical Director brings a unique set of knowledge and skills to the business... ...and experience to support value‑based strategies, clinical operations and our organizational... ...Operations Medical reimbursement and policy Care management (utilization...Policy$170k - $200k
...experience.To achieve our vision, Bond Vet is currently seeking an Medical Director to help lead the medical operations of the ClinicThe Medical... ...data rates may apply. Find more information in our privacy policy.Employment with Bond Vet is contingent upon the Company's...Policy$120k - $150k
...Risk Manager reports to the Director of Risk Management and Patient... ...and is responsible for reviewing, summarizing, analyzing, presenting... ...developing risk reduction strategies, policy and/or organizational... ...to field inquiries from all medical center staff (outside normal...PolicyTraineeshipLocal areaFlexible hoursShift work- ...within R&D Quality, Associate Director, Good Clinical Practice (GCP)... ...responsible for leading the strategy, execution, and oversight of... ...with relevant stakeholders; Review documentation, procedures, and... ...FDA regulations, and company policies. Develop and implement a robust...PolicyContract workRemote workFlexible hoursNight shift
- ...Distribution Operations Director - Relo... ...performance, and execute growth strategies in a highly regulated... ...financial performance to review account-level profit and... ...to internal standards, policies, procedures, and... ...Healthcare, pharmaceutical, medical device, life sciences,...PolicyHourly payPermanent employmentWork at officeRelocationRelocation package
- ...Jersey City, Hoboken University Medical Center and Bayonne Medical... ...Operations and is responsible to the Director, Clinical Nutrition and... ...nutrition operational policies and procedures.Serves as a clinical... ...including program reviews, self-studies and continuing...PolicyFull timeTraineeshipInternshipDay shift
$60k
...billing and expense management by regularly reviewing reports and developing action plans... ...maintenance.* Implement and refine practice policies and procedures to improve efficiency and... ...Relations*** Execute marketing strategies to attract new clients and retain current...PolicyFull timeWork at officeWeekend workAfternoon shift- ...Associate Medical Director The Department of Emergency Medicine, at Richmond University Medical... ..., etc.). You will be responsible for reviewing the quality and flow metrics related to... ...Director oversees the entire bi-yearly policy process including ongoing review,...PolicyFull timeTemporary workTraineeshipWork at officeLocal area
- ...employing a variety of innovative strategies to help families and... ...supervision from the program Director, with some latitude for independent... ..., and productivity. Review the daily statical reports prepared... ...for new and revised policies and procedures. Rate and evaluate...PolicyFull timeTemporary workWork at officeMonday to FridayShift work
- ...role in shaping market strategy, driving adoption... ...clear, impactful business review narratives. If you are... ...leaders, service line directors, corporate partners, or... ...health system or medical group network. 1+ years... ...future Generous time-off policies : Including 2 company-...PolicyRemote jobFull timeLive inCurrently hiringLocal areaHome office
- ...planet. The Team The Client Director is a senior member of our sales... ...leadership and platform strategy—owning a focused portfolio of... ...urgency. Own executive business reviews that are forward-looking and... ...our inclusive parental leave policy—24 weeks of fully paid leave...PolicyFull timeWork at officeLocal areaImmediate startRemote workWorldwideFlexible hours
- ...professional standards within the program, develops and implements policies and procedures for the program relevant to clinical services... ...procedures, facilitate team meetings, write staff evaluations, review all program documentation to ensure compliance with program...PolicyDaily paid
$75k
...clinical oversight and case review are assigned based on active... ...clinical leadership for the Acute Medical Detox Unit. This role... ...and HIPAA) and organizational policies.Maintain court scheduling, filing... ...operational issues to the Patient Care Director.Perform other duties as...PolicyWork at officeLocal areaMonday to FridayAfternoon shift- ...Clinical Supervisor REPORTS TO: Program Director POSITION SUMMARY: Under the... ...designated staff as per VIP Community Services policies. Prepare written annual evaluations,... ...members are adequately trained. Review all admissions to the residence and assigns...PolicyFlexible hoursAfternoon shift
- ...Under supervision of the Program Director the Clinical Supervisor will... ...for client case record reviews, performance improvement and... ....Become familiar with ACACIA policies and procedures and implements... ...effectively. Also ensures all medical and other services to which patients...PolicyWork experience placement
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