Medical Director: Care, Utilization & Policy Leader
100 Horizon Healthcare Services, Inc
100 Horizon Healthcare Services, Inc is seeking a Medical Director to act as a medical spokesperson and provide leadership for the provider network across New Jersey. Responsibilities include managing clinical activities, supporting the development of medical policy, and enhancing collaborative relationships with healthcare providers. The ideal candidate will possess a Board Certification, an MD or DO license, and 5-7 years of clinical experience. The role includes comprehensive health benefits and significant growth opportunities. #J-18808-Ljbffr
Vacancy posted 2 days ago
Similar jobs that could be interesting for youBased on the Medical Director: Care, Utilization & Policy Leader in Hopewell, NJ vacancy
- ...Physician Medical Director Location: Hopewell, NJ 08560 Contract Duration: Two (2) Years... ...compliant, and patient-centered medical care for incarcerated individuals while... ...leadership input for operational planning and policy development. Support reporting...PolicyHourly payFull timeContract workMonday to Friday
Veracity
Hopewell, NJ2 days ago - ...highest level of care to patients, conducting... ...educating future leaders in the field of... ...leading academic medical center means collaboration... ...? The Medical Director of the Princeton... ...coordination, utilization management, and nursing... ...organizational policies, procedures, and...Policy
Pennsylvania Medicine
Plainsboro, NJ5 days ago $298k - $409.8k
...Become a part of our caring community The National Physician Leader relies on medical background and reviews... ...and post-acute utilization management, while also... ...post-acute medical director team for home health,... ...Employer It is the policy of Humana not to discriminate...PolicyFull timeTemporary workRemote workShift workHumana
Trenton, NJ6 days ago- ...Provides high quality patient care to patients. Provides oversight of medical quality, delivery of medical care... ...monitoring ongoing compliance with policies and procedures f. Promote resident... ...: Supervisory and/or Medical Director experience highly desirable License...PolicyHourly pay
Hunterdon Health
Flemington, NJ5 days ago $95 - $100 per hour
...specialties and primary care, we seek to connect... ...be a key member of the utilization management team. We can... ...meet the applicable medical necessity guidelines,... ...compliance with SBU`s policies/procedures, as well as... ...assist the Senior Medical Director in research activities...PolicyPart timeWork at officeImmediate startEvolent
Trenton, NJ2 days ago$214.1k - $297.89k
...About the Role The Medical Director is a medical spokesperson for Horizon Blue Cross Blue... ...activities include, but are not limited to, utilization management, care management, disease management,... ...medical management program. Medical Policy and HPIRIT only: The position has...PolicyContract workLive inLocal area100 Horizon Healthcare Services, Inc
Hopewell, NJ1 day ago$223.8k - $313.1k
...Humana Inc. in Trenton, NJ is seeking a Medical Director National OP Medicare to oversee complex clinical reviews. The ideal candidate will... ...DO degree along with 5+ years of experience in direct patient care. Responsibilities include determining authorization for services...Remote workHumana
Ewing, NJ1 day ago- ...Facility in Trenton, NJ is seeking a Full Time Medical Director. The MD is a psychiatrist whose functions are diverse and ranges from direct... ...in regard to planning for individual clients or formulating policies. Great salary and benefits 90% adult population. Current New...PolicyPermanent employmentFull timeMonday to Friday
FCS - Psychiatric Recruitment
Trenton, NJ5 days ago $79.1k - $105.95k
...Jersey’s health solutions leader driving innovations that improve health care quality, affordability,... ...of the patient are medically appropriate for inpatient... ...to coordinate resource utilization and evaluation of... ...and current organization policies.Interacts and communicates...PolicyLive inLocal areaMonday to FridayWeekend workHorizon Blue Cross Blue Shield of New Jersey
Hopewell, NJ2 days ago- ...Health is the region's leader in providing progressive, quality patient care with significant investments... .... Capital Health Medical Group is made up of more... ...2,142.00 The Medical Director of Maternal–Fetal Medicine... ...updates departmental policies, clinical pathways, and...PolicyFull timeTemporary workPart timeFlexible hours
$200k - $240k
...The Group Medical Director (GMD) is a key medical leader responsible for driving high-quality veterinary care, patient safety, and clinical excellence across multiple VCA hospitals. In this role, you will lead and mentor Medical Directors and veterinary teams, ensuring...Full timeVCA Animal Hospitals
Trenton, NJ3 days ago- ...providing the highest level of care to patients, conducting... ..., and educating future leaders in the field of... ...this leading academic medical center means collaboration... ...communication and/or policy changes and solicits proactive... ...weekly review overtime utilization and manage...PolicyFull timeWork at officeLocal areaImmediate start
Pennsylvania Medicine
Lawrence, NJ6 days ago - ...are done to meet standards of care for clients. SHIFT : Sunday to... ...healthy living, hygiene, personal medical care, coping skills, social... ...building, and how to utilize their community resources. Make... ...basis protected by law. This policy of non-discrimination and equal...PolicyDaily paidFull timeLocal areaShift workWeekend work
Resources For Human Development
Ewing, NJ1 day ago - ...Health is the region's leader in providing progressive, quality patient care with investments in our... ...specialty care. Capital Health Medical Group is made up of... ...conduct continued stay utilization review activities with... ...regulations, policies and timelines. Identifies...PolicyFull timeTemporary workPart timeWork at officeLocal areaFlexible hoursNight shift
Capital Health (US)
Pennington, NJ1 day ago $85k - $143k
...regulatory and FMS policy requirements.... ...of quality patient care while maintaining... ...policies as the clinical leader, has the authority... ...integrity of medical records and other... ...collaboration with the Director. Plans,... ...Responsible for efficient utilization of medication,...PolicyFull timeTemporary workWork experience placementLocal areaImmediate startRelocation packageFresenius Medical Care
Princeton, NJ15 hours ago$45 - $80 per hour
...will your job look like? The Medical Director will provide clinical oversight... ...guidelines Review and approve medical policies related to transportation eligibility and utilization Develop and maintain coverage... ...review firm or health care claims processing organization...PolicyCasual workLocal areaMTM
Ewing, NJ1 day ago$39.4 - $51.47 per hour
...Health is the region's leader in providing progressive, quality patient care with significant investments... ...care. Capital Health Medical Group is made up of... ...Performs a variety of utilization and resource management... ...applicable regulations, policies and timelines. Adheres...PolicyFull timeTemporary workPart timeWork at officeLocal areaImmediate startFlexible hoursNight shiftCapital Health Services
Pennington, NJ3 days ago$170 - $175 per hour
...Medical Director Req number: R7707 Employment type: Full time... ...Medical Director to ensure utilization management responsibilities... ...escalated cases against medical policy criteria, which may include... ...with community standards of care Participate as a member...PolicyHourly payFull timePrivate practiceWork at officeLocal areaRemote workWorldwideCAI
Trenton, NJ3 days ago- ...Health is the region's leader in providing progressive, quality patient care with significant investments... ...care. Capital Health Medical Group is made up of... ...,142.00 The Medical Director of Maternal-Fetal Medicine... ...updates departmental policies, clinical pathways, and...PolicyFull timeTemporary workPart timeFlexible hours
Capital Health Services
Pennington, NJ5 days ago $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... ...guidelines, CMS requirements, Humana policies, clinical standards, and... ...Intermediate to advanced skills utilizing Microsoft Office and Internet...PolicyFull timeTemporary workApprenticeshipWork at officeRemote workWork from homeMonday to FridayHumana
Ewing, NJ2 days ago$227.6k
...part of a physician team, ensures that utilization management responsibilities are performed... ...cases electronically and using Medical Policy criteria sets to evaluate the medical necessity... ...to help support and improve the care of our members ESSENTIAL RESPONSIBILITIES...PolicyFor contractorsPrivate practiceWork at officeLocal areaHighmark Health
Trenton, NJ2 days ago$223.8k - $313.1k
...Become a part of our caring community The Medical Director National OP Medicare relies on medical background... ...national clinical guidelines, CMS policies and determinations, clinical reference... ...Advantage requirements in daily utilization management and coverage determination...PolicyBi-weekly payFull timeTemporary workApprenticeshipRemote workWork from homeHome officeHumana
Ewing, NJ1 day ago$223.8k - $313.1k
...Become a part of our caring community The Behavioral Health Medical Director is responsible for behavioral health care... ...national clinical guidelines, CMS policies and determinations, Medicaid... ...focusing on quality management, utilization management, case management,...PolicyBi-weekly payFull timeTemporary workApprenticeshipRemote workWork from homeHome officeWeekend workHumana
Trenton, NJ6 days ago$340.87k - $413.05k
...Clinical Development Team Leader sits within Clinical... ...Development, Regulatory, Medical, Commercial and other... ...pharmacy, dental, and vision care. Wellbeing Support:... ...data privacy policies and regulations. If... ...R1601919 : Executive Director, Clinical Development Team...PolicyHourly payFull timeTemporary workPart timeFor contractorsSummer workLive inWork at officeLocal areaRemote workFlexible hoursShift workBristol-Myers Squibb Company
Princeton, NJ4 days ago$79.1k - $158.2k
...decisions and better patient care. We want people just as dedicated... ...on customer success in utilizing Oracle's solutions. Using... ...and organizational security policies and procedures, understand personal... ...includes the following: # Medical, dental, and vision insurance...PolicyTemporary workWork experience placementLocal areaRemote workFlexible hoursOracle
Trenton, NJ6 days ago- ...Statewide Associate Medical Director UCHC Administration... ...University Correctional Health Care (UCHC), operating... ...committed to being a leader in the delivery of effective... ...Equipment Utilized Physical Demands and... ...Requirements Under Policy 100.3.1 Immunization Policy...PolicyFull timeSeasonal workFlexible hoursShift work
Rutgers University
Trenton, NJ2 days ago $120 - $135 per hour
...across specialties and primary care, we seek to connect the pieces of... ...Doing: As a Cardiology, Field Medical Director you will be a key member of the utilization management team. We can offer... ...utilization and compliance with SBU`s policies/procedures, as well as...PolicyWork at officeImmediate startEvolent
Trenton, NJ4 days ago- ...for an outstanding opportunity?NOW HIRING: Medical Director ResponsibilitiesWork directly with providers to educate them on our care process and determine what can be done to... ...clinical services such as cost management, utilization review, quality assurance, and medical...Permanent employmentImmediate start
Outsourcing Business Needs
Trenton, NJ2 days ago $30k
...Health Care Director A certified Great Place To Work (voted by associates) 7 years in a row... ...performance) ~ Mileage reimbursement ~ Medical, Dental, Vision offerings) ~ Company... ...accepted on an ongoing basis. It is the policy of Legend Senior Living to provide equal...PolicyLocal areaWeekend workAfternoon shift- ...Registered Nurse-Utilization Review One of our direct client is looking... ...Emergency room or intensive care units. We get a variety of... ...pediatric members with various medical conditions and will process... ...practice and current organization policies. Interacts and...PolicyLocal area
Careers Integrated Resources Inc
Trenton, NJ4 days ago
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Medical Director: Care, Utilization & Policy Leader. Be the first to apply!
Related searches
- medical claims auditor Hopewell, NJ
- medical office full time Hopewell, NJ
- medical technology Hopewell, NJ
- capital regional medical center Hopewell, NJ
- medical collections work from home Hopewell, NJ
- medical equipment planner Hopewell, NJ
- remote medical data entry Hopewell, NJ
- medical & healthcare Hopewell, NJ
- part time medical Hopewell, NJ
- medical equipment delivery service technician Hopewell, NJ