Inpatient Medical Director: Utilization Review Expert
$223.8k - $313.1kHumana Inc
A leading healthcare organization is seeking a Medical Director to lead clinical review of inpatient medical records, ensuring compliance with guidelines and regulations. Candidates must have an MD or DO, along with at least 5 years of clinical experience. This role involves analysis of complex cases and collaboration with other physicians while offering flexibility in work hours and the chance to impact patient outcomes without the demands of bedside care. The pay range is $223,800 - $313,100 annually, including potential bonuses. #J-18808-Ljbffr Humana Inc
$223.8k - $313.1k
...caring community The Medical Director relies on medical background and reviews health claims. The Medical... ...the quality of inpatient care through clinical... ...those experienced in Utilization Review are encouraged... ...Role Overview Perform expert clinical review of inpatient...SuggestedBi-weekly payFull timeTemporary workApprenticeshipWork at officeLocal areaRemote workWork from homeHome officeMonday to FridayWeekend work$223.8k - $313.1k
...of our caring community The Medical Director National OP Medicare relies on medical background and reviews preauthorization requests for... ...predominantly arise from inpatient or post‑acute care environments... ...requirements in daily utilization management and coverage determination...SuggestedBi-weekly payFull timeTemporary workApprenticeshipRemote workWork from homeHome office$223.8k - $313.1k
...help us put health first The Medical Director relies on fundamentals of... ...Guidance on following and reviewing Home Health, SNF, DME, dual... ...Intermediate to advanced skills utilizing Microsoft Office and... ...Qualifications Experience in an inpatient environment and/or related...SuggestedFull timeTemporary workApprenticeshipWork at officeRemote workWork from homeMonday to Friday$95 - $100 per hour
...be a key member of the utilization management team. We... ...as the Physician match reviewer in Imaging cases, that... ...initially meet the applicable medical necessity guidelines,... ...by the subject matter expert. Discusses... ...assist the Senior Medical Director in research activities...SuggestedPart timeWork at officeImmediate start$50 per hour
...CGS Federal (Contact Government Services) seeks a German Document Reviewer for remote work, assisting with document reviews and privilege evaluations. The position requires fluency in Hebrew and familiarity with document review workflows and electronic technologies like...SuggestedHourly payRemote workFlexible hours$38 - $41 per hour
...The Analytical Science Clinical Data Review Supervisor is responsible for supervising... ...appropriate internal and client-facing teams. Utilize the Laboratory Information Management... ...full-time benefits, including comprehensive medical coverage, dental, and vision options ~...Hourly payFull timeMonday to FridayWeekend workDay shift$202k - $303k
...Summary: This position assists the Chief Medical Director to direct and coordinate the medical... ...Provides medical leadership of all for utilization management, cost containment, and... ...improvement activities. Performs medical review activities pertaining to utilization review...Remote work$270k - $340k
...individuals facing cancer. As a Performance Suite Medical Director in Medical Oncology, you will play a... .... Unlike traditional medical review roles that emphasize volume throughput, this position integrates utilization management with collaborative engagement...Immediate start$24 - $33 per hour
...power prosperity around the world. As a QuickBooks Live Expert you are the center of that mission, providing... ...business owners on bookkeeping best practices and optimal utilization of the QuickBooks Online platform Review information input by small business owners for...Part timeWork at officeWork from homeFlexible hours- ...HBITS: HBITS-07-14815 Expert, Database Administrator 30 month contract Interview... .... The environment is very complex and utilizes many advanced features such as RAC, multitenant... ...our Oracle environment by careful reviewing of all incoming requests from app teams,...Contract workWork at officeRemote work
- ...Development of the new HMIS Application project Research and provide review and direction of various other Microsoft.Net based open system... ..., Wijmo. ~36 months experience developing applications utilizing ASP.Net MVC. ~24 months experience creating Angular.net...
- ...Colonie is seeking a licensed physician to assist the Chief Medical Director in directing medical management and quality improvement... ...certification in psychiatry. The successful candidate will engage in utilization review, support quality improvement strategies, and collaborate...Remote job
- ...seeking a highly skilled and experienced Expert Workfront Architect (Adobe Practice) to... ...best practices and business requirements, utilizing features like scenarios, modules, and... ...platform’s effectiveness. Conduct regular reviews and assessments to ensure the platform...Work experience placementLocal areaRemote work
$4,000 per month
...University is seeking a Subject Matter Expert (SME) on a contractual basis to support the... ..., and inclusion (JEDI) principles. Utilize Excelsior’s course shell and instructional... ...laws. For further information, please review the Know Your Rights notice from the Department...Local area$79.1k - $158.2k
...health record across services. Utilizing effective consulting skills... ...activities and workflow reviews, facilitate business process... ...Work alongside Oracle clinical experts, implementation consultants,... ...includes the following: # Medical, dental, and vision insurance...Contract workTemporary workWork experience placementLocal areaRemote workFlexible hours$120 - $135 per hour
...Doing: As a Cardiology, Field Medical Director you will be a key member of the utilization management team. We can offer... ...a resource to Initial Clinical Reviewers. What You Will Be Doing:... ...completed by the subject matter expert. Provides clinical rationale...Work at officeImmediate start$176.6k - $294.3k
...Oncology Field Medical, Director (non-MD), Solid Tumors and Early Pipeline... ...Subject matter expert recognized across internal and... ...needed Rapidly adopt and utilize new digital technology and other... ...disclosure. Subject to further legal review and statutory or regulatory...Permanent employmentH1bLocal areaRemote workVisa sponsorshipWork visaRelocation packageFlexible hours$40.08 per hour
...Mexico Environment Departments Medical Imaging and Radiation Therapy... ...: adheres to portal image review/approval guidelines as required... ...staff and/or Administrative Director for Therapy Services. Checks... ...time management. Utilizes resources and controls resources...Part timeShift workNight shiftWeekend work$310.02k
...Agency Mental Health, Office of Title Medical Director (Psychiatrist 2) (NY HELPS), Central... ...initiatives including medical necessity reviews, MMC organization Medical Directors meetings... ...attributes and skills are valued and utilized to support the mission of the Agency....Permanent employmentFull timeTraineeshipWork at officeLocal areaRemote work$74.68k - $88.8k
...gain customer acceptance of the FUJIFILM Medical Systems solution. Participates in teaching... ...The ability to walk long distances and utilize stairs. Close Vision: The ability to see... ...affirmative program/plan is available for review upon formal request by employees and...Work at officeLocal areaRemote workLong distanceFlexible hours$130.84k - $209.35k
...00 The Clinical Chemistry Director possesses the character, competence... ..., (4) Result reports are reviewed to evaluate laboratory... ...Coordinate the interaction of medical staff and clinical chemistry... ...limited to the clinical laboratory utilization committee. Serves as a...Contract workLocal areaImmediate startShift work$176.6k - $294.3k
...SUMMARY The Specialty Care Field Medical, Director is responsible for providing... ...experience Subject matter expert recognized across internal... ...skills Rapidly adopt and utilize new digital technology and other... .... Subject to further legal review and statutory or regulatory...Permanent employmentH1bLocal areaRemote workVisa sponsorshipWork visaRelocation packageFlexible hours$200k
...Maryland and Puerto Rico. Join us! POSITION OVERVIEW The Medical Director engages in the professional, organizational, and... ...provided. Meets with all scheduled patients efficiently and reviews scheduling with supervisor daily. Develops and reviews all...Full timeLocal area- ...feasibility, protocol writing or optimization, medical monitoring and pharmacovigilance. Parexel... ...in learning more about the Medical Director role. *Candidates with a subspecialty in... .... In addition, you will also: Review all individual adverse experience reports...Contract workRemote work
$160k - $230k
...Are you a seasoned networking and security expert with a passion for driving innovation and... ...through training programs and peer review processes. Drive thought leadership initiatives... ...awards in addition to a full range of medical, financial, and/or other benefits (...Work at officeLocal areaRemote workRelocation packageFlexible hours$160k - $230k
...Heart. The Opportunity Subject Matter Expert - Cloud Native Are you an expert at... ...Establish and uphold technical standards, peer review processes, and best practices across... ...awards in addition to a full range of medical, financial, and/or other benefits (including...Work at officeLocal areaRemote workRelocation package3 days per week$223.8k - $313.1k
Humana Inc is seeking a full-time remote Medical Director to manage acute inpatient rehabilitation authorization requests. Responsibilities include providing medical interpretations, collaborating with teams, and ensuring compliance with national guidelines. Qualified...Remote jobFull time$22.75 per hour
...a gathering place for readers and the community. As a Café Team Expert (CTE), you are an integral leader for the café team. You work through... ...to customers, acting as a role model to the team. Review category sales, inventory quantities and product waste reports,...Hourly payFull timeFlexible hoursShift workAfternoon shiftEarly shift$202k - $303k
...seeking a licensed physician in New York to assist the Chief Medical Director in directing and coordinating medical management, quality... ...credentialing functions. The role involves providing leadership in utilization management and developing educational programs for...- Albany Med Health System is looking for a skilled Hospital Coder to join their Health Information Services team. In this role, you will utilize your expertise to ensure accurate coding and compliance with healthcare regulations, contributing to high-quality patient care....Remote jobHourly pay
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