- CVS Health (Tallahassee, FL)
- …the full continuum of our members' health care and social determinant needs. The Case Management (CM) Medical Director will participate in designing, ... reside in Florida and and must have a Florida medical license or be willing to obtain one. **Primary...business needs * 3-5 years of Managed Care experience; Medicare highly preferred * 3-5 year of Case… more
- Humana (Jefferson City, MO)
- **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The ... Medical Director work assignments involve moderately complex to complex issues...materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and … more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Director Case Mgmt Social Svcs position is responsible for strategy, function and operations of the Case Management & Social Work ... while promoting the most cost-effective utilization of the hospital's resources. The Director Case Mgmt Social Svcs position deploys population-focused teams to… more
- Henry Ford Health System (Clinton Township, MI)
- …practice guidelines, behavior change theory, Medicare and Medicaid regulations and case management principles. . Knowledge of medical ethics and legal ... Under the direction of VP Operations, CNO, the Regional Director of Case Management is responsible for...Ford is one of the nation's most respected academic medical centers and is leading the Future of Health:… more
- LifePoint Health (Johnstown, PA)
- …Case Management/Social Services* **Organization:** ** **Title:** *Market Director Case Managemen* **Location:** *Pennsylvania-Johnstown* **Requisition ID:** ... are not just what you can do. Conemaugh Memorial Medical Center is the largest healthcare provider in west...Growth Opportunities . And much more Position Summary: Provide Case Management leadership and management for hospitals within a… more
- AmeriHealth Caritas (Detroit, MI)
- …facilitating authorizations/referrals for the utilization of services. + Interfaces with the Medical Director and other Integrated Care Team participants on ... this job:** Under the supervision of the Supervisor of Medicare LTSS Operations, the Medicare LTSS Care...chronic illnesses, co-morbidities, and/or disabilities in a service coordinator, case management, or similar role or any combination of… more
- Humana (Jefferson City, MO)
- …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 ... national guidelines such as NCD/LCD, MCG(R) or InterQual The Medical Director conducts clinical case ... Medicare population and reports to the Lead Medical Director . **Other duties:** + Identify … more
- Humana (Nashville, TN)
- **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The ... Medical Director work assignments involve moderately complex to complex issues...group practice management. + Utilization management experience in a medical management review organization, such as Medicare … more
- Humana (Juneau, AK)
- **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The ... Medical Director work assignments involve moderately complex to complex issues...group practice management. + Utilization management experience in a medical management review organization, such as Medicare … more
- Sharp HealthCare (San Diego, CA)
- …the position, and employer business practices. **What You Will Do** This Senior Medical Director position provides critical management and oversight for Sharp ... + 5 years' experience as an HMO Health Plan Medical Director . + California Physicians and Surgeons...and reports findings in conjunction with the Quality Improvement Director . + Assists in POS/PPO Case Management… more