The Medical Director, working together with a coder (DRG Integrity Specialist), will review inpatient charts to ensure the acuity and complexity of the patient's hospital stay is appropriately captured in the clinical documentation and translated into coding. The Medical Director is responsible for ...
The Medical Director relies on medical background and reviews health claims. The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized. The M...
Highmark Health Medical Director, Medicaid (Remote PA, DE or WV) Charleston, West Virginia. The incumbent reviews escalated cases electronically and using Medical Policy criteria sets to evaluate the medical necessity and appropriateness of the requested treatment of service. Conduct electronic revi...
The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should meet authorization requirements. The Medical Director provides medical interpretation and determi...
Merck Global Senior Director, Medical Affairs - Atherosclerosis. The Global Senior Director, Medical Affairs (GDMA) is responsible for driving execution of value and implementation plans for atherosclerosis programs in key countries and regions. They consolidate actionable medical insights from coun...
The Medical Director reports directly to the Executive Director, Medical & Scientific Affairs. The Medical Affairs Director provides support to the Medical Affairs/Clinical Affairs Group for the Pharma and Consumer products portfolio. Actively contributes to and drives Medical planning including...
The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized. The Medical Director provides medical interpretation and determinations whether se...
In the Medical Director role you will provide oversight for medical policy implementation. CVS Health Medical Director (National Accounts) Charleston, West Virginia. You'll participate in the development, implementation, and evaluation of clinical/medical programs and expand Aetna's medical manageme...
The Medical Director relies on medical background and reviews health claims. The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized. The M...
CVS Health - Medical Director (Ortho/Total Joint) - Charleston, West Virginia. Aetna, a CVS Health Company, is looking for a Medical Director (Ortho/Total Joint) who will be a Subject Matter Expert (SME) with a background in Orthopedic specialty. This role expands Aetna's medical management programs...
WVUHS Medical Group OB/GYN Medical Director - Charleston, WV. WVUHS Medical Group seeks a Medical Director, Obstetrics & Gynecology. Applicants must have an MD or DO degree or foreign equivalent and be eligible to obtain a West Virginia state medical license. WVUHS Medical Group is an AA/EO empl...
Medical Director -Psychiatrist- Behavioral Health page is loaded Medical Director -Psychiatrist- Behavioral Health Apply locations Highland Hospital time type Full time posted on Posted 2 Days Ago job requisition id JR108720 Medical Director -Psychiatrist- Behavioral Health | Highland Hospital | Cha...
Health System, located in Charleston WV, is seeking a BC OBGYN to join a multi-specialty physician group made up of over 80 providers in a Medical Director role. ...
Highmark Health Medical Director Charleston, West Virginia Apply Now. The incumbent reviews escalated cases electronically and using Medical Policy criteria sets to evaluate the medical necessity and appropriateness of the requested treatment of service. Conduct electronic review of escalated cases ...
CVS Health - Medical Director - Behavioral Health. In this role as Medical Director (Behavioral Health) you will:. Provide leadership and day-to-day physician oversight for utilization management team, including the management of high-risk cases and medical necessity decisions. Participate in the de...
In the Medical Director role you will provide oversight for medical policy implementation. The Medical Director will act as lead business and clinical liaison to network providers and facilities to support the effective execution of medical services programs by the clinical teams. You will participa...
Medical Director – Physician. Assume the administrative authority, responsibility, and accountability of implementing our medical services, policies, and procedures according to federal, state and local regulations; and current practice of post-acute and long-term care medicine. Coordinate med...
In the Medical Director role you will provide oversight for medical policy implementation. The Medical Director will act as lead business and clinical liaison to network providers and facilities to support the effective execution of medical services programs by the clinical teams. You will participa...
WEST VIRGINIA PSYCHIATRY (MEDICAL DIRECTOR) OPPORTUNITY!!. Client is seeking a Medical Director for one of its West Virginia Psychiatric inpatient units. The hospital is offering a competitive base salary, incentive bonus, medical director stipend and complete benefits package. This area qualifies a...
Attend meetings as appropriate, including medical director meetings, QI committee and subcommittees, as assigned. Effectively interact with professional groups, such as state and county medical societies, hospital executive committees, medical staff executive committees, payers, member related assoc...
The Duals Care Management (CM) Medical Director will participate in designing, developing and deploying our Models of Care across all markets. Consults with plan medical staff regarding adverse determinations, addresses issues related to network providers, performs medical chart reviews, and conduct...
Health System, located in Charleston WV, is seeking a BC OBGYN to join multi-specialty physician group made up of over 80 providers in Medical Director role. ...
Whether you are caring for our patients at one of the critical access hospitals, community sites, regional or academic medical centers, we are all one WVU Health System. ...
We help negotiate your salary and contract.We coordinate interviews and help with licenses.Specialized recruiters match your career preferences.Experienced support teams take care of every detail....
Medical Director – Physician. Assume the administrative authority, responsibility, and accountability of implementing our medical services, policies, and procedures according to federal, state and local regulations; and current practice of post-acute and long-term care medicine. Coordinate med...