MD Appeals Medical DirectorVirtualVocations • Chula Vista, California, United States
MD Appeals Medical Director
VirtualVocations • Chula Vista, California, United States
job_description.job_card.variable_days_ago
serp_jobs.job_preview.job_type
- serp_jobs.job_card.full_time
job_description.job_card.job_description
A company is looking for an Appeals M.D. - Member Appeals to perform clinical reviews and adjudications of appeals and grievances cases.
Key Responsibilities
Conduct individual case reviews for appeals and grievances related to various health plan products
Respond to regulatory inquiries from the Department of Insurance, Department of Managed Healthcare, and CMS
Collaborate with medical directors and staff on access, network, and quality issues while participating in team meetings
Required Qualifications
MD or DO with an active, unrestricted license
Board Certified in an ABMS or AOBMS specialty (excluding Pediatrics)
5+ years of clinical practice experience
serp_jobs.job_alerts.create_a_job
Medical Director • Chula Vista, California, United States
Job_description.internal_linking.related_jobs
Impact Lives, Impact Community.Family Health Centers of San Diego (FHCSD) is passionate about providing exceptional health care to all, especially underserved communities with limited health care o...serp_jobs.internal_linking.show_more
Posterity Group is a veteran owned, service-disabled Government contractor located in Rockville, MD.We have partnered with Valor Healthcare to provide numerous medical providers in various locales,...serp_jobs.internal_linking.show_more
Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United Sta...serp_jobs.internal_linking.show_more Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United Sta...serp_jobs.internal_linking.show_more 
Executive Medical Director - ER - Encinitas, CA .Papaya Veterinary Care is looking for Executive Medical Director of Veterinary Medicine (DVM) candidates for our ER Hospital in Encinitas, CA.W...serp_jobs.internal_linking.show_more
Medical Director — Early Clinical Development.Lead early-phase clinical development for one or more programs.You’ll shape clinical strategy, design and execute Phase 1 studies, collabor...serp_jobs.internal_linking.show_more
DocCafe has an immediate opening for the following position : Physician - Medical Director in San Diego, California.DocCafe is the premier physician and advanced practice job board to help you advan...serp_jobs.internal_linking.show_more
DocCafe has an immediate opening for the following position : Physician - Medical Director in San Diego, California.DocCafe is the premier physician and advanced practice job board to help you advan...serp_jobs.internal_linking.show_more Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United Sta...serp_jobs.internal_linking.show_more 
Clinical Resource Management Director.Responsible for the operations for Clinical Resource Management Department.Accountable for leading the operations of the Clinical Excellence initiatives of the...serp_jobs.internal_linking.show_more Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United Sta...serp_jobs.internal_linking.show_more 
At Gameday Men's Health, we are redefining men's wellness by combining cutting-edge treatments with personalized concierge-level care.
Our global expansion reflects our commitment to helping men opt...serp_jobs.internal_linking.show_more
Bay Area, CA (in-person; some remote coordination).We are seeking a highly experienced and detail-oriented Personal Medical Director to manage and execute an intensive, multi-phase health recovery ...serp_jobs.internal_linking.show_more
Account Director, Medical Education & Communications.MedForce, an IQVIA business, provides best-in-class medical communication services to help life sciences companies connect with HCPs and improv...serp_jobs.internal_linking.show_more
Vivo HealthStaff is searching for an Internal Medicine or Family Practice Physician with a desire to work with the geriatric population.
The physician will be the clinical leader of an expansion in ...serp_jobs.internal_linking.show_more
We are seeking a highly motivated Medical Director, Clinical Development to lead the execution of our early-stage clinical programs (Phase III) who will report directly to the VP, Clinical Developm...serp_jobs.internal_linking.show_more Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United Sta...serp_jobs.internal_linking.show_more Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United Sta...serp_jobs.internal_linking.show_more Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United Sta...serp_jobs.internal_linking.show_more 
Considering Local Candidates only.The Account Specialist will perform a wide range of duties to foster critical partnerships and ensure patients receive appropriate and timely care.This is an offic...serp_jobs.internal_linking.show_more
Assistant Medical Director, Psychiatry
Family Health Centers of San Diego • San Diego, CA, United States
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Chief Medical Director
Posterity Group LLC • Escondido, CA, US
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Physician / Oncology / California / Permanent / Associate Medical Director - Oncology - 100% Remote
eviCore healthcare • San Diego, CA, US
serp_jobs.filters.remote
serp_jobs.job_card.part_time
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Physician / Neurology / California / Permanent / Associate Medical Director - Neurology - 100% Remot
eviCore healthcare • San Diego, CA, US
serp_jobs.job_card.part_time
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Executive Medical Director - ER - Encinitas, CA
Papaya Veterinary Care • Encinitas, CA, US
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Medical Director
BioPhase Solutions • San Diego, CA, US
serp_jobs.job_card.full_time +1
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Medical Director Physician - Competitive Salary (San Diego)
DocCafe • San Diego, CA, US
serp_jobs.job_card.part_time
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Medical Director Physician - Competitive Salary
DocCafe • San Diego, California, US
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Physician / Other / California / Permanent / Associate Medical Director - Maternal Fetal - 100% Remo
eviCore healthcare • San Diego, CA, US
serp_jobs.job_card.part_time
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
District Director Clinical Resource Mgmt
Palomar Health Rehabilitation Institute • Escondido, CA, US
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Physician / Oncology - Radiation / California / Permanent / Associate Medical Director - Radiation O
eviCore healthcare • San Diego, CA, US
serp_jobs.job_card.part_time
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Gameday Men's Health Clinic Director - PA or NP
Gameday Men's Health • San Diego, CA, US
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Personal Medical Director
Town + Country Resources • San Diego, CA, United States
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Account Director, Medical Education & Communications
IQVIA Holdings • San Diego, CA, US
serp_jobs.job_card.part_time
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Medical Director Physician
Vivo HealthStaff • San Diego, CA, United States
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Medical Director, Clinical Development
Alterome Therapeutics • San Diego, CA, US
serp_jobs.job_card.temporary
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Physician / Cardiology / California / Permanent / Associate Medical Director - Cardiology - 100% Rem
eviCore healthcare • San Diego, CA, US
serp_jobs.job_card.part_time
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Physician / Gastroenterology / California / Permanent / Associate Medical Director - Gastro - 100% R
eviCore healthcare • San Diego, CA, US
serp_jobs.job_card.part_time
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Physician / Surgery - Orthopedics / California / Permanent / Associate Medical Director - Orthopedic
eviCore healthcare • San Diego, CA, US
serp_jobs.job_card.part_time
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Account Specialist Medical Sales
Stance Health Solutions • San Diego, CA, US
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted