Clinical Coverage Review Medical Director
A company is looking for a Clinical Coverage Review Medical Director to support pharmacy operations and clinical review processes.
Key ResponsibilitiesReview and approve proposed pharmacist denials for outpatient medication requestsConduct coverage reviews and render determinations based on medical necessity and policy guidelinesCollaborate with clinical staff and providers to ensure accurate and timely benefit determinationsRequired QualificationsActive, unrestricted physician licenseCurrent board certification in an ABMS or AOA specialty5+ years of clinical practice experience post-residencyExperience with electronic clinical systemsAbility to participate in rotational call coverage
Medical Director Opportunity - Medicare Risk Adjustment HCC Review - Michigan!!
ROLE: The Medical Director reviews outpatient/inpatient medical records for proper documentation relevant to Medicare Risk Adjustment reimbursement payment system. Receives, reviews, verifies, and processes requests for medical record audits, including but not limited to, inpatient hospitalizations,...
Claims Clinical Specialist – Medical Review Team
Claims Clinical Specialist – Medical Review Team. Bring your nursing knowledge and experience, and Genworth will provide the training necessary to succeed as a Medical Review Nurse. The Claims Clinical Specialist role is an excellent opportunity for a Registered Nurse seeking a career change. You wi...
Medical Director - MedVet Commerce
Medical Director (MD) works collaboratively with the Hospital Director (HD) to lead the Healthcare Team. The MD, who reports to a Regional Medical Director, is the local leader of Medical Services and oversees all specialty and emergency doctors. MedVet has an opportunity for a strong Medical Direct...
Physician - Medical Director - Anesthesiology/Critical Care
The Medical Director partners with faculty from Cardiac Surgery, Vascular Surgery, and Intensivists (Anesthesiology/SICU) as well as the Clinical Nursing Director and Service Line partners to provide leadership for the operations of the 20-bed CVICU, creating a culture that engenders delivery of sup...
Medical Director of Addiction Psychiatry - Maplegrove
As an integrated part of Henry Ford Psychiatry and Behavioral Medicine, patients have access to full-range of psychiatric and medical resources. ...
Director Patient Care RN - Medical/surgical and Acuity Adaptable Units
Director Patient Care RN - Medical/surgical and Acuity Adaptable UnitsSouthfield MI. Director Patient Care RN - Medical/surgical and Acuity Adaptable Units in Southfield MI. Ascension have an immediate need for Director Patient Care RN - Medical/surgical and Acuity Adaptable Units. If you happen to ...
Physician - Medical Director - Anesthesiology/Critical Care
The Medical Director partners with faculty from Cardiac Surgery, Vascular Surgery, and Intensivists (Anesthesiology/SICU) as well as the Clinical Nursing Director and Service Line partners to provide leadership for the clinical operations of Cardiovascular Patients, creating a culture that engenders...
Veterinarian Medical Director
As the Veterinary Medical Director, you will play a vital role in leading our veterinary team and ensuring the delivery of top-notch medical care to our patients. We are seeking a Medical Director at . The Medical Director (MD) is responsible for providing strong leadership for the hospital in coord...
Medical Director - Aetna One Advocate
The Medical Director (MD) for Aetna One Advocacy is responsible for providing clinical expertise and business direction in support of medical management programs to promote the delivery of high quality, constituent responsive medical care. The MD is a critical medical/business leader resource for ex...
Delivery Driver - No Experience Needed.
Available in over 4,000 cities in the U.S, DoorDash connects local businesses and local drivers (called Dashers) with opportunities to earn, work, and live.All you need is a mode of transportation (bike, car, scooter) and a smartphone to start making money.You can even sign up and begin working that...