Jobs related to Remote Medical Director Utilization Jobs in Some College

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• Oncology Medical Director - Remote

  A company is looking for a Medical Director responsible for providing clinical oncology expertise regarding cancer treatment and diagnostics.

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• State Licensed Medical Director - Remote

  A company is looking for a Medical Director - Case Management - Remote.

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• State Licensed Medical Director - Remote

  A company is looking for a Medical Director - Behavioral Company.

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• State Licensed Medical Director - Remote

  A company is looking for a Medical Director - Medicare Grievances and Appeals Corporate.

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• Massachusetts Licensed Medical Director - Remote

  A company is looking for a Health Plan Medical Director to lead medical management and clinical services operations.

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• Kansas Licensed OBGYN Medical Director - Remote

  A company is looking for a Weekend Per Diem Medical Director specializing in OBGYN.

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• New York Licensed Behavioral Health Clinician - Remote

  Assess services for members to ensure compliance with regulations and optimal outcomes Conduct prior authorization reviews and process requests within required timelines Collaborate with multidisciplinary teams and refer appropriate requests to Medical...Directors Required Qualifications Licensed Behavioral Health Practitioner in the US with a minimum of three years of experience in a behavioral health setting At least one year of experience in Utilization Management (UM) Familiarity with Behavioral

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• Inpatient Medical Coder - Remote

  Key Responsibilities Develop clinical and coding products in collaboration with Medical Directors and Innovation Teams Analyze data and conduct research to enhance claim selection methodologies and performance Provide Subject Matter Expert (SME) support

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• Compact RN Hospice Triage - Remote

  Key Responsibilities Provide after-hours triage support for hospice and home health patients Access electronic medical records and utilize internal applications for documentation Complete required charting and shift preparation before and after taking

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• Utilization Review Nurse - RN - Remote

  level reviews for outpatient and inpatient pre-certification requests for medical appropriateness and manage post-service reviews Ensure proper referrals and documentation for denial authorizations and appeals, while maintaining confidentiality and utilizing...medical guidelines Required Qualifications Current RN license in the United States or U.S. territory 1+ years of clinical experience required Knowledge of medical claims and ICD-10, CPT, HCPCS coding Proficiency in software applications including

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