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Regularly meet with naviHealth’s leadership to review care coordination issues, develop collaborative intervention plans, and share ideas about network management issues. Conduct provider telephonic review and discussion and share tools, information, and guidelines as they relate to cost-effective healthcare delivery and quality of care.
$397,743 a yearFull-timeRemoteExpandApply NowActive JobUpdated 1 month ago - UpvoteDownvoteShare Job
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Review and approve their site’s medical provider time-off requests & timecards. Under the direction of the Chief Medical Officer (CMO) the Site Medical Director supports their site’s medical provider team to achieve high job performance and satisfaction; assists the CMO to ensure access to high-quality medical services for APLA Health & Wellness patients at their clinical site.
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You will lead all aspects of utilization review/quality assurance, directing case management. This role can be remote based anywhere in the US.The Medical Director (Cardiology) will be a Subject Matter Expert (SME) with a background in Cardiology specialty, including post-graduate direct patient care experience specifically.
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Unless expressly allowed by state or federal law, or regulation, must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US military base, vessel or any embassy located in or outside of the US.
$429,600 a yearFull-timeExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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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 States.
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Due to the continuing growth of our organization, Medical Review Institute of America (MRIoA) is currently offering a full-time, remote (work from home) position for a Medical Director (Physician Reviewer.
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The Assistant Medical Director will assist the Medical Director to coordinate and oversee the Quality Assurance/Quality Management, Risk Management Committees and meetings including quarterly peer review.
$287,670 a yearFull-timeExpandApply NowActive JobUpdated 1 month ago - UpvoteDownvoteShare Job
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Demonstrated ability to positively interact with other clinicians, management, and all levels of medical and non-medical professionals. Respond to clinical inquiries and serve as a non-promotional medical contact point for various healthcare providers.
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Review pre- and post-service behavioral health service requests and render decisions based on the member's benefits, medical necessity, Blue Shield of California medical policy, FEP (Federal Employee Program) medical policy, as well as legal and regulatory requirements.
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Monogram’s innovative, in-home approach utilizes a national nephrology practice powered by a suite of technology-enabled clinical services, including case and disease management, utilization management and review, and medication therapy management services that improve health outcomes while lowering medical costs across the healthcare continuum.
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