South Florida
The Long Term Services and Support Medical Director will oversee and be responsible for all LTSS and execution of all health care affordability and clinical quality initiatives to achieve goals. The Medical Director is accountable for quality initiatives to improve HEDIS […]
Various locations in CA, AZ, WA, TX, FL
Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care. […]
Kansas City area, KS
Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit. […]
Chicago area
Perform duties to direct and coordinate the medical management, quality improvement and credentialing functions for the assigned health plan based on, and in support of the company’s strategic plan; establishing the strategic vision and attendant policies and procedures. […]
FL; IN; Omaha; Tempe or Tucson, AZ; Various Washington and Texas locations
Perform duties related to the day-to-day operations of the High Risk Case Management functions to include working with members identified as high risk to identify needs and goals to achieve empowerment and improved quality of life. […]
Miami, FL; Remote possibility from Miami area
Gathers and synthesizes clinical information in order to authorize services. Reviews health care services to determine consistency with contract requirements, coverage policies and evidence-based medical necessity criteria. Collects and analyzes utilization information. […]
Portland, ME
This position serves as the leader for all clinical operations. The Director has primary responsibility to carry out all care coordination services. Accountabilities include all clinical operations, processes, programs, policies, procedures, documentation and reporting. […]
Fort Lauderdale area, FL & Lanexa, KS
Supervise the daily operations of the utilization management (UM) department. […]
Jacksonville, Tampa and Fort Lauderdale areas, FL
Responsible for defining and directing a complete Case Management Program in conjunction with corporate goals and objectives. […]
Ohio, Arizona
The Psychiatric Medical Director will assist the Chief Medical Officer to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit. […]
Sacramento or Fresno CA
The Senior Medical Director will provide medical leadership for utilization management, cost containment, and medical quality improvement activities. Performs medical review activities pertaining to utilization review, […]
Tacoma, WA
Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit. […]
Tacoma, WA
The Chief Medical Director directs and coordinates the medical management, quality improvement and credentialing functions for the assigned business unit based on, and in support of the strategic plan, establishing the strategic vision and attendant policies and procedures. […]
Jacksonville and Fort Lauderdale area, FL
The Manager, Care Coordination, is responsible for the oversight, management and optimization of all care coordination activities as it relates to pre-admission, ambulatory case management, inpatient, social service, home health, health education, behavioral health and other health care delivery programs. […]
WA, AZ, IN, NY, FL
The RN Case Manager is responsible for providing care coordination services by working collaboratively with a team of individuals involved in the care team as they provide medical, behavioral, psycho/social care, health and wellness classes, and other related services and supports members. […]
