57 medical director jobs found

Looking for an intellectually stimulating role that will challenge you to use your current knowledge and build new skills? Join us as an Associate Medical Director at eviCore, where you’ll be empowered to make a difference in the lives of patients by improving the quality of healthcare nationwide.     What you’ll do:   Use your analytical mindset.  Provide timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria. Review appeals for denied services related to relevant medical experience and our evidence based guidelines, in accordance with appeal policies, if so delegated.  Be a team player.  Work collaboratively with over 400 eviCore Physician Peers to help ensure patients receive proper care via evidence based decision making.  Provide timely peer-to-peer...

Office Location:  Newtown Square, PA with remote opportunities available Commitment:  Full-time Versalus Health provides data-driven solutions combined with clinical operations support to hospitals and health systems to help them enhance Medicare compliance and improve financial performance. Versalus Health was founded by industry leaders who established the standard for reviews of Medicare short-stay cases and remain trusted advisors to hospitals across the country. As a Medical Director for Versalus Health , you’ll have the unique opportunity to evaluate hospitalizations across the country while utilizing your medical knowledge and gaining experience as an expert advisor to Versalus Health’s client hospitals. You will perform clinical case reviews and provide recommendations that focus on establishing the appropriate admission status. Versalus Health offers a career path that allows you to continue using your clinical...

Alpha Medical is seeking an Associate Medical Director with a passion for patient advocacy and improving the way people access healthcare today. The Associate Medical Director will work collaboratively under the supervision of the Medical Director and have a strong focus on the operations for our clinical and provider Team.    As an Associate Medical Director, you will be part of a small but mighty provider and clinical team that’s focused on identifying departmental needs and implementing scalable processes. You will get experience working with stakeholders from various departments, aligning clinical operational roadmaps to Alpha’s strategic growth, assisting with training and development programs, reviewing and suggesting policy updates, performance and provider reviews, and other tasks as assigned.   Alpha Values: We are mission-driven -  We’re changing the paradigm of healthcare for patients who are historically...

The Medical Director is responsible for providing clinical leadership within Sentara Health Plans, aligned to one or more plans. Accountable for monitoring utilization, case management and quality outcomes. The Medical Director collaborates with the Sentara Health Plans Chief Medical Director, Senior Medical Director(s) and Clinical Care Services (CCS) teams to establish, implement, and evaluate effectiveness of clinical programs to support members and meet the department goals. Medical Director activities further include support of the CCS nurses, Government services nurses, Pharmacy staff, Population Health and Quality Improvement Teams. Lastly, Medical Directors interact externally with network physicians, vended program clinical leaders, and government program leaders as required to improve the quality of clinical outcomes, cost efficiency and patient/member experience with the Health Plan and Health Systems with which we contract. Physical Location Optima...

Hi, we're Oscar. We're hiring a Behavioral Health Utilization Management Medical Director to join our Member Strategy & Ops team. Oscar is the first health insurance company built around a full stack technology platform and a focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family.   About the role You will determine the medical appropriateness of behavioral health services by reviewing clinical information and applying evidence-based guidelines. This role is required to meet Oscar's contractual services to Cigna as part of our C+O partnership, for which Oscar is delegated for behavioral health utilization management services. The services performed by this role are central to both the compliance and accreditation of Oscar's utilization management program. You will report to the VP Medical Director, Member Programs. This is a remote /...

This role is eligible for a $10,000 sign-on bonus for external candidates. This role is 100% remote. Qualified candidates, regardless of geographic location, will be considered. The Medical Director provides organizational leadership in the operational areas of care management, utilization review, appeals, quality improvement and related policy and practice initiatives in collaboration with the Corporate Medical Director(s), Utilization Management and the Vice President, Utilization Management Physician. The following responsibilities are in regards to members with medical conditions and their providers: Identifying and implementing evidence-based practice guidelines throughout the provider network. Overseeing the quality of clinical care for network and non-network providers. Engaging the provider network in Continuous Quality Improvement through the diffusion of practice standards, and through an internal quality assurance program that measures network...

Bottom line up front: Early-stage digital health company, have raised a $12 million seed round. Co-Founders are seasoned operators who’ve built and grown companies before.  Founders believe in the critical importance of top-notch clinical talent and leadership in the medical group. Miga Health helps people lead longer, healthier lives, using at-home blood pressure monitoring, telemedicine, mail-order pharmacy, and lifestyle coaching.  Remote team from day one, supporting physicians all across the United States. What will I do? We exist to prevent heart attacks and strokes, and reduce suffering and death. Fundamentally that is what you will do, too! The problem is complex and mind bendingly difficult, but if you’re a purpose-driven individual who likes challenges, then you’ll love working with Miga Health. As Medical Director of Miga Health’s medical group, you will be responsible for launching our new offerings in...

When you join New York Life, you’re joining a company that values development, career growth, collaboration, innovation, and diversity & inclusion. We want employees to feel proud about being part of a company that is committed to doing the right thing. Through various resources and programs, you can grow your career while developing personally and professionally. Corporate Vice President – Medical Director – Internal Medicine with Specialty Certification - Cardiology   A career at New York Life offers many opportunities. To be part of a growing and successful business. To reach your full potential, whatever your specialty. Above all, to make a difference in the world by helping people achieve financial security. It’s a career journey you can be proud of, and you’ll find plenty of support along the way. Our development programs range from skill-building to management training, and we value our diverse and inclusive workplace where all...

Cohere Health is illuminating healthcare for patients, their doctors, and all those who are important in a patient’s healthcare experience, both in and out of the doctor’s office. Founded in August 2019, we are obsessed with eliminating wasteful friction that patients and doctors experience in areas that have nothing to do with health and treatment, particularly for diagnoses that require expensive procedures or medications. To that end, we build software that is expressly designed to ensure the appropriate plan of care is understood and expeditiously approved, so that patients and doctors can focus on health, rather than payment or administrative hassles. Opportunity Overview: We are looking for a Medical Director who will lead our Cardiology Associate Medical Directors and perform clinical reviews. Reporting to the Senior Medical Director for Cohere Health, and part of the review team that includes non-clinical intake specialists and nurses, this is a critical...

Cohere Health is illuminating healthcare for patients, their doctors, and all those who are important in a patient’s healthcare experience, both in and out of the doctor’s office. Founded in August 2019, we are obsessed with eliminating wasteful friction that patients and doctors experience in areas that have nothing to do with health and treatment, particularly for diagnoses that require expensive procedures or medications. To that end, we build software that is expressly designed to ensure the appropriate plan of care is understood and expeditiously approved, so that patients and doctors can focus on health, rather than payment or administrative hassles. Opportunity Overview: We are looking for physicians who have expertise in Cardiology to deliver on Cohere’s Cardiology program by determining the medical appropriateness of services by reviewing clinical information and applying evidence-based guidelines.  Reporting to the Chief Medical Officer...

Why Charlie Health? Young people across the country need our help. The sad reality is that a mental health crisis has taken hold of our most vulnerable population—leading to record levels of depression, anxiety, substance abuse, and self-harm. From Manhattan to Montana, this reality is compounded by issues of access, both geographic and financial. The mental health landscape is systemically broken, and our young people are suffering as a result. Charlie Health has set out on a mission to reimagine how high acuity care is delivered to young people and families in crisis. Our initial offering is a virtual intensive outpatient program, which places peers with similar mental health experiences and goals into customized virtual groups. Our team of masters-level clinicians lead groups multiple times per week to deliver a higher level of care. Our goal is to help young people and families heal together. Through a combination of exceptional medical and psychological...

Position is remote. 100% telehealth. Available as full-time! Compact State required. Who we are: Bend Health is revolutionizing the treatment of mental health conditions for kids and teens. Our innovative technology achieves better outcomes and leads to happier, healthier lives while ensuring stigma, costs, and logistics are no longer barriers. Come and be part of a fun, collaborative, supportive, motivated, and data-driven team creating the first scalable and integrated model in mental healthcare for kids and teens. Help shape the future of pediatric mental health and bend the healthcare system to work better for everyone. Today’s world can be intense and stressful, and it’s taking an unprecedented toll on kids, teens, and families. Bend Health’s collaborative care model relies on therapy to help families manage the ups and downs of everyday life. These challenges could involve managing emotions, challenging negative thinking, and reducing stress...

Position is remote, 100% tele-health. Available as full-time. Who we are: Bend Health is revolutionizing the treatment of mental health conditions for kids and teens. Our innovative technology achieves better outcomes and leads to happier, healthier lives while ensuring stigma, costs, and logistics are no longer barriers. Come and be part of a fun, collaborative, supportive, motivated, and data-driven team that’s creating the first scalable and integrated model in mental healthcare for kids and teens. Help us shape the future of pediatric mental health and bend the healthcare system to work better for everyone. Today’s world can be intense and stressful, and it’s taking an unprecedented toll on kids, teens, and families. Bend Health’s collaborative care model relies on an evidence-based approach to help families manage the ups and downs of everyday life. We are looking for a part-time child/adolescent psychiatrist passionate about whole-person,...

POSITION TITLE Vascular Teleneurologist – Full Time LOCATION 100% Remote (US Based Applicants Only) SHIFT AVAILABILITY Full Time – 14 shifts/month (10 weekdays, 1 full weekend) COMPANY DESCRIPTION Sevaro is a data-driven Teleneurology company bringing clinical quality, academic training, innovation, and modern technology to the market. Our compassion or “Seva” pushes us to serve others without expecting anything in return. Sevaro was designed for physicians, by physicians! We are vascular trained neurologists with experience at academic medical centers focused on creating stroke survivors. POSITION HIGHLIGHTS As a Teleneurologist, you will examine stroke and neurology patients virtually using HIPAA-compliant telemedicine technologies. This exciting opportunity offers the ability to provide best-in-class patient care with an extremely competitive pay and a flexible work life balance. Sevaro’s innovative solution...

Clinical Reviewer (Remote - LCSW/LMHC/RN/PsyD/PhD) Are you an experienced Clinical Reviewer looking for a new challenge? Do you value care management and quality improvement ? Are you motivated , energetic , and excited to become part of the Kepro team? If so, you might be our next new team member! Who we need: The Clinical Reviewer completes comprehensive PASRR determinations for individuals with serious mental illness, intellectual disability, or related conditions, who require nursing facility level of services. Summary determinations are person-centered assessments utilizing medical and behavioral health records, evaluations, and treatment team consultations and will include the need for confirming diagnoses and making recommendations for care, including specialized services, within integrated settings. Why us? Kepro is a rapidly growing national quality improvement and care management organization. We work to ensure that over 20...

Hi, we're Oscar Medical Group. We're hiring a Nurse Practitioner or Physician Assistant to join our Virtual Primary Care team. Oscar is the first health insurance company built around a full stack technology platform and a focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family. About the role We're looking for a full-time APP to manage a panel of members within the state of Texas and other Oscar states where we offer Virtual Primary Care or expand to (including Florida, New York, Colorado, Arizona, or Georgia). You'll keep a set patient schedule and will be the primary care provider for your panel. We're building this program from the ground up, so you'll engage with new products and tooling that we're rolling out for the virtual care service lines. You will report to the Virtual Primary Care Medical Director. This is a remote / work-from-home...