Medical Director
5 days ago
The Aetna Duals Center of Excellence (COE) is seeking a Medical Director to join our centralized team. This role will support the Medical Management staff in ensuring timely and consistent responses to members and providers related to precertification, concurrent review, and appeal requests.
Key Responsibilities- Perform concurrent and prior authorization reviews with peer-to-peer coverage of denials.
- Conduct appeals in their base plan and in the round-robin based on same or similar specialty needs.
- Participate in and lead daily rounds.
- Minimum 3-5 years of clinical practice experience.
- Two (2) + years of experience in managed care (Medicare and/or Medicaid).
- Experience with managed care (Medicare and Medicaid) utilization review preferred.
- MD or DO; Board certification in an ABMS or AOA recognized specialty is required.
- Active and current state medical license without encumbrances is required. Multiple state licensure a plus.
- Previous experience in utilization management/claims determination with another health plan/payor or hospital system/health system.
- Licensed in or willing to obtain license in at least one state where we have an Integrated plan.
MD (Doctor of Medicine) or DO (Doctor of Osteopathic Medicine)
CompensationThe typical pay range for this role is $174,374.90. This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography, and other relevant factors.
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Medical Director Physician
1 day ago
missouri, United States HealthPlus Staffing Full timeDocCafe has an immediate opening for the following position: Medical Director Physician in Missouri. DocCafe is the premier physician and advanced practice job board to help you advance your healthcare career. Register now to apply for this job and for access to 125,000+ other openings. DocCafe Offers: Free Physician and Advanced Practice Job Search Easily...
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Medical Director Physician
4 days ago
missouri, United States HealthPlus Staffing Full timeDocCafe has an immediate opening for the following position: Medical Director Physician in Missouri. DocCafe is the premier physician and advanced practice job board to help you advance your healthcare career. Register now to apply for this job and for access to 125,000+ other openings. DocCafe Offers: Free Physician and Advanced Practice Job Search Easily...
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Medical Director Physician Leader
10 hours ago
missouri, United States HealthPlus Staffing Full timeJob Opportunity at HealthPlus StaffingWe are seeking a highly skilled Medical Director Physician to join our team at HealthPlus Staffing.About the Role:Lead a team of healthcare professionals to provide high-quality patient care and services.Develop and implement medical strategies to improve patient outcomes and satisfaction.Collaborate with other...
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Missouri, United States Healthcare Connections Full timeStart Date: ASAPKansas City Family Medicine + Medical Director FAST TRACKA brand new exciting opportunity just opened in the sought-after Kansas City market This is an employed opportunity to join a state-wide organization celebrating 50 years of care to Missouri residents This is an opportunity to join an established practice just 25 minutes from the heart...
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Missouri, United States Healthcare Connections Full timeStart Date: ASAPKansas City Family Medicine + Medical Director FAST TRACK!A brand new exciting opportunity just opened in the sought-after Kansas City market! This is an employed opportunity to join a state-wide organization celebrating 50 years of care to Missouri residents! This is an opportunity to join an established practice just 25 minutes from the...
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Director of Mental Health Services
5 days ago
Missouri Valley, Iowa, United States Psychiatric Medical Care Full timeAbout the RoleWe are seeking a highly skilled and compassionate Director of Mental Health Services to lead our interdisciplinary team in providing exceptional care to older adults. As a key member of our Psychiatric Medical Care team, you will be responsible for overseeing the delivery of mental health services, developing and implementing treatment plans,...
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RN Director of Mental Health
2 days ago
Missouri Valley, United States Psychiatric Medical Care Full timeDescription:Come join our nurse leadership team with NO CALL AND NO WEEKENDS!Salary: up to $96,000 / year (dependent upon experience)Location: Missouri Valley, IowaPopulation: Older Adults (65+)This is our newest program in Iowa set to open October 2024. We have over a dozen of Iowa programs, so if this location isn't for you - reach out today and we can...
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Director of Mental Health Services
5 days ago
Missouri Valley, Iowa, United States Psychiatric Medical Care LLC Full timeJob SummaryWe are seeking a highly skilled and compassionate RN Director to lead our Mental Health Program in Missouri Valley, IA. As a key member of our team, you will be responsible for overseeing the daily operations of our program, ensuring the highest level of care for our patients, and collaborating with our interdisciplinary team to provide...
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RN Director of Mental Health
3 weeks ago
Missouri Valley, United States Psychiatric Medical Care LLC Full time $86,000 - $96,000Job DescriptionJob DescriptionDescription:Are you a Registered Nurse looking to take the next step in your career? Do you want to lead a small interdisciplinary team? We are hiring for our newest program in Iowa! Apply today!Salary: up to $96,000 / year (dependent upon experience) Location: Missouri Valley, Iowa Population: Older Adults (65+)**This is our...
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Certified Medication Technician
6 days ago
Chesterfield, Missouri, United States Sunrise Senior Living Full timeJob Summary:Sunrise Senior Living is seeking a highly skilled and compassionate Medication Care Manager to join our team. As a Medication Care Manager, you will play a vital role in ensuring the highest quality of care for our residents by administering medications and treatments in a safe and organized manner.Responsibilities:Administer medications and...
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RN Director of Mental Health Program
2 months ago
Missouri Valley, United States Psychiatric Medical Care LLC Full timeJob DescriptionJob DescriptionDescription:Salary: up to $96k / year (dependent upon experience) Location: Missouri Valley, IA **This is our newest program in Iowa set to open September 2024.Responsibilities:Lead a small disciplinary team comprised of a psychiatric physician, therapist, and medical office coordinator providing services to the senior...
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Primary Care Medical Director
7 days ago
O'Fallon, Missouri, United States St. Luke's Hospital - MO Full timeJob Posting:We are dedicated to providing exceptional care to every patient, every time.Our Commitment to Quality:At St. Luke's Hospital - MO, we strive to deliver high-quality, patient-centered care that exceeds expectations.We are a value-driven health system that has been nationally recognized for our commitment to excellence and patient...
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Business Development Director
4 months ago
Missouri City, United States Encompass Health Full timeThe Business Development Director is responsible for hospital inpatient and outpatient census in the IRF and/or LTCH and mix through the design and implementation of referral programs and customer service strategies. This position oversees inpatient admission process. The Business Development Director manages, trains and develops hospital-wide Business...
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Medical Insurance Credentialing Specialist
9 hours ago
Kansas City, Missouri, United States St. Joseph Medical Group (Kansas City Physician Care) Full timeJob SummaryWe are seeking a highly skilled Medical Insurance Credentialing Coordinator to join our team at St. Joseph Medical Group (Kansas City Physician Care). As a key member of our healthcare team, you will be responsible for ensuring the smooth operation of our provider enrollment and credentialing processes.Key ResponsibilitiesTrack and manage provider...
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Director of Nursing Operations
13 hours ago
Kansas City, Missouri, United States Children's Mercy KC Full timeAbout the RoleChildren's Mercy KC is seeking a highly skilled and experienced professional to fill the position of Assistant Director of Nursing Services. As a key member of our nursing leadership team, you will be responsible for providing leadership and direction to our nursing staff, ensuring the delivery of high-quality patient care and services.Key...
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RN Director of Mental Health
2 weeks ago
Missouri Valley, IA, United States Psychiatric Medical Care Full timeDescription:Are you a Registered Nurse looking to take the next step in your career? Do you want to lead a small interdisciplinary team? We are hiring for our newest program in Iowa! Apply today!Salary: up to $96,000 / year (dependent upon experience)Location: Missouri Valley, IowaPopulation: Older Adults (65+)**This is our newest program in Iowa set to open...
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RN Director of Mental Health
2 days ago
Missouri Valley, Iowa, United States Psychiatric Medical Care LLC Full timeJob SummaryWe are seeking a highly skilled and compassionate Registered Nurse to lead our interdisciplinary team in providing exceptional care to older adults experiencing depression and/or anxiety related to life changes.Key ResponsibilitiesLead a small team of healthcare professionals, including a psychiatric physician, therapist, and medical office...
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Director of Concessions
2 months ago
Missouri City, United States Compass Group Careers Full timeJob DescriptionJob Description Levy Sector LOCATION: Toyota Center is home of the NBA's Houston Rockets. Toyota Center also plays host to the nation's top concerts and touring shows.Different perspectives make us better. We’re committed to creating an equal opportunity and fair treatment environment, where learning and growing together is just part...
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Practical Nurse Specialist
2 weeks ago
Missouri, United States New Season Full timeJoin Our Mission to Support Recovery Are you passionate about making a positive impact in the lives of individuals struggling with Opioid Use Disorder? At New Season Treatment Centers, we are dedicated to providing exceptional care and support to our patients. As a Licensed Practical Nurse, you will play a vital role in our mission. About Us With over three...
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Full Time Emergency Medicine Physician
3 months ago
Missouri, United States The Medicus Firm Full timeMissouri Emergency MedicineMedical DirectorExcellent quality of Life – You determine your work scheduleExcellent support staff – Scribe coverage for every shiftAround the clock physician coverage$100, Student loan repaymentDesirable benefits package:Retirement, relocation assistance, medical/dental, PTO,CME ($5k/5-days), malpractice and much...