Jobs near Anaheim: 11,931
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Relevance Score ranked on: MEDICAL DIRECTOR
Appeals Medical Director- Cardiology
COSTA MESA, 3080 BRISTOL ST, STE 200
Appeal Reviews. Supports clinicians to ensure timely and consistent responses to members and providers. Provides guidance for clinical operational aspects of a program. May conduct peer-to-peer clinical case reviews with attending physicians or other ordering providers to discuss review determination...
Search Terms: Medical Director, Director, Appeals, Cardio, Medical
85.5
12mi
Updated: May 28
Appeals Medical Director - General Medicine - Required - Remote
Cypress
Perform individual case review for appeals and grievances for various health plan and insurance products, which may include PPO, ASO, HMO, MAPD, and PDP. The appeals are in response to adverse determinations for medical services related to benefit design and coverage and the application of clinical c...
Search Terms: Medical Director, Director, Appeals, Medicine, Medical
85.4
5mi
Updated: May 16
Appeals Medical Director - General Medicine - Required - Remote
Cypress
Perform individual case review for appeals and grievances for various health plan and insurance products, which may include PPO, ASO, HMO, MAPD, and PDP. The appeals are in response to adverse determinations for medical services related to benefit design and coverage and the application of clinical c...
Search Terms: Medical Director, Director, Appeals, Medicine, Medical
85.4
5mi
Updated: May 16
Medical Director, Utilization Management - Commercial Prior Authorization Review
Long Beach
The Medical Management team ensures that Blue Shield of California (BSC) is on the cutting edge of utilization management reimagined to accelerate the development and sustainability of a value-based health care system in California. The Medical Director, Utilization Management – Commercial Prior Auth...
Search Terms: Medical Director, Management, Director, Commercial, Authorization
84.9
14mi
Updated: May 27
Associate Medical Director - Outpatient Rehab
Costa Mesa
Ensures timely completion of clinical case reviews for their board-certified specialty. Makes physician to physician calls to gather medical appropriate information in order to make medical necessity determinations for services requested. Makes medical necessity determinations for grievance and appea...
Search Terms: Medical Director, Director, Medical, Outpatient, Rehab
84.3
12mi
Updated: May 22
Appeals Medical Director – Urology
COSTA MESA, 3080 BRISTOL ST, STE 200
Appeal Reviews. Supports clinicians to ensure timely and consistent responses to members and providers. Provides guidance for clinical operational aspects of a program. May conduct peer-to-peer clinical case reviews with attending physicians or other ordering providers to discuss review determination...
Search Terms: Medical Director, Director, Appeals, Medical, Behavioral Health
84.3
12mi
Updated: May 22
Medical Director Associate – CarelonRx
COSTA MESA, 3080 BRISTOL ST, STE 200
May provide clinical guidance for pharmacy prior authorizations using Carelon. Rx clinical guidelines. Supports clinicians to ensure timely and consistent responses to members and providers. Conducts peer-to-peer prior authorization reviews for medications with attending physicians or other ordering ...
Search Terms: Medical Director, Director, Associate, Medical, Healthcare
84.1
12mi
Updated: May 20
Specialty Medical Director - Criticalist, Internist, Surgeon - Open to All Specialties
Fountain Valley
Introduction. Join us as a board certified or residency trained Specialty Medical Director at VCA West Coast Specialty & Emergency Animal Hospital you’ll quickly discover that you’re well supported by world-class medicine, technology, facilities and a talented team. You’ll be empowered to do your bes...
Search Terms: Medical Director, Director, Surgeon, Medical, Leadership
84
8.7mi
Updated: May 12
Scientific Director / Medical Director, Medical Affairs – Oncology
Irvine
The Medical Affairs (MA) organization provides patients, healthcare providers and payers everywhere with the practical and clinically relevant information and solutions they need to use AbbVie products safely and effectively, throughout the product lifecycle and the patient’s journey. The Scientific ...
Search Terms: Director, Medical, Medical Director, Oncology, Clinical
83.9
14mi
Updated: May 21
Appeals Medical Director – Oncology
COSTA MESA, 3080 BRISTOL ST, STE 200
Appeal Reviews. Supports clinicians to ensure timely and consistent responses to members and providers. Provides guidance for clinical operational aspects of a program. May conduct peer-to-peer clinical case reviews with attending physicians or other ordering providers to discuss review determination...
Search Terms: Medical Director, Director, Appeals, Oncology, Medical
83.4
12mi
Updated: May 12
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