Jobs near Placentia: 9,280
RS
Relevance Score ranked on: MEDICAL DIRECTOR
Physician Medical Director
Ontario
100% center based providing direct patient care, mentoring, leading by example, and demonstrating clinical excellence and an exceptional patient experience. Assumes role and responsibilities of CMD, whether functioning in the capacity of a CMD at a specific location. Collaborates under Director of Me...
Search Terms: Medical Director, Director, Medical, Physician, Operations
85.5
19mi
Updated: December 18
Med Mgmt Clinician Sr (US)
PLACENTIA, 1325 N ROSE DR, STE 201
The Med Mgmt Clinician Sr is responsible for ensuring appropriate, consistent administration of plan benefits by reviewing clinical information and assessing medical necessity under relevant guidelines and/or medical policies. May collaborate with healthcare providers. Focuses on relatively complex c...
Search Terms: Clinician, Medical Director, Clinical, Clinic, Benefits
85.3
0mi
Updated: December 19
Appeals and Grievances Medical Director - Cardiology Specialty Required - Virtual
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, Cardio, Medical
84.9
11mi
Updated: December 13
Appeals and Grievances Medical Director - Cardiology Specialty Required - Virtual
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, Cardio, Medical
84.9
11mi
Updated: December 13
Medical Director- Utilization Management for Carelon Health
CERRITOS
Supports clinicians to ensure timely and consistent responses to members and providers. Provides guidance for clinical operational aspects of a program. Conducts peer-to-peer clinical reviews with attending physicians or other providers to discuss review determinations, and patients’ office visits wi...
Search Terms: Medical Director, Director, Health, Management, Medical
84.7
11mi
Updated: December 12
Center Medical Director (CMD)
Anaheim
Provides medical oversight to Medical Staff Associates, including the training of other physicians and Medical Staff Associates. Usually serves as the primary center physician registered as the Laboratory Director with the Food and Drug Administration (FDA). Job Description. Serves as the primary phy...
Search Terms: Medical Director, Director, Medical, Associate, Staff
84.2
6.2mi
Updated: November 22
Associate Medical Director, Clinical Operations
CERRITOS, 12900 PARK PLAZA DR
Perform physician-level case review, following initial nurse review, of high-tech diagnostic imaging, upper endoscopy, other surgical procedures, surgical site of care and sleep testing. Imaging modalities include CT, CTA, MRI, MRA, PET, Ultrasounds, Nuclear Medicine imaging and Cardiology diagnostic...
Search Terms: Medical Director, Operations, Clinical, Medical, Director
83.8
11mi
Updated: December 04
Associate Medical Director, Clinical Operations (Surgery)
CERRITOS, 12900 PARK PLAZA DR
Determine medical necessity of requests using applicable clinical criteria, which may include AIM Appropriateness Guidelines, client-specific health plan medical policy, well established evidenced based guidelines, state mandated policies, and CMS Coverage Determinations, as applicable. Perform physi...
Search Terms: Medical Director, Clinical, Operations, Medical, Director
83.7
11mi
Updated: December 03
Clinical Ops Medical Director
COSTA MESA, 3080 BRISTOL ST, STE 200
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, Clinical, Director, Medical, Healthcare
83
14mi
Updated: November 28
Associate Medical Director - Sleep Medicine
CERRITOS
Determine medical necessity of requests using applicable clinical criteria, which may include Carelon Medical Benefits Management Appropriateness Guidelines, client-specific health plan medical policy, well established evidenced based guidelines, and CMS Coverage Determinations, as applicable. Perfor...
Search Terms: Medical Director, Medicine, Sleep, Director, Associate
83
11mi
Updated: November 19
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