Medical Director Mpo Jobs

Become a part of our caring community Provides executive leadership to Humana. The Regional Chief Medical Officer (CMO) is an entrepreneurial & experienced physician leader committed to the principles of comprehensive primary care and unlocking the power of value-based care for…

Position Summary This position supports the daily processing of appeals in the Commercial Member Clinical Appeals (CMCA). Job functions include but not limited to, completing appeals determination letters, intake and launching of expedited requests, verbal expedited…

Become a part of our caring community The Market CMO, Primary Care, role is an instrumental clinical leader of our primary care team, combining clinical practice experience with leadership and operational management to ensure high-quality patient care and alignment with…

Position Summary The Waste & Error Certified Coding Manager is responsible for leading the Certified Coding Analyst and W&E Team Lead roles that conduct medical claim reviews and coding audits to identify billing errors, waste, abuse, fraud, and payment integrity opportunities.…

Location : The territory for this position includes Georgia, Alabama and Florida and will require 75%+ of travel. We are hiring a Women’s Health Strategic Account Manager (SAM) to join Natera! The Strategic Account Manager works with the local women’s health sales team to…

TERRITORY : The territory covers Northern California (from CA/OR border to Santa Barbara). Ideal candidate must reside in the territory. The District Manager, Women’s Health Sales is a leadership position responsible for growing Natera’s Women’s Health Prenatal and Hereditary…

Opportunity Overview: The RN Reviewer position is a crucial role in our organization — in this role you are responsible for performing a full range of activities that will positively impact the organization and contribute to guiding the strategic operations for the company. As…

Utilization Management Nurse Consultant (RN) Remote | Prior Authorization | Utilization Management Are you an experienced RN with utilization management or prior authorization experience looking to make an impact beyond bedside care? Join our team and help ensure members receive…

Position Summary This position is open to candidates located in Arizona. The work schedule is Monday through Friday, from 8:30 AM to 5:00 PM Arizona time. The Care Management Associate (CMA) supports comprehensive coordination of medical services that include intake and outgoing…

Position Summary Supporting comprehensive coordination of National Medical Excellence Program handling inbound calls from the phone queue. Additional responsibilities to include but not limited to the following: - Performs intake of calls from providers or members - Utilizes…

Utilization Management Nurse Consultant (RN) – Concurrent Review Remote | Acute Inpatient Utilization Management | RN Opportunity Are you an experienced RN with a background in acute care and utilization management? Join our team and play a vital role in ensuring members receive…

Utilization Management Nurse Consultant (RN) Remote | Concurrent Review | Utilization Management Are you an experienced RN with utilization management or prior authorization experience looking to make an impact beyond bedside care? Join our team and help ensure members receive…

Position Summary This position is responsible for performing utilization management (UM) reviews and authorization activities for post-acute services, including Skilled Nursing Facilities (SNF), Inpatient Rehabilitation Facilities (IRF), Long-Term Acute Care Hospitals (LTACH),…

We are hiring a Women’s Health Strategic Account Manager (SAM) to join Natera! The Strategic Account Manager works with the local women’s health sales team to develop and execute strategies to increase Natera testing in IDNs, large hospital systems and Academic Medical Centers.…

Work Flexibility: Field-based Emergency Care (Fire/EMS) Sales Representative As a Sales Representative at Stryker, you will be at the forefront of promoting and selling our Emergency Care products, with a focus on Fire Emergency Medical Services solutions, to pre-hospital…