... interventions.• Work with medical director teams focusing on inpatient care management, clinical coverage review ... Departments of Medicaid in person as needed• Outward facing position to interact and collaborate with medical ...

... Medical Director provides oversight for medical policy implementation, and participates in the development, implementation, and evaluation of clinical/medical programs. This is a full-time telework position, with ...

... director to be part of a centralized team that supports the Medical Management staff ensuring timely and ... request. The medical director is a work-at-home position located anywhere in the US. The ...

... . Position Summary As the Executive Director, Asset Protection Field Operations, you are an ... to leading all aspects of Asset Protection in the field, the Executive Director, Asset Protection ...

... p Position SummaryReview grievance and appeal cases for medical necessity and create summaries for medical director reviews A Brief OverviewAdministers review and resolution of ...

... team. In this role you will work in conjunction with the Senior Manager and the Director of Finance ... into caring for our colleagues and our communities. The Company offers a full range of medical, dental ...

... . Aetna has an exciting opportunity to join its leadership team as an Executive Director, Network ... Health resources to enable and improve clinical outcomes. Responsibility for understanding medical ...

... implements assigned care plan activities and monitors care plan progress. Enhancement of Medical Appropriateness and Quality of Care: - Using holistic approach consults with case managers, supervisors, Medical ...

... (nurse case managers, dietitians, social workers, medical directors) to support members on their path to better health, decrease hospital readmissions, and reduce medical costs. -Provides comprehensive ...

... ) and Region Director to brief DL, RX on key priorities and upcoming milestones. Set up video conference ... into caring for our colleagues and our communities. The Company offers a full range of medical, dental ...

... intervention with members experiencing a behavioral health or medical crisis and refers them to the appropriate ... , Medical Directors and/or other programs to overcome barriers to meeting goals and objectives; presents ...

... Medical Appropriateness and Quality of Care: - Using holistic approach consults with case managers, supervisors, Medical Directors and/or other health programs to overcome barriers to meeting goals and ...

... holistic approach consults with case managers, supervisors, Medical Directors and/or other health ... ongoing independent medical and/or healthy lifestyle choices. Helps member actively and knowledgably ...

... . • Enhancement of Medical Appropriateness and Quality of Care: o Using holistic approach consults with case managers, supervisors, Medical Directors and/or other health/behavioral health programs to ...

... medical appropriateness and quality of care-using holistic approach consults with case managers, supervisors, medical directors and/or other health programs to overcome barriers to meeting goals and ...