Medical Director
hace 2 semanas
UnitedHealth Group is seeking a highly skilled Medical Director to lead our Enterprise Clinical Services operations. As a key member of our clinical leadership team, you will be responsible for providing physician support and collaborating with leadership and staff to establish, implement, and maintain clinical and operational processes.
Key Responsibilities- Conduct coverage reviews and render determinations based on individual member plan benefits and national and proprietary coverage review policies
- Document clinical review findings, actions, and outcomes in accordance with policies and regulatory requirements
- Engage with requesting providers in peer-to-peer discussions and communicate with network and non-network providers to ensure accurate and timely benefit determinations
- Participate in daily clinical rounds and collaborate with internal partners to achieve optimal health outcomes
- M.D. or D.O. degree
- Active unrestricted license to practice medicine
- Board certification in an ABMS specialty
- 3+ years of clinical practice experience after completing residency training
- Solid understanding of Evidence-Based Medicine (EBM) and proficiency in MS Word, Outlook, and Excel
- Experience in utilization and clinical coverage review
- Proven data analysis and interpretation aptitude
- Proven innovative problem-solving skills and excellent presentation skills for clinical and non-clinical audiences
UnitedHealth Group offers a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401(k) contribution. We are an equal employment opportunity/affirmative action employer and welcome candidates from diverse backgrounds.
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Medical Director Role
hace 3 semanas
San Juan, San Juan, Puerto Rico Humana A tiempo completoAbout the RoleHumana is seeking a Medical Director to lead our team in delivering high-quality healthcare services to our customers. As a Medical Director, you will be responsible for overseeing the development and implementation of medical policies, procedures, and programs that align with our company's mission and values.Key ResponsibilitiesDevelop and...
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Medical Director Physician
hace 3 semanas
San Juan, San Juan, Puerto Rico Wellpath A tiempo completoMake a Difference in the Lives of the UnderservedWe are seeking a highly skilled Medical Director to join our team at Wellpath. As a Medical Director, you will play a critical role in providing medical oversight and guidance to our healthcare team, ensuring that our patients receive the highest quality care.Key Responsibilities:Provide clinical oversight to...
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Medical Director
hace 2 días
San Juan, San Juan, Puerto Rico Humana A tiempo completoAbout the RoleHumana is seeking a Medical Director to lead our medical affairs team. As a key member of our leadership team, you will be responsible for developing and implementing strategies to improve patient outcomes and advance our company's mission to put health first.Key ResponsibilitiesDevelop and implement medical strategies to improve patient...
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Medical Director
hace 3 semanas
San Juan, San Juan, Puerto Rico Advocate Health A tiempo completoMedical Director - Transplant and Cell Therapy OpportunityAdvocate Health is seeking a highly skilled Medical Director to lead our Transplant and Cell Therapy program at Advocate Lutheran General Hospital in Park Ridge, IL. As a key member of our physician-led medical group, you will be responsible for clinical operations, quality and regulatory compliance,...
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Medical Director
hace 3 semanas
San Juan, San Juan, Puerto Rico Humana A tiempo completoAbout the RoleAs a Medical Director at Humana, you will play a critical role in shaping the company's healthcare strategy and delivering high-quality patient care. This is an exciting opportunity to join a leading health insurance company and contribute to the well-being of millions of people.Key ResponsibilitiesDevelop and implement clinical strategies to...
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Medical Director
hace 2 días
San Juan, San Juan, Puerto Rico Vitalcore Health Strategies A tiempo completoMedical Director / Physician Position SummaryThe Site Medical Director serves as the responsible Physician and health authority required by national standards. They provide overall supervision for clinical services for the site to ensure appropriate delivery of on and off site necessary medical care but have no other managerial responsibilities.Key...
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Senior Director Medical and Scientific Affairs
hace 3 semanas
San Juan, San Juan, Puerto Rico Abbott A tiempo completoJob Title: Senior Director Medical and Scientific AffairsAbbott is a global healthcare leader that helps people live more fully at all stages of life. Our portfolio of life-changing technologies spans the spectrum of healthcare, with leading businesses and products in diagnostics, medical devices, nutritionals and branded generic medicines.Job Summary:We are...
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Oncology Medical Director
hace 2 días
San Juan, San Juan, Puerto Rico Advocate Health A tiempo completoAbout the RoleThe Medical Director of Transplant and Cell Therapy Services will lead the development and implementation of the hematopoietic cellular therapy program, ensuring compliance with FACT-JACIE standards. This individual will oversee clinical operations, manage quality and regulatory aspects, and collaborate with multidisciplinary teams to advance...
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San Juan, San Juan, Puerto Rico Jobleads-Us A tiempo completoJob Summary: We are seeking a highly experienced Senior Director to lead our Medical and Scientific Affairs team in the Infectious Disease business. As a key member of our senior leadership team, you will be responsible for developing and implementing medical and scientific strategies for our global product portfolio.Key Responsibilities:Develop and execute...
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Medical Director Physician
hace 1 semana
San Juan, San Juan, Puerto Rico Integrity Healthcare A tiempo completoJob Summary: We are seeking an experienced Physician to lead our Occupational Medicine clinic as Medical Director. The ideal candidate will have a strong background in Occupational Medicine and/or Urgent Care, with excellent leadership and clinical skills.Key Responsibilities:Provide high-quality patient care in a clinical settingLead and manage the...
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Lifestyle Director
hace 3 semanas
San Juan, San Juan, Puerto Rico Frontier Management (Or) A tiempo completoJob Title: Lifestyle DirectorFrontier Management (Or) is seeking a highly motivated and experienced Lifestyle Director to join our team at Arbor Oaks Terrace Memory Care Residence in Newberg, Oregon.Job Summary:The Lifestyle Director will be responsible for planning, implementing, and supervising social, educational, recreational, spiritual, therapeutic,...
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Medical Care Provider
hace 2 días
San Juan, San Juan, Puerto Rico Altamed Health Services A tiempo completoAt AltaMed Health Services, we're dedicated to providing exceptional medical care to our communities. As a passionate healthcare professional, you'll have the opportunity to make a meaningful difference in the lives of our patients. Our commitment to quality care and patient-centered services drives us forward every day.Job OverviewUnder the supervision of...
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Chief Medical Officer
hace 3 semanas
San Juan, San Juan, Puerto Rico Humana A tiempo completoPosition OverviewThe Medical Director plays a pivotal role in overseeing clinical operations and ensuring the delivery of high-quality healthcare services.BenefitsHumana and its affiliated subsidiaries provide a comprehensive benefits package designed to enhance overall well-being.Our employee benefits focus on fostering personal health and informed...
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Lifestyle Director
hace 3 semanas
San Juan, San Juan, Puerto Rico Frontier Management Group A tiempo completoJob Title: Lifestyle DirectorFrontier Management Group is seeking a highly motivated and experienced Lifestyle Director to join our team. As a key member of our senior living community, you will be responsible for developing and implementing a comprehensive activity program that promotes resident engagement, socialization, and overall well-being.Key...
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Practice Director
hace 3 semanas
San Juan, San Juan, Puerto Rico Mycare Health Center A tiempo completoJob Title: Practice ManagerJob Summary:The Practice Manager is responsible for leading the clinical and transportation departments, ensuring a standard of quality and consistency for all clinic operations. This role requires strong leadership, administrative, and technical skills to develop and implement programs or projects as identified by the executive...
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Chief Medical Officer
hace 3 semanas
San Juan, San Juan, Puerto Rico Humana A tiempo completoKey ResponsibilitiesThe Medical Director plays a crucial role in overseeing the clinical operations and ensuring the delivery of high-quality healthcare services. This position involves:Leading clinical initiatives to enhance patient care and outcomes.Collaborating with healthcare professionals to implement effective treatment protocols.Monitoring compliance...
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Chief Medical Officer
hace 3 semanas
San Juan, San Juan, Puerto Rico Humana A tiempo completoRole OverviewThe Medical Director plays a pivotal role in overseeing clinical strategies and ensuring the delivery of high-quality healthcare services. This position involves collaboration with various stakeholders to enhance patient outcomes and promote effective healthcare practices.BenefitsHumana and its affiliated entities provide a comprehensive...
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Global Medical Strategy Director
hace 17 horas
San Juan, San Juan, Puerto Rico Jobleads-Us A tiempo completoNavigate Career Advancement with AbbottJob SummaryThis position within the Infectious Disease Business Unit serves as a senior leadership role within the Medical and Scientific Operations (MCSO) team. As a leader, you will oversee the global medical and scientific strategy for various disease states, guiding teams to adopt leading practices in product...
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Medical Provider
hace 3 semanas
San Juan, San Juan, Puerto Rico First Steps Recovery A tiempo completoJob Title: Provider, Substance Use Disorder Program (Inpatient)We are seeking highly motivated and experienced medical professionals to join our team at First Steps Recovery. As a primary provider for our El Dorado County location, you will be responsible for delivering high-quality care to patients with substance use disorders in collaboration with a...
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Medical Records Specialist
hace 3 semanas
San Juan, San Juan, Puerto Rico Advantmed A tiempo completoMedical Records Technician Job DescriptionAdvantmed is seeking a detail-oriented Medical Records Technician to join our team. As a Medical Records Technician, you will play a crucial role in ensuring the accuracy and completeness of patient medical records.Key Responsibilities:Travel to various medical facilities and hospitals to scan patient records,...