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Keywords: Managed Medical Review Organization, Location: USA

Page: 1

Medical Director, BH Children's Services

and continuous improvement. To achieve this, we're looking for a Medical Director, Behavioral Health Children's Services.... Board Certified in child and adolescent psychiatry. Minimum of five years of experience working with children in BH managed...

Company: MVP Health Care
Location: Schenectady, NY
Posted Date: 27 Sep 2025

Medical Director Managed Care Physician Engagement

to providing quality managed care administrative and clinical services to medical groups, hospitals, health plans and employers... include: - Collaborate with the Chief Medical Officer, Managed Care and executive leadership to develop, implement...

Posted Date: 18 Oct 2025

Medical Director Managed Care Physician Engagement

to align and drive toward shared goals. Responsibilities include: - Collaborate with the Chief Medical Officer, Managed Care... medical director for the Population Health Services Organization (PHSO) quality division. - Analyze Physician/APP KPIs...

Posted Date: 17 Oct 2025

Behavioral Health Medical Director - Managed Care (DC, DE, or NC)

utilization management, including review of prior authorizations, concurrent reviews, and appeals. Collaborate with medical... peer-to-peer reviews with providers to discuss medical necessity, care coordination, and best practices. Review...

Location: USA
Posted Date: 11 Oct 2025

Spine Surgeon Telecommute Medical Review Stream Physician

Responsibilities: MAJOR DUTIES AND RESPONSIBILITIES: Reviews medical files and provides recommendations for utilization review... Review Medical Director to discuss quality of care and credentialing and state licensure issues. Maintain proper...

Company: Concentra
Location: Los Angeles, CA
Posted Date: 19 Oct 2025

Ophthalmologist Telecommute Medical Review Stream Physician

AND RESPONSIBILITIES: Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity... and workers’ compensation claims. Meets (when required) with Concentra Physician Review Medical Director to discuss quality...

Company: Concentra
Location: Los Angeles, CA
Posted Date: 16 Oct 2025

Utilization and Clinical Review - Medical Director - Orthopedic Surgery - Remote

and coordination of the medical review services. Additionally, performs Utilization Management reviews and directs/coordinates aspects...Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives...

Company: CPS Solutions
Location: Minneapolis, MN
Posted Date: 12 Oct 2025

Utilization and Clinical Review - Medical Director - Orthopedic Surgery - Remote

and coordination of the medical review services. Additionally, performs Utilization Management reviews and directs/coordinates aspects...Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives...

Company: CPS Solutions
Location: Minneapolis, MN
Posted Date: 12 Oct 2025

Chief Medical Officer - UCS Clinical Assessment Review Expert

. Growing together. The Chief Medical Officer of United Clinical Services (UCS) Clinical Assessment Review Expert (CAREs) team... Authorization, and Medical Claims Review as distinct examples Work in partnership with enterprise operational, LOB partners...

Company: CPS Solutions
Location: Minnetonka, MN
Posted Date: 12 Oct 2025

Medical Management - Supervisor Medical Review 145

The Medical Review Supervisor is responsible for overseeing activities and personnel involved in the day to day... operations of CommunityCare’s medical claim review program. The Supervisor guides individuals in implementing auditing...

Company: CommunityCare
Location: Tulsa, OK
Posted Date: 12 Oct 2025

Chief Medical Officer - UCS Clinical Assessment Review Expert

. Growing together. The Chief Medical Officer of United Clinical Services (UCS) Clinical Assessment Review Expert (CAREs) team... Authorization, and Medical Claims Review as distinct examples Work in partnership with enterprise operational, LOB partners...

Company: CPS Solutions
Location: Minnetonka, MN
Posted Date: 11 Oct 2025

Senior Manager, Medical Information & Review

: Join Takeda as a Senior Manager, US Medical Information and Review where you will deliver high-quality, balanced and timely... medical and scientific information regarding specific products and provide advanced medical and scientific review...

Company: Takeda
Location: Lexington, MA
Posted Date: 04 Oct 2025

Medical Management - Supervisor Medical Review 145

The Medical Review Supervisor is responsible for overseeing activities and personnel involved in the day to day... operations of CommunityCare’s medical claim review program. The Supervisor guides individuals in implementing auditing...

Company: CommunityCare
Location: Tulsa, OK
Posted Date: 27 Sep 2025

Medical Review RN / Nurse Specialist II

, utilization review, managed care organization quality review, and quality assurance for programs serving individuals...Medical Review RN / Nurse Specialist II Work from Home within the Continental United States @Orchard LLC...

Company: @Orchard
Location: USA
Posted Date: 14 Sep 2025

Medical Review RN / Nurse Specialist II

, utilization review, managed care organization quality review, and quality assurance for programs serving individuals...Medical Review RN / Nurse Specialist II Work from Home within the Continental United States @Orchard LLC...

Company: @Orchard
Location: USA
Posted Date: 14 Sep 2025

Medical Review RN / Nurse Specialist II

, utilization review, managed care organization quality review, and quality assurance for programs serving individuals...Medical Review RN / Nurse Specialist II Work from Home within the Continental United States @Orchard LLC...

Company: @Orchard
Location: USA
Posted Date: 14 Sep 2025

Medical Review RN / Nurse Specialist II

, utilization review, managed care organization quality review, and quality assurance for programs serving individuals...Medical Review RN / Nurse Specialist II Work from Home within the Continental United States @Orchard LLC...

Company: @Orchard
Location: USA
Posted Date: 13 Sep 2025

Medical Review RN / Nurse Specialist II

, utilization review, managed care organization quality review, and quality assurance for programs serving individuals...Medical Review RN / Nurse Specialist II Work from Home within the Continental United States @Orchard LLC...

Company: @Orchard
Location: USA
Posted Date: 13 Sep 2025

Medical Review RN / Nurse Specialist II

, utilization review, managed care organization quality review, and quality assurance for programs serving individuals...Medical Review RN / Nurse Specialist II Work from Home within the Continental United States @Orchard LLC...

Company: @Orchard
Location: USA
Posted Date: 13 Sep 2025

Atlassian Organization & Site Administrator (Engineering-Focused)

Immediate need for a talented Atlassian Organization & Multiple Site Administrator (Engineering-Focused). This is a 06...+months contract opportunity with long-term potential and is located in U.S(Remote). Please review the...

Location: San Diego, CA
Posted Date: 04 Sep 2025
Salary: $55 - 70 per hour