MD Appeals Medical DirectorVirtualVocations • Chula Vista, California, United States
MD Appeals Medical Director
VirtualVocations • Chula Vista, California, United States
Hace 18 horas
Tipo de contrato
- A tiempo completo
Descripción del trabajo
A company is looking for an Appeals M.D. - Member Appeals to perform clinical reviews and adjudications of appeals and grievances cases.
Key Responsibilities
Conduct individual case reviews for appeals and grievances related to various health plan products
Respond to regulatory inquiries from the Department of Insurance, Department of Managed Healthcare, and CMS
Collaborate with medical directors and staff on access, network, and quality issues while participating in team meetings
Required Qualifications
MD or DO with an active, unrestricted license
Board Certified in an ABMS or AOBMS specialty (excluding Pediatrics)
5+ years of clinical practice experience
Crear una alerta de empleo para esta búsqueda
Medical Director • Chula Vista, California, United States
Ofertas relacionadas
Impact Lives, Impact Community.Family Health Centers of San Diego (FHCSD) is passionate about providing exceptional health care to all, especially underserved communities with limited health care o...Mostrar más
At Gameday Men’s Health, we are redefining men’s wellness by combining cutting-edge treatments with personalized concierge-level care.
Our global expansion reflects our commitment to helping men opt...Mostrar más
Associate Director / Director, CMC Regulatory Affairs.Headquartered in Carlsbad, California, and with offices in Boston, Massachusetts, and Dublin, Ireland, Ionis has been at work for more than three...Mostrar más
Medical Director OpportunitySan Diego, CA more information on this Medical Director opening and others like it through Metropolis, a Provider Engagement Platform that connects you with organization...Mostrar más
JOB TITLE : Clinical Manager of Care Management.REPORTS TO : Director of Clinical Strategy.WORK SCHEDULE : 7-7 / M-F (Flexible 9 / 80 schedule).
This job description is intended to be a general statement a...Mostrar más
Executive Medical Director - ER - Encinitas, CA .Papaya Veterinary Care is looking for Executive Medical Director of Veterinary Medicine (DVM) candidates for our ER Hospital in Encinitas, CA.W...Mostrar más
Drives strategic organizational plans and policies for clinical trials / research and data collection activities.Works with a multidisciplinary team involving R & D project teams, clinical project ma...Mostrar más Strategic Expert In Medical Device Development.At Neurocrine Biosciences, we pride ourselves on having a strong, inclusive, and positive culture based on our shared purpose and values.We know what ...Mostrar más 
Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United Sta...Mostrar más
Campus Point Drive, San Diego, CA 92037, United States .Filing Deadline : Mon 10 / 27 / 2025.UC San Diego values and welcomes people from all backgrounds.
If you are interested in being part of our team,...Mostrar más
Clinical Resource Management Director.Responsible for the operations for Clinical Resource Management Department.Accountable for leading the operations of the Clinical Excellence initiatives of the...Mostrar más
Clinical Care Delivery provides high quality, patient-centered care focused on diagnosing, treating and managing care while ensuring the safety, efficiency and effectiveness of the practice.Clinica...Mostrar más
Our vision aims to empower our clients by actively leveraging our broad range of services.With our global presence, we have career opportunities all across the world which can lead to a unique, exc...Mostrar más
Bay Area, CA (in-person; some remote coordination).We are seeking a highly experienced and detail-oriented Personal Medical Director to manage and execute an intensive, multi-phase health recovery ...Mostrar más
Account Director, Medical Education & Communications.MedForce, an IQVIA business, provides best-in-class medical communication services to help life sciences companies connect with HCPs and improv...Mostrar más At Neurocrine Biosciences, we pride ourselves on having a strong, inclusive, and positive culture based on our shared purpose and values.
We know what it takes to be great, and we are as passionate ...Mostrar más 
At Gameday Mens Health, we are redefining mens wellness by combining cutting-edge treatments with personalized concierge-level care.
Our global expansion reflects our commitment to helping men optim...Mostrar más
We are seeking a an experienced Medical Biller to join our team! This position is involved in all elements of revenue cycle management.
We utilize an EHR / Practice Management system called EZDerm and...Mostrar más
Considering Local Candidates only.The Account Specialist will perform a wide range of duties to foster critical partnerships and ensure patients receive appropriate and timely care.This is an offic...Mostrar más Director, Commercialized Asset Planning Lead.Headquartered in Carlsbad, California, and with offices in Boston, Massachusetts, and Dublin, Ireland, Ionis has been at work for more than three decade...Mostrar más
Assistant Medical Director, Psychiatry
Family Health Centers of San Diego • San Diego, CA, United States
A tiempo completo
Última actualización: hace más de 30 días • Oferta promocionada
Gameday Men's Health Clinic Director - PA or NP
Gameday Men's Health • San Diego County, CA, United States
A tiempo completo
Última actualización: hace 8 días • Oferta promocionada
Associate Director / Director, CMC Regulatory Affiars
Ionis Brand • Carlsbad, CA, US
A tiempo completo
Última actualización: hace más de 30 días • Oferta promocionada
Physician / Medical Director / California / Permanent / Medical Director Opening, San Diego, California Job
Confidential • San Diego, CA, United States
A tiempo completo
Última actualización: hace 1 día • Oferta promocionada
Manager of Case Management (RN Required)
Integrated Health Partners of Southern California • San Diego, CA, US
A tiempo completo
Última actualización: hace 6 días • Oferta promocionada
Executive Medical Director - ER - Encinitas, CA
Papaya Veterinary Care • Encinitas, CA, US
A tiempo completo
Última actualización: hace 17 días • Oferta promocionada
Executive Director, Medical MD, Endo
Neurocrine Biosciences • San Diego, CA, US
A tiempo completo
Última actualización: hace más de 30 días • Oferta promocionada
Sr. Director, Combination Drug Product / Device
Neurocrine Biosciences • San Diego, CA, US
A tiempo completo
Última actualización: hace 19 días • Oferta promocionada
Physician / Oncology / California / Permanent / Associate Medical Director - Oncology - 100% Remote
eviCore healthcare • San Diego, CA, United States
Teletrabajo
A tiempo parcial
Última actualización: hace 27 días • Oferta promocionada
Director, Licensing - 136915
UC San Diego • San Diego, CA, United States
A tiempo completo
Última actualización: hace 12 días • Oferta promocionada
District Director Clinical Resource Mgmt
Palomar Health Rehabilitation Institute • Escondido, CA, US
A tiempo completo
Última actualización: hace más de 30 días • Oferta promocionada
Medical Assistant, Injections
Cardinal Health • La Jolla, CA, US
A tiempo completo
Última actualización: hace 26 días • Oferta promocionada
Medical Operations Manager (Notional Opportunity)
Acuity International • La Jolla, CA, US
A tiempo completo
Última actualización: hace más de 30 días • Oferta promocionada
Personal Medical Director
Town + Country Resources • San Diego, CA, United States
A tiempo completo
Última actualización: hace 12 horas • Oferta promocionada • Nueva oferta
Account Director, Medical Education & Communications
IQVIA Holdings • San Diego, CA, US
A tiempo parcial
Última actualización: hace 1 día • Oferta promocionada
Associate Director, Medical Communications Strategy
Neurocrine Biosciences • San Diego, CA, US
A tiempo completo
Última actualización: hace 20 días • Oferta promocionada
Gameday Men's Health Clinic Director - PA or NP (San Diego County)
Gameday Men's Health • San Diego County, CA, United States
A tiempo completo
Última actualización: hace 8 días • Oferta promocionada
Medical Biller Dermatology Group Practice
Bernardo Dermatology Medical Group • Poway, CA, US
A tiempo completo
Última actualización: hace más de 30 días • Oferta promocionada
Account Specialist Medical Sales
Stance Health Solutions • San Diego, CA, US
A tiempo completo
Última actualización: hace más de 30 días • Oferta promocionada
Director, Commercialized Asset Planning Lead
Ionis Brand • Carlsbad, CA, US
A tiempo completo
Última actualización: hace más de 30 días • Oferta promocionada