About the Opportunity:
As an experienced M.D.
or D.O.
in adult acute care setting(s), you will use evidence-based decision making to perform inpatient case reviews that are timely and clinically appropriate.
You will concisely, effectively, and consistently synthesize clinical information to document a clear summary of a medically necessary determination.
While case reviews are this role's primary priority and function, you will have the opportunity to make recommendations on efficiencies and innovations to ensure our members are getting appropriate and timely care based on their health plan coverage.
You will partner across the organization with other internal teams, such as Business Analytics, Claims, Operations, Actuarial, and BlueCard, to name a few.
Join us on this continuous journey as we make health care better for our members!
About You:
You are decisive and have a strong ability to influence internally and externally by appropriately and effectively presenting evidence-based medicine to support a determination.
Critical thinking, sound judgment, and decisiveness are key; however, you will be able to draw from your colleagues' subject matter expertise from various departments, to help make evidence-based prior authorization decisions.
You are collaborative by nature and are energized by the opportunity to work in a highly integrated and matrixed culture.
Managed care experience in a large commercial organization, such as at another Blue Cross & Blue Shield plan, a plus.
If this sounds like you, apply to our Medical Director-Inpatient Utilization Management opportunity today!
Iowa or South Dakota-based candidates preferred but open to remote for the right candidate.
This full-time position will also work a rotating on-call schedule for weekend and vacation reviews.
US - IA - IA - Palo
November 6, 2024
About the Job: • Monitor patients throughout their treatment. • Perform routine checks of patients' vital signs. • Ensure that patients take their medication. • Assist doctors and registered nurses. • Liaise with patients' families. • Qualifications: • LPN state...
US - IA - IA - Newhall
November 6, 2024
About the Job: • Monitor patients throughout their treatment. • Perform routine checks of patients' vital signs. • Ensure that patients take their medication. • Assist doctors and registered nurses. • Liaise with patients' families. • Qualifications: • LPN state...
US - IA - IA - Alburnett
November 6, 2024
About the Job: • Monitor patients throughout their treatment. • Perform routine checks of patients' vital signs. • Ensure that patients take their medication. • Assist doctors and registered nurses. • Liaise with patients' families. • Qualifications: • LPN state...
US - IA - IA - Luzerne
November 6, 2024
About the Job: • Monitor patients throughout their treatment. • Perform routine checks of patients' vital signs. • Ensure that patients take their medication. • Assist doctors and registered nurses. • Liaise with patients' families. • Qualifications: • LPN state...
US - IA - IA - Viola
November 6, 2024
About the Job: • Monitor patients throughout their treatment. • Perform routine checks of patients' vital signs. • Ensure that patients take their medication. • Assist doctors and registered nurses. • Liaise with patients' families. • Qualifications: • LPN state...
US - IA - IA - North Liberty
November 6, 2024
About the Job: • Monitor patients throughout their treatment. • Perform routine checks of patients' vital signs. • Ensure that patients take their medication. • Assist doctors and registered nurses. • Liaise with patients' families. • Qualifications: • LPN state...
US - IA - IA - Oxford Junction
November 6, 2024
About the Job: • Monitor patients throughout their treatment. • Perform routine checks of patients' vital signs. • Ensure that patients take their medication. • Assist doctors and registered nurses. • Liaise with patients' families. • Qualifications: • LPN state...
US - IA - IA - Toddville
November 6, 2024
About the Job: • Monitor patients throughout their treatment. • Perform routine checks of patients' vital signs. • Ensure that patients take their medication. • Assist doctors and registered nurses. • Liaise with patients' families. • Qualifications: • LPN state...
US - IA - IA - Stanwood
November 6, 2024
About the Job: • Monitor patients throughout their treatment. • Perform routine checks of patients' vital signs. • Ensure that patients take their medication. • Assist doctors and registered nurses. • Liaise with patients' families. • Qualifications: • LPN state...
US - IA - IA - Conroy
November 6, 2024
About the Job: • Monitor patients throughout their treatment. • Perform routine checks of patients' vital signs. • Ensure that patients take their medication. • Assist doctors and registered nurses. • Liaise with patients' families. • Qualifications: • LPN state...
US - IA - IA - Riverside
November 6, 2024
About the Job: • Monitor patients throughout their treatment. • Perform routine checks of patients' vital signs. • Ensure that patients take their medication. • Assist doctors and registered nurses. • Liaise with patients' families. • Qualifications: • LPN state...
US - IA - IA - Troy Mills
November 6, 2024
About the Job: • Monitor patients throughout their treatment. • Perform routine checks of patients' vital signs. • Ensure that patients take their medication. • Assist doctors and registered nurses. • Liaise with patients' families. • Qualifications: • LPN state...
US - IA - IA - Oakdale
November 6, 2024
About the Job: • Monitor patients throughout their treatment. • Perform routine checks of patients' vital signs. • Ensure that patients take their medication. • Assist doctors and registered nurses. • Liaise with patients' families. • Qualifications: • LPN state...
US - IA - IA - Olin
November 6, 2024
About the Job: • Monitor patients throughout their treatment. • Perform routine checks of patients' vital signs. • Ensure that patients take their medication. • Assist doctors and registered nurses. • Liaise with patients' families. • Qualifications: • LPN state...
US - IA - IA - Prairieburg
November 6, 2024
About the Job: • Monitor patients throughout their treatment. • Perform routine checks of patients' vital signs. • Ensure that patients take their medication. • Assist doctors and registered nurses. • Liaise with patients' families. • Qualifications: • LPN state...
US - IA - IA - Marion
November 6, 2024
About the Job: • Monitor patients throughout their treatment. • Perform routine checks of patients' vital signs. • Ensure that patients take their medication. • Assist doctors and registered nurses. • Liaise with patients' families. • Qualifications: • LPN state...
US - IA - IA - Oxford
November 6, 2024
About the Job: • Monitor patients throughout their treatment. • Perform routine checks of patients' vital signs. • Ensure that patients take their medication. • Assist doctors and registered nurses. • Liaise with patients' families. • Qualifications: • LPN state...
US - IA - IA - Delaware
November 6, 2024
About the Job: • Monitor patients throughout their treatment. • Perform routine checks of patients' vital signs. • Ensure that patients take their medication. • Assist doctors and registered nurses. • Liaise with patients' families. • Qualifications: • LPN state...
US - IA - IA - Williamsburg
November 6, 2024
About the Job: • Monitor patients throughout their treatment. • Perform routine checks of patients' vital signs. • Ensure that patients take their medication. • Assist doctors and registered nurses. • Liaise with patients' families. • Qualifications: • LPN state...
US - IA - IA - Hopkinton
November 6, 2024
About the Job: • Monitor patients throughout their treatment. • Perform routine checks of patients' vital signs. • Ensure that patients take their medication. • Assist doctors and registered nurses. • Liaise with patients' families. • Qualifications: • LPN state...
US - IA - IA - Coralville
November 6, 2024
About the Job: • Monitor patients throughout their treatment. • Perform routine checks of patients' vital signs. • Ensure that patients take their medication. • Assist doctors and registered nurses. • Liaise with patients' families. • Qualifications: • LPN state...
US - IA - IA - Rowley
November 6, 2024
About the Job: • Monitor patients throughout their treatment. • Perform routine checks of patients' vital signs. • Ensure that patients take their medication. • Assist doctors and registered nurses. • Liaise with patients' families. • Qualifications: • LPN state...
US - IA - IA - South Amana
November 6, 2024
About the Job: • Monitor patients throughout their treatment. • Perform routine checks of patients' vital signs. • Ensure that patients take their medication. • Assist doctors and registered nurses. • Liaise with patients' families. • Qualifications: • LPN state...
US - IA - IA - Lowden
November 6, 2024
About the Job: • Monitor patients throughout their treatment. • Perform routine checks of patients' vital signs. • Ensure that patients take their medication. • Assist doctors and registered nurses. • Liaise with patients' families. • Qualifications: • LPN state...
US - IA - IA - Mechanicsville
November 6, 2024
About the Job: • Monitor patients throughout their treatment. • Perform routine checks of patients' vital signs. • Ensure that patients take their medication. • Assist doctors and registered nurses. • Liaise with patients' families. • Qualifications: • LPN state...
US - IA - IA - Hiawatha
November 6, 2024
About the Job: • Monitor patients throughout their treatment. • Perform routine checks of patients' vital signs. • Ensure that patients take their medication. • Assist doctors and registered nurses. • Liaise with patients' families. • Qualifications: • LPN state...
US - IA - IA - Cedar Rapids
November 6, 2024
About the Job: • Monitor patients throughout their treatment. • Perform routine checks of patients' vital signs. • Ensure that patients take their medication. • Assist doctors and registered nurses. • Liaise with patients' families. • Qualifications: • LPN state...