Medical Director Jobs in Little Rock, AR

Wheeler Staffing Partners is seeking a Patient Access Manager I for our client in Little Rock, AR area. This is a 100% onsite leadership role responsible for managing patient access operations, overseeing financial clearance activities, and ensuring compliance with hospital policies. Key Responsibilities: Operational Leadership: Assist in short- and long-range planning for Registration Process areas, including pre-service and point-of-service financial clearance activities. Develop and implement action plans to improve operational performance. Manage operational metrics to ensure the department meets client goals, including SLAs and budgetary guidelines. Staffing & Team Development: Oversee staffing activities including hiring, selection, orientation, training, and performance management. Mentor supervisors and ensure staff engagement, aligning them with the organization's mission and strategy. Communicate proactively with leadership to ensure professional growth and departmental success. Policy & Compliance: Enforce departmental policies, procedures, and work rules in accordance with hospital policies. Assist in the development of new policies aligned with corporate guidelines. Communicate operational updates to the Director and CFO, identifying problems and recommending solutions. Supervisory Responsibilities: Direct Reports: Supervisor, Patient Access (PA) Indirect Reports: PA Representatives (I-IV) Reports to: Director I or II onsite Leadership: Can be a standalone leader at a clinic facility; must be Manager, PA I if Patient Access Director is onsite. Required Skills & Qualifications: Education: High School Diploma or equivalent required; college degree preferred. Experience: 3-5 years of healthcare supervisory experience preferred. Technical Knowledge: Strong understanding of Revenue Cycle Management, regulatory agencies, and healthcare IT systems. Skills: Excellent interpersonal, organizational, and leadership skills. Ability to manage operational metrics and drive performance improvements. Strong written and verbal communication abilities. Work Environment & Physical Demands: Setting: Hospital work environment. Physical Requirements: Must be able to work in a seated position. Schedule: Must be available as needed based on departmental/system demands, including on-call responsibilities. Vaccination & Compliance Requirements: Candidates must comply with all required vaccinations and screenings, including COVID-19 and influenza vaccinations, as mandated by law and hospital policy. If you have the required healthcare leadership experience and are looking for a growth opportunity, we encourage you to apply!

**Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Medical Director provides medical interpretation and decisions about the appropriateness of services provided by other healthcare professionals in compliance with review policies, procedures, and performance standards. Begins to influence department's strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments. **Use your skills to make an impact** **Responsibilities** The Medical Director provides medical interpretation and determinations whether services provided by other healthcare professionals are in agreement with national guidelines, CMS requirements, Humana policies, clinical standards, and (in some cases) contracts. The ideal candidate supports and collaborates with other team members, other departments, Humana colleagues and the Regional VP Health Services. After completion of mentored training, daily work is performed with minimal direction. Enjoys working in a structured environment with expectations for consistency in thinking and authorship. Exercises independence in meeting departmental expectations, and meets compliance timelines **Required Qualifications** + MD or DO degree + 5+ years of direct clinical patient care experience post residency or fellowship, which preferably includes some experience in an inpatient environment and/or related to care of a Medicare type population (disabled or >65 years of age). + Current and ongoing Board Certification an approved ABMS Medical Specialty + A current and unrestricted license in at least one jurisdiction and willing to obtain additional license, if required. + No current sanction from Federal or State Governmental organizations, and able to pass credentialing requirements. + Excellent verbal and written communication skills . + Evidence of analytic and interpretation skills, with prior experience participating in teams focusing on quality management, utilization management, case management, discharge planning and/or home health or post acute services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management. + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance. + Experience with national guidelines such as MCG or InterQual + Internal Medicine, Family Practice, Geriatrics, Hospitalist, Emergency Medicine clinical specialists + Advanced degree such as an MBA, MHA, MPH + Exposure to Public Health, Population Health, analytics, and use of business metrics. + Experience working with Case managers or Care managers on complex case management, including familiarity with social determinants of health. + The curiosity to learn, the flexibility to adapt and the courage to innovate **Additional Information** Typically reports to a Regional Vice President of Health Services, Lead, or Corporate Medical Director, depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an assigned market, member population, or condition type. May also engage in grievance and appeals reviews. May participate on project teams or organizational committees. \#physiciancareers **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $223,800 - $313,100 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 05-31-2025 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************

About Us: Let's face it-client care that was once warm and personalized has become cold and clinical. Portrait is here to change that. Portrait is a breakthrough collective of healthcare visionaries joined in their desire to deliver inspired care. We are handling the headaches that can keep providers from doing their best work and living their best lives. Our transformative model and first-of-its-kind platform empowers ambitious providers to fall back in love with aesthetic medicine-and deliver the personalized care that clients deserve. We are one of the fastest-growing healthcare technology startups ever and recently raised more than $20m in Series A funding from leading Silicon Valley VC firms and individual investors like the founders and leaders of DreamWorks, GoodRx, Dropbox, Stripe, and more. Our diverse, fiercely passionate team - composed of industry veterans and hyper-growth operators that have built multi-billion dollar companies - is united in our focus to put expert providers back in the driver's seat of their careers to transform the way that care is delivered. We are committed to our mission and vision and work hard as a collective to make it a reality. Let's change the face of healthcare and make dream work a reality - together. About The Role: We are a forward-thinking, provider-centric aesthetic / concierge dermatology medspa, and we are seeking experienced Medical Directors. We work with some of the most talented nurse injectors in the industry and use a high-tech, high-touch experience to deliver optimal care to our clients. The Medical Director is expected to provide appropriate oversight to our RN, NP, and PA providers in accordance with state regulations and standard of care. What You'll Do: Respond to emergent issues when a provider contacts you Guidance on specific patients or procedures when a provider contacts you Occasional review of Good Faith Examinations performed by one of our advanced practice providers Assist with provider training (optional) Provide feedback on company policies and procedures (optional) About You: MD or DO with an active, unrestricted state medical license 2+ years of experience in aesthetic medicine Preferred board certification in ophthalmology, dermatology, plastic surgery, or otolaryngology Collegial demeanor and strong communication skills Portrait is an equal opportunity employer, we encourage all to apply, even if you do not meet each requirement above. We are building a diverse, inclusive workforce and hope you will join us!

This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and most current clinical standards. The incumbent reviews escalated cases electronically and using Medical Policy criteria sets to evaluate the medical necessity and appropriateness of the requested treatment of service. Depending on the nature of the case, telephonic peer to peer discussions may be required. The incumbent ensures compliance to NCQA, URAC, CMS, DOH, and DOL regulations at all times. In addition to utilization review, the incumbent participates as the physician member of the multidisciplinary team for case and disease management. They will advise the multidisciplinary team on cases, particularly high-risk cases, through the team structure. Additionally, the incumbent may be assigned special projects to help support and improve the care of our members **ESSENTIAL RESPONSIBILITIES** + Conduct electronic review of escalated cases against medical policy criteria, which may include telephonic peer to peer discussions, to determine medical necessity and appropriateness. Complete initial determination of cases, review of appeals and grievances, and other reviews as assigned. Compose clear and concise rationales for member and provider determination notifications all while adhering to required compliance standards (NCQA, URAC, CMS, DOH, and DOL regulations, etc.). Ensure that all aspects of the medical management process are consistent with community standards of care. + Participate as a member of the CMDM multidisciplinary team. Attend huddles and grand rounds. Advise multidisciplinary team on cases that require physician expertise. + Participate in protocol and guidelines development to ensure consistency in the review process. + Actively manage projects and/or participate on project teams that require a physician subject matter expert. + Other duties as assigned. **EDUCATION** **Required** + Medical Doctor (MD) or Doctor of Osteopathic Medicine (DO) **Substitutions** + None **Preferred** + Master's Degree in Business Administration/Management or Public Health **EXPERIENCE** **Required** + 5 years in Clinical, Direct Patient care (hospital, outpatient, or private practice) **Preferred** + 1 year in Medical Management in a Health Insurance Plan; strong knowledge of managed care industry **LICENSES AND CERTIFICATION** **Required** + Medical Doctor or Doctor of Osteopathic Medicine (DO) + Awarded Board Certification at least once in specialty recognized by the American Board of Medical Specialties or the American Osteopathic Association Specialty Certifying Boards + Active medical state licensure required. Additional specific state licensure(s) may be required based on business need. **Preferred** + None **SKILLS** + Critical Thinking + Case Management + Customer Service + Oral & Written Communication Skills + Collaboration + Listening + Telephone Skills + General Computer Skills + Clinical Software + Managed Care **Language (Other than English)** None **Travel Required** 0% - 25% **PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS** Position Type Office-Based Teaches / trains others regularly Occasionally Travel regularly from the office to various work sites or from site-to-site Rarely Works primarily out-of-the office selling products/services (sales employees) Never Physical work site required No Lifting: up to 10 pounds Constantly Lifting: 10 to 25 pounds Rarely Lifting: 25 to 50 pounds Rarely **_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._ **_Compliance Requirement_** _: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies._ _As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy._ _Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements._ **Pay Range Minimum:** $170,000.00 **Pay Range Maximum:** $352,500.00 _Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets._ Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at ***************************** California Consumer Privacy Act Employees, Contractors, and Applicants Notice Req ID: J253096

The Specialty Care Field Medical, Director is responsible for providing therapeutic area/product expertise for the designated therapeutic area across a broad range of external medical stakeholders ("EMS") and initiatives in KS, MO, OK, AR, LA territories. The ideal candidate would reside in one of the assigned territories. **ROLE RESPONSIBILITIES** + Plan and execute independent Medical strategies and engagements for appropriate assigned external medical stakeholders within a territory, compliantly coordinating with other Pfizer colleagues as needed to achieve Medical objectives + Maintain required level of knowledge of relevant TA/disease states and Pfizer medicines, providing therapeutic area/product information to both internal and external stakeholders as needed + Serve as a conduit and resource for Medical Information and external medical stakeholder insights, providing requested information to external medical stakeholder as allowed by Pfizer guidance and sharing external medical stakeholder viewpoints with Pfizer as appropriate + Understand the priorities of Pfizer Medical Affairs in order to contribute to Medical educational content strategy development and execute aligned Field Medical tactics + Maintain effective and appropriate scientific communication and collaboration among headquarters Medical colleagues, Medical Information, and other Pfizer Field Medical colleagues + Demonstrate expertise in scientific communication across multiple channels, including, but not limited to, live and virtual presentations in small or large settings, written communication, and telephone or virtual conversations + Optimize patient care improvement in Medical communications and deliverables, incorporating Health Literacy and cultural awareness principles to ensure that patients remain the ultimate focus + Conduct all activities in accordance with all relevant policies, procedures and compliance guidance + Educate external medical stakeholders based on patient care gaps and aligned to medical strategy with the goal of enhancing understanding of disease state and guideline-based care and improve overall patient care + Achieve leadership-defined expectations regarding the number of external medical stakeholders engaged. **Field Medical Role Responsibilities** + Deliver approved medical content about Pfizer medicines and relevant topics in the designated therapeutic area + Identify and seek medical scientific engagement from priority external medical stakeholder segments in assigned Therapeutic Area + Provide truthful, accurate, and scientifically supported information in response to direct unsolicited medical requests from external medical stakeholders in a manner that complies with all applicable Pfizer guidelines, policies, and procedures + Leads advisory boards (BRF,Vendor) with manager oversight. + Field relevant inbound queries from external medical stakeholders via established triage process + In collaboration with US and/or Global Medical Affairs colleagues, partner with IM/SC Research & Development and Global Product Development (GPD) in the identification of potential sites for Pfizer-sponsored clinical trials, including identification of sites serving under-represented patient populations in trials + Serve as a Medical resource to HQ Medical Affairs, other Field Medical colleagues, and external Therapeutic Area investigators and researchers as appropriate + Appropriately provide Medical support throughout the Investigator Sponsored Research (ISR) process + Cultivate research and therapeutic area expertise, including familiarity with latest congress data and disease state literature + Provides Asset leadership + Understand the principles of study design, methodology, data analysis, and interpretation and communicate these concepts with external medical stakeholders + Strong territory leadership + Reactively and proactively communicate with local Patient Advocacy Group(s), as appropriate, in close collaboration with Corporate Affairs and HQ Medical Affairs + Deliver insights on local patient organization structure, capabilities, and patient population needs + Serve on Medical and/or TA and asset cross-functional committees, as appropriate + Represent Pfizer Medical Affairs leadership with clinical/professional associations and/or societies, consistently demonstrating medical professionalism in all interactions + Mentorship - Onboarding partner, ad board and study lead mentor. + Participate in special projects as needed **BASIC QUALIFICATIONS** + MD or DO Degree required + 4 years of relevant experience required + Subject matter expert recognized across internal and external stakeholders. + Demonstrate a breadth of diverse leadership experiences and capabilities including the ability to influence and collaborate with peers and create business impact. + Demonstrate excellent oral and written communication skills + Demonstrate excellent interpersonal skills: ability to understand and respond to multiple external and internal stakeholders' demands and manage and handle conflict constructively. + Demonstrate ability to manage a significant volume of projects developed in a remote environment, while exhibiting the ability to prioritize, successfully implement, and demonstrate excellent judgment skills and work in a continuous improvement environment + Work within a matrixed, multi-disciplinary team to foster strong Pfizer/external medical stakeholder professional relationships which are aligned with Pfizer Medical objectives + Effectively manage through and lead change in an ever-changing and evolving external health care environment + Demonstrate change agility; be flexible to new opportunities (e.g. new therapeutic areas) and adaptable to organizational change + Problem-solve and network enterprise wide as appropriate to identify solutions + Collaborate effectively and demonstrate leadership and teamwork with peers, internal stakeholders and external medical stakeholders that inspires alignment and partnership on a shared vision or strategy + Be a self-starter, be accountable, and have a sense of urgency in delivering results that have medical impact and yield a positive external medical stakeholder experience + Maintain self-awareness and continually choose behaviors and responses based on how it impacts one's own and others' performance and engagement + Demonstrate clinical and technical skills + Rapidly adopt and utilize new digital technology and other resources with medical external medical stakeholders and record medical interactions **PREFERRED QUALIFICATIONS** + Familiarity with internal/external SOPs/Rules/Regulations regarding Pfizer/external medical stakeholder interactions and relationships, etc. + Previous Field Medical and Medical Science Liaison (MSL) experience strongly preferred. **NON-STANDARD WORK SCHEDULE, TRAVEL OR ENVIRONMENT REQUIREMENTS** Operate a Pfizer company car and regularly fly on airplanes (i.e. attend external medical stakeholder meetings; attend NYHQ meetings, etc. required; proximity to airline 'hub' city); maintain flexibility to travel 40-50% of time Last Date to Apply for Job: 4/9/2025 The annual base salary for this position ranges from $219,800.00 to $366,400.00. In addition, this position is eligible for participation in Pfizer's Global Performance Plan with a bonus target of 25.0% of the base salary and eligibility to participate in our share based long term incentive program. We offer comprehensive and generous benefits and programs to help our colleagues lead healthy lives and to support each of life's moments. Benefits offered include a 401(k) plan with Pfizer Matching Contributions and an additional Pfizer Retirement Savings Contribution, paid vacation, holiday and personal days, paid caregiver/parental and medical leave, and health benefits to include medical, prescription drug, dental and vision coverage. Learn more at Pfizer Candidate Site - U.S. Benefits | (uscandidates.mypfizerbenefits.com). Pfizer compensation structures and benefit packages are aligned based on the location of hire. The United States salary range provided does not apply to Tampa, FL or any location outside of the United States. Relocation assistance may be available based on business needs and/or eligibility. **Sunshine Act** Pfizer reports payments and other transfers of value to health care providers as required by federal and state transparency laws and implementing regulations. These laws and regulations require Pfizer to provide government agencies with information such as a health care provider's name, address and the type of payments or other value received, generally for public disclosure. Subject to further legal review and statutory or regulatory clarification, which Pfizer intends to pursue, reimbursement of recruiting expenses for licensed physicians may constitute a reportable transfer of value under the federal transparency law commonly known as the Sunshine Act. Therefore, if you are a licensed physician who incurs recruiting expenses as a result of interviewing with Pfizer that we pay or reimburse, your name, address and the amount of payments made currently will be reported to the government. If you have questions regarding this matter, please do not hesitate to contact your Talent Acquisition representative. **EEO & Employment Eligibility** Pfizer is committed to equal opportunity in the terms and conditions of employment for all employees and job applicants without regard to race, color, religion, sex, sexual orientation, age, gender identity or gender expression, national origin, disability or veteran status. Pfizer also complies with all applicable national, state and local laws governing nondiscrimination in employment as well as work authorization and employment eligibility verification requirements of the Immigration and Nationality Act and IRCA. Pfizer is an E-Verify employer. This position requires permanent work authorization in the United States. Medical \#LI-Remote #LI-PFE

Bonus Potential! Monthly and Quarterly Bonus Incentives! Are you looking for a physician practice with a family environment, but with the benefits and support a large organization can provide? Where daily patient care is backed by evidenced based medicine and career options are limitless, then look no further! At Concentra, our Medical Directors spend most of their time clinically treating patients; the remaining time is focused on quality improvements and building the center business with the Center Leadership Team. This role offers an opportunity for physicians to blend their love of patient care with their management skills, working for the leader in the workplace health industry. Concentra is recognized as the nation's leading occupational health care company and one of “America's Greatest Workplaces," as noted in Newsweek. Responsibilities Responsibilities This clinic-based position provides direct patient care, leading by example, and creating an exceptional patient experience Provides leadership in healthcare management to ensure day-to-day execution of medical model collaborating with therapists and specialists to drive optimal clinical outcomes and case closure Manages clinicians, support staff, and complies with APC supervisory requirements Creates a professional and collaborative working environment Works with leaders to identify and implement changes to ensure continuous medical clinic improvement Maintains relationships with center clients and payers Works with medical clinic leadership team to manage clinical and support staffing levels Promotes, cultivates, and exemplifies Concentra values for all clinic colleagues Fosters an environment of collaboration, professionalism, patient/colleague safety, quality care, continuous improvement and reward and recognition Possesses financial awareness and provides input to clinic budget and key business metrics Why Choose Us With more than 40 years of experience, Concentra is dedicated to our mission to improve the health of America's workforce, one patient at a time. With a wide range of services and proactive approaches to care, Concentra colleagues provide exceptional service to employers and exceptional care to their employees. This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice. . Qualifications Qualifications Active and unrestricted medical license Unrestricted DEA license and dispensing license for state of jurisdiction (required prior to start date) Must be eligible to participate in Medicare Board Certification or Eligibility in an ABMS or AOA recognized specialty preferred FMCSA NRCME certification preferred or willingness to obtain

1. Serves as the primary physician for reporting to the Food and Drug Administration and in such capacity provides medical oversight in compliance with applicable Federal and State regulations including the applicable sections of Title 21 of the Code of Federal Regulations and monitors medical compliance of the center. 2. Either serves as or delegates to another appropriate physician the duties of "laboratory director", "technical consultant", or "clinical consultant" as prescribed by the Clinical Laboratory Improvement Act of 1988 regulations (CLIA). Assures that CLIA/COLA training, CLIA/COLA proficiency testing for hematocrit and total protein, and signed of logs involving standardization takes place. 3. Reviews, understands, and complies with all CSL Plasma Services policies and procedures in the performance of services. Maintains high medical standards and ensures that cGMPs are adhered to through involvement with center management, center quality unit, and overall center activities. Is physically present at the center for agreed upon hours. 4. Provides medical oversight to Medical Staff Associates, including their training, although such training may be delegated to an approved Medical Staff Associate. Trains other physicians. Evaluates newly trained Medical Staff Associates for completion of training and recommendation for certification by Regulatory Affairs. Functionally directs the Center Medical Staff. Provides training to other center staff on medically related procedures and practices. 5. Reviews and signed Medical Staff Associates notebooks weekly, including a review of approximately one out of five screening medical evaluations and unsuitable test result communications. 6. Meets with Medical Staff Associates at least once a month to discuss medically related topics. Documents each meeting. Meets with the Center Manager and Compliance Specialist (or designees) during weekly visits to the center. Serves as a member of the Quality Assurance Team. Acts as a liaison between the Corporate or Divisional Medical Director and the Center Medical Staff, which includes preparation of monthly reports and periodic conference calls. 7. Responds to questions and phone calls regarding donor suitability for long-term serial plasmapheresis. Responds to calls from and provides instruction to Center Medical Staff with donor suitability questions. Conducts confidential and effective interviews with donors to obtain information in a variety of situations. Interviews donors with positive STS/negative FTA and documents approval to resume donating. 8. Maintains confidentiality with respect to employee, donor and center records reviewed during the course of all duties. Responsible for overseeing maintenance of medical supplies ad other emergency equipment. 9. Reviews and sings moderate and severe medical incident reports prior to donor being permitted to resume donating. Reviews abnormal test results including abnormal serum protein electrophoresis (SPE) test results and donor record files. Reviews normal SPE test results following an abnormal one and documents approval to resume donating. 10. Assures the health and safety of donors participating in the non-red blood cell immunization programs, if applicable. Monitors donor clinical response to immunizations, when applicable. Oversees hyper-immune programs, if applicable. 11. For red cell recipients in the Anti-D Program, if applicable: Performs qualifying evaluation (e.g. administers consents, medical history and physical exam) on donors before enrollment; provides review and approval for red blood cell immunization; is present when red cell immunizations are given. Submits monthly report to Divisional (or Corporate) Medical Director. 12. Determines donor suitability following adverse reactions in consultation with the Corporate or Divisional Medical Director. Maintains current knowledge of infectious disease markets (i.e. HIV, HBV, HCV, syphilis, etc.) 13. May perform Center Physician functions including but not limited to notifying donors of unsuitable test results, performing screening medical evaluations, assessing results of donor screening and laboratory tests to determine a donor's initial and continued suitability for plasmapheresis, explaining informed consent materials to donors. 14. Performs additional services as and when requested by the company. Additional Additional Education MD or DO degree from an accredited medical or osteopathic school · Must maintain a current and active medical license in the state in which the Center is located Experience · One year of residency training as an MD or OD Additional Comments · Familiarity with Code of Federal Regulations (CFR) and all relevant procedures in the company Plasma Operating Procedures Working Conditions (physical & mental requirements) · Ability to make decisions which have significant impact on the department's creditability, operations and services · Ability to formulate complex and comprehensive materials such as authoritative reports of major scope and impact, etc. and/or to make formal presentations · Frequently exposed to hazardous chemicals, extreme temperatures and to blood borne pathogens · Required to wear Personal Protective Equipment while performing specific tasks or in certain areas · Overnight travel required up to 75% of the time without lengthy lead-time · Frequent standing and walking · Fast paced environment with frequent interruptions Note: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, disability, veteran status, national origin or other legally protected classifications. CSL is introducing a new Career Framework, which will provide a common, global infrastructure for managing jobs and serve as a foundation for future career development and competitive rewards. Certain components of this job description, including Title and Level are subject to change relative to applicable local laws. Your Talent Acquisition Consultant will discuss the pending changes with you. **Our Benefits** We encourage you to make your well-being a priority. It's important and so are you. Learn more about how we care (*********************************************************************** at CSL. **About CSL Plasma** CSL Plasma is one of the world's largest collectors of human plasma. Our work helps to ensure that people with rare and serious diseases are able to live normal, healthy lives. We are committed to our work because lives depend on us. Learn more about CSL Plasma (******************************************* . **We want CSL to reflect the world around us** As a global organization with employees in 35+ countries, CSL embraces diversity and inclusion. Learn more about Diversity & Inclusion (********************************************************** at CSL. **Do work that matters at CSL Plasma!** R-089734 CSL makes all employment decisions without regard to race, color, religion, national origin, ancestry, age, sex, gender, pregnancy, disability, marital status, sexual orientation, gender identity, genetic information, military status, protected veteran status (specifically status as a disabled veteran, recently separated veteran, armed forces service medal veteran, or active duty wartime or campaign badge veteran) or other classification protected by applicable US federal, state or local law. CSL complies with all applicable employment laws, including but not limited to Title VII of the Civil Rights Act of 1964, the Americans with Disabilities Act, the Fair Labor Standards Act, and the Immigration Reform and Control Act. ************************************************

**Your Future Evolves Here** Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones. Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business. Join Evolent for the mission. Stay for the culture. **What You'll Be Doing:** As a FMD, you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in patients' lives, in a non-clinical environment. You can enjoy better work- life balance on a team that values collaboration and continuous learning while providing better health outcomes. Collaboration Opportunities: + Routinely interacts with leadership and management staff, other Physicians, and staff whenever a physician`s input is needed or required. What You Will Be Doing: + Serve as the Physician match reviewer in Radiation Oncology and imaging cases, that do not initially meet the applicable medical necessity guidelines, as well as other imaging requests when providers, clients, or state laws require specialty reviews to be completed by the subject matter expert. + Discusses determinations (peer to peer phone calls) with requesting physicians or ordering providers, when available, within the regulatory timeframe of the request and provides clinical rationale for standard and expedited appeals. + Utilizes medical/clinical review guidelines and parameters to assure consistency in the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality Assurance (NCQA) guidelines. + Aids and acts as a resource to Initial Clinical Reviewers. + Ensures documentation of all communications with medical office staff and/or MD provider is recorded in a timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + Participates in on-going training per inter-rater reliability process. Qualifications- + MD/DO/MBBS + Minimum of five (5) years' experience in the practice of Medicine, post residency and Active Clinical practice within the last 2 years is preferred + Current, unrestricted clinical license in medicine or required specialty- + Obtaining and maintaining medical licenses in the state you reside, as well as, any license required per business needs + Active Board Certification in Radiation Oncology + Strong clinical, management, communication, and organizational skills + Energetic and curious with a passion for quality and value in health care + Computer Proficiency **Technical Requirements:** We require that all employees have the following technical capability at their home: High speed internet over 10 Mbps and, specifically for all call center employees, the ability to plug in directly to the home internet router. These at-home technical requirements are subject to change with any scheduled re-opening of our office locations. **Evolent is an equal opportunity employer and considers all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or disability status.** **If you need reasonable accommodation to access the information provided on this website, please contact** ************************** **for further assistance.** The expected base salary/wage range for this position is $115-$130/hr. This position is also eligible for a bonus component that would be dependent on pre-defined performance factors. As part of our total compensation package, Evolent is proud to offer comprehensive benefits (including health insurance benefits) to qualifying employees. All compensation determinations are based on the skills and experience required for the position and commensurate with experience of selected individuals, which may vary above and below the stated amounts. Don't see the dream job you are looking for? Drop off your contact information and resume and we will reach out to you if we find the perfect fit!

Sumitomo Pharma Co., Ltd. is a global pharmaceutical company based in Japan with key operations in the U.S. (Sumitomo Pharma America, Inc.), Canada (Sumitomo Pharma Canada, Inc.) and Europe (Sumitomo Pharma Switzerland GmbH) focused on addressing patient needs in oncology, urology, women's health, rare diseases, psychiatry & neurology, and cell & gene therapies. With several marketed products in the U.S., Canada, and Europe, a diverse pipeline of early- to late-stage assets, and in-house advanced technology capabilities, we aim to accelerate discovery, research, and development to bring novel therapies to patients sooner. For more information on SMPA, visit our website ********************************** (***************************************************************************************************************************************************** or follow us on LinkedIn (https://c212.net/c/link/?t=0&l=en&o=4190475-1&h=**********&u=https%3A%2F%2Fwww.linkedin.com%2Fcompany%2Fsumitomo-pharma-america%2F&a=LinkedIn) . **Job Overview** The **Associate Director, Medical Strateg** **y (** **Hematology/Oncology** **)** will be a key member of the Medical Affairs team reporting to the Executive Director, Medical Affairs Strategy. In this role, individuals are responsible for medical affairs direction and management for Oncology Pipeline assets, with input into the strategy for both internal company programs and external facing interactions. The job will oversee the management of the Oncology Products, pre-, and post launch activities related to Medical Affairs function. This individual will lead program coordination with Clinical Development leadership to ensure alignment between Medical Affairs, Advocacy, Translational Medicine, and Commercial launch strategy and guide the tactical implementation of Medical Affairs plans. The Associate Director will also collaborate with company outreach and patient advocacy efforts to ensure that Medical Affairs activities align with these patient focused programs. **Job Duties and Responsibilities** + Ensure coordination and alignment of all Oncology Products medical affairs activities and budget within SMPA and with alliance partners. + Oversee the strategy and development of Medical Affairs plans and scientific platforms in support of Oncology products. + Represent the Oncology Products Medical Strategy Team within the Medical Affairs leadership and executive leadership teams, including presentations at the Global Medical Affair Monthly and Global Product Development Monthly Meetings. + Serve as Subject Matter Expert within Medical Affairs Team provide medical training, evaluation, motivation, and control of activities in alignment with the company's corporate strategies and objectives. + Ensure cross-functional medical alignment with the US Field Medical team, Medical Communications & Operations, Japan medical affairs colleagues, RWE (Real World Evidence) & HEOR (Health Economics and Outcomes Research) for SMPA and ex-US colleagues (Basel and Canada). + Develop and direct the implementation of plans that will be executed through multi-modal medical education channels, including publications, presentations, congresses, advisory boards, CME (Continuing Medical Education), medical symposia, and other channels in support of combination therapy commercialization. + Oversee the development and implementation of detailed scientific Publication Plans, Medical Advisory Boards, and Patient Advisory Boards upon review and approval of Legal and Compliance process. + Represent the Medical Affairs department on the lifecycle team to provide medical affairs input to Clinical Development and Clinical Operation's needs. + Proactively seek and create relationships directly with key opinion leaders, prominent clinical investigators, and scientific advisory groups in designated therapeutic area, providing them with credible, fair, balanced, scientific information about product development, research activities, and therapy(s) + Upon submission of NDA (New Drug Application) and approval of the VP of Medical Affairs, work closely with the commercial organization to bring the medical and pharmacoeconomic perspectives to commercial strategies and tactics, aligning with Marketing & Market Access to collaborate. + Partner with the Clinical Development organization for ongoing and post-marketing clinical development activities. + Provide detailed and compliant medical review and approval of external resources, communications, and publications - ensuring medical accuracy, relevance, and fair-balance. + Define and attend relevant medical and scientific conferences to help coordinate medical affairs activities, as well as support speakers and presenters, ensure the success of publication/communication goals, and participate in the collection and reporting of competitive intelligence within company guidelines. + Provide input into budget and long-term Medical Education programming or Medical Sponsorships. + Provide input and decision-making for the development of Areas of Research Interest that supports a robust and active Investigator Initiated Study program. + Ensure that all interactions and activities in the US adhere to corporate and healthcare compliance guidance in all activities, including those related to clinical trials, scientific interactions with internal and external groups, and responses to unsolicited requests for medical/scientific information. + Serves as Medical Affairs Lead on select therapeutics topics, and provides input into developing scientific messages, + Provide feedback on Medical Information response documents. + Ability to travel (domestic and some international) to attend scientific congresses, participate in internal meetings, and meet key stakeholders in the development of medical activities - up to 30% travel. **Key Core Competencies** + Excellent verbal and written communication skills, as the position will interface with key opinion leaders and a wide range of internal employees. + Ability to effectively communicate, collaborate and deliver excellent work in a fast-paced, and rapidly changing dynamic company. + Must have excellent interpersonal skills, with experience in conflict management and relationship building. + Ability to analyze complex issues critically and develop realistic and accomplishable plans and solutions. + Mentorship attitude with the capability to work cross-functionally with peers and other colleagues, as appropriate. + Capable of translating broad corporate objectives into actionable medical and scientific strategies. + Proven record of accomplishment of detailed, medically accurate, and scientifically relevant writing and review skills in line with compliance requirements. + Experience representing a broad range of stakeholders in the development and communication of medical activities and plans. **Education and Experience** + Bachelor's degree in a related field required. + Advanced degree in medical science (MD, PharmD, PhD) or equivalent professional experience in Oncology is required. + 3+ years of relevant professional experience in biotech or pharmaceutical industry, with prior Medical Affairs involvement preferred. + Experience leading in a matrix team environment is considered a plus. + Strong familiarity working on PCs and the Microsoft Office Suite. The base salary range for this role is $167,750 to $210,000. Base salary is part of our total rewards package which also includes the opportunity for merit-based salary increases, short incentive plan participation, eligibility for our 401(k) plan, medical, dental, vision, life and disability insurances and leaves provided in line with your work state. Our robust time-off policy includes flexible paid time off, 11 paid holidays plus additional time off for a shut-down period during the last week of December, 80 hours of paid sick time upon hire and each year thereafter. Total compensation, including base salary to be offered, will depend on elements unique to each candidate, including candidate experience, skills, education and other factors permitted by law. Disclaimer: The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. All personnel may be required to perform duties outside of their normal responsibilities from time to time, as needed. **Confidential Data** : All information (written, verbal, electronic, etc.) that an employee encounters is considered confidential. **Compliance** : Achieve and maintain Compliance with all applicable regulatory, legal and operational rules and procedures, by ensuring that all plans and activities for and on behalf of Sumitomo Pharma America (SMPA) and affiliates are carried out with the "best" industry practices and the highest ethical standards. **Mental/Physical Requirements** : Fast paced environment handling multiple demands. Must be able to exercise appropriate judgment as necessary. Requires a high level of initiative and independence. Excellent written and oral communication skills required. Requires ability to use a personal computer for extended periods of time. **Sumitomo Pharma America (SMPA)** **is an Equal Employment Opportunity (EEO) employer** Qualified applicants will receive consideration for employment without regard to race; color; creed; religion; national origin; age; ancestry; nationality; marital, domestic partnership or civil union status; sex, gender; affectional or sexual orientation; disability; veteran or military status or liability for military status; domestic violence victim status; atypical cellular or blood trait; genetic information (including the refusal to submit to genetic testing) or any other characteristic protected by law. Sumitomo Pharma Co., Ltd. is a global pharmaceutical company based in Japan with key operations in the U.S. (Sumitomo Pharma America, Inc.), Canada (Sumitomo Pharma Canada, Inc.) and Europe (Sumitomo Pharma Switzerland GmbH) focused on addressing patient needs in oncology, urology, women's health, rare diseases, psychiatry & neurology, and cell & gene therapies. With several marketed products in the U.S., Canada, and Europe, a diverse pipeline of early- to late-stage assets, and in-house advanced technology capabilities, we aim to accelerate discovery, research, and development to bring novel therapies to patients sooner. For more information on SMPA, visit our website ********************************** (***************************************************************************************************************************************************** or follow us on LinkedIn (https://c212.net/c/link/?t=0&l=en&o=4190475-1&h=**********&u=https%3A%2F%2Fwww.linkedin.com%2Fcompany%2Fsumitomo-pharma-america%2F&a=LinkedIn) . At Sumitomo Pharma America, our work is guided by the Sumitomo Pharma mission, vision and values, which tie closely to our company's cultural pillars. **Our** **Mission** _To broadly contribute to society through value creation based on innovative research and development activities for the betterment of healthcare and fuller lives of people_ _worldwide_ **Our** **Vision** _For Longer and Healthier Lives, we unlock the future with cutting edge technology and_ _ideas_

Lead a team of amazing Physical Therapists as the Clinic Director at SERC in Little Rock, AR $5k SIGN ON BONUS Looking for future leaders to obtain our Partnership & Ownership Opportunities! + I am passionate about serving our patients through high quality care and exceeding expectations. + I feel fulfilled when I connect with patients and team member on a personal and professional level. + I seek to continually grow professionally and to create an environment of learning for my team members. + I value the support of a community of Physical Therapists, Mentors, and Regional Leadership. + I am an experienced, licensed Physical Therapist, with a degree from an accredited PT program with the drive to pursue professional growth. If this described you above-we want to talk to you. SERC, a brand partner of Upstream Rehabilitation, in Little Rock proudly boasts to be well above the national average for effectiveness of care. SERC's mission is to serve our patients and we are committed to treating each of them promptly with integrity, honesty and compassion. Our reputation for best-in-class patient care and unparalleled customer service, combined with our local and regional density, make us the provider of choice for both patients and referral sources in the markets we serve. Our highly skilled team deserves a leader that is also the best of the best. Become a LEADER with Upstream Rehabilitation Partners... Upstream is a network of over 1200 clinics from coast to coast, 26 brand partners, that leads the outpatient physical therapy field. The Upstream family offers something for every clinician- continue your educational training through our mentorship or residency programs, find a path to ownership by becoming a partner in one of our clinics, share your knowledge with others as a clinical instructor, lead a team by advancing in to leadership, make an impact on the community with our advocacy partnerships, and more. Upstream seeks to provide competitive benefits that you care about: Flexible Work Schedules Clinical Care Bonus Medical, Dental, and Vision Benefits 401k with company match Paid Time Off and Holidays Student Loan Reimbursement Opportunities Partnership/Ownership Opportunities Company Paid Life Insurance (1x base salary) Voluntary Short-Term and Long-Term Disability Offerings Upstream is committed to your professional growth: $1500 annual CE dollars plus unlimited use of MedBridge Partnership with IAMT for training in Manual Therapy: ***************************** Orthopedic and Sports Residencies available in-house: *********************************** Leadership development coursework and mentorship New graduate mentoring & onboarding Follow @Lifeatupstream on Instagram, and check out our LinkedIn company page to learn more about what it's like to be part of the #upstreamfamily. CLICK HERE TO LEARN EVEN MORE ABOUT UPSTREAM

Cardinal Health Sonexus Access and Patient Support helps specialty pharmaceutical manufacturers remove barriers to care so that patients can access, afford and remain on the therapy they need for a better quality of life. Our diverse expertise in pharma, payer and hub services allows us to deliver best-in-class solutions-driving brand and patient markers of success. We're continuously integrating advanced and emerging technologies to streamline patient onboarding, qualification and adherence. Our non-commercial specialty pharmacy is centralized at our custom-designed facility outside of Dallas, Texas, empowering manufacturers to rethink the reach and impact of their products. **Together, we can get life-changing therapies to patients who need them-faster.** **_Responsibilities_** + Lead by example and develop team members for positions of greater responsibility in the future. + Maintain working knowledge of client-facing, clinical, and industry trends, and as well as providing updates to program and team leadership. + Provide insight and analysis to clients to demonstrate subject matter expertise. + Grow program margin through demonstrated performance, patient support, and implementation of all applicable Sonexus offerings. + Own client relationship and act as the escalation point / liaison for all program services, projects, and operational performance issues. + Ability to create, modify and provide professional client-facing reporting and analytics. + Interact with clients, project sponsors, stakeholders, and various project members to ensure specified business needs are met; assist in the post-implementation analysis to ensure requirements are fulfilled. + Develop and demonstrate a comprehensive knowledge of customer invoicing, payment terms, collections, and customer payment history to assist Accounts Receivable. + Analyze program processes and provide recommendations for improving efficiency; reduce client expenses when possible while never sacrificing quality of care. + Urgently resolve, escalate, and own issues negatively impacting productivity or quality. + Build a knowledge base of each client's business, organization and objectives + Participate in organizational-wide initiatives to support clinical staff **_Qualifications_** + Bachelor's degree in clinical field, preferred + 8-12 years of experience in direct leadership, preferred + 4-5 years of experience directly in oncology or related fields, preferred + Demonstrated project management experience preferred. + Understanding of P&L statements. + Intermediate to advanced experience with Microsoft Office products including Word, PowerPoint, and Excel. + Proven ability to hold self and others accountable in pursuit of providing world-class support. + Ability to travel 25% of time. **_What is expected of you and others at this level_** + Demonstrate advanced knowledge of Cardinal Health and client landscape, including but not limited to the following: key competitors, terminology, technology, trends, challenges, reimbursement and government regulation; demonstrates working knowledge of how Cardinal Health offerings match with a client's unique business needs. + Demonstrate advanced clinical knowledge of disease states and treatment modalities of program products + Coach, teach, and mentor direct reports to maximize efficiency, effectiveness, and productivity while developing others for positions of greater responsibility in the future. + Interact with clients to provide resolution to inquiries and updates on program performance. + Deliver broad-based portfolio of solutions that meet Cardinal Health and customer goals. + Effectively facilitate cross-functional coordination with both internal and external partners with minimal guidance; includes account on-boarding, implementation, and post-launch expertise. + Influence account profitability. + Basic understanding of information technology as it relates to client and program technical support. + Build and maintain high-level, long-term trusted advisor relationships. + Lead and deliver professional program status to clients and Sonexus senior leadership in accordance with agreed upon cadence; includes Quarterly Business Reviews, Monthly Program Reviews, and Client Health Reports + Identify and qualify opportunities within service portfolio (including but not limited to technology, program design, services expansion, etc....) with existing client and develop plans for introducing new solutions through collaborative relationships. **TRAINING AND WORK SCHEDULES:** + Your new hire training will take place 8:00am-5:00pm CST, mandatory attendance is required. + This position is full-time (40 hours/week). + Employees are required to have flexibility to work any of our shift schedules during our normal business hours of Monday-Friday, 7:00am- 7:00pm CST. **REMOTE DETAILS:** + You will work remotely, full-time. It will require a dedicated, quiet, private, distraction free environment with access to highspeed internet. + We will provide you with the computer, technology and equipment needed to successfully perform your job. + You will be responsible for providing high-speed internet. + Internet requirements include the following: + Maintain a secure, high-speed, broadband internet connection (DSL, Cable, or Fiber) at the remote location. Dial-up, satellite, WIFI, Cellular connections are NOT acceptable. + Download speed of 15Mbps (megabyte per second) + Upload speed of 5Mbps (megabyte per second) + Ping Rate Maximum of 30ms (milliseconds) + Hardwired to the router + Surge protector with Network Line Protection for CAH issued equipment **Anticipated hourly range:** $121,600 - $173,700 **Bonus eligible:** Yes **Benefits:** Cardinal Health offers a wide variety of benefits and programs to support health and well-being. + Medical, dental and vision coverage + Paid time off plan + Health savings account (HSA) + 401k savings plan + Access to wages before pay day with my FlexPay + Flexible spending accounts (FSAs) + Short- and long-term disability coverage + Work-Life resources + Paid parental leave + Healthy lifestyle programs **Application window anticipated to close:** 5/10/2025 *if interested in opportunity, please submit application as soon as possible. The hourly range listed is an estimate. Pay at Cardinal Health is determined by multiple factors including, but not limited to, a candidate's geographical location, relevant education, experience and skills and an evaluation of internal pay equity. _Candidates who are back-to-work, people with disabilities, without a college degree, and Veterans are encouraged to apply._ _Cardinal Health supports an inclusive workplace that values diversity of thought, experience and background. We celebrate the power of our differences to create better solutions for our customers by ensuring employees can be their authentic selves each day. Cardinal Health is an Equal_ _Opportunity/Affirmative_ _Action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, ancestry, age, physical or mental disability, sex, sexual orientation, gender identity/expression, pregnancy, veteran status, marital status, creed, status with regard to public assistance, genetic status or any other status protected by federal, state or local law._ _To read and review this privacy notice click_ here (***************************************************************************************************************************

**Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews preauthorization requests for services. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Medical Director for the National Medicare Outpatient Team provides medical interpretation and determinations whether services provided by other healthcare professionals are in agreement with national guidelines, CMS requirements, Humana policies, clinical standards, and (in some cases) contracts. Primary work reviewing prior-authorization reviews as well as some claims and provider dispute cases for outpatient reviews. **Use your skills to make an impact** **Responsibilities** The Medical Director provides medical interpretation and determinations whether services provided by other healthcare professionals are in agreement with national guidelines, CMS requirements, Humana policies and clinical standards. The ideal candidate supports and collaborates with other team members, other departments and Humana colleagues. After completion of mentored training, daily work is performed with minimal direction. Enjoys working in a structured environment with expectations for consistency in thinking and authorship. Exercises independence in meeting departmental expectations, and meets compliance timelines. Supports the assigned work with respect to market-wide objectives and community relations as directed. May participate on project teams or organizational committees. Reports to a Lead Medical Director. **Required Qualifications** + MD or DO degree + 5+ years of direct clinical patient care experience post residency or fellowship, which preferably includes some experience in an inpatient environment and/or related to care of a Medicare type population (disabled or >65 years of age). + Current and ongoing Board Certification in an approved ABMS Medical Specialty + A current and unrestricted license in at least one jurisdiction and willing to obtain additional license, if required. + No current sanction from Federal or State Governmental organizations, and able to pass credentialing requirements. + Excellent verbal and written communication skills. + Evidence of analytic and interpretation skills + The curiosity to learn, the flexibility to adapt and the courage to innovate. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management. + Prefer Medical Hematology/Oncology specialties + Prefer Medicaid experience + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance. + Experience with national guidelines such as NCD/LCD, MCG or InterQual. + Advanced degree such as an MBA, MHA, MPH + Prior experience participating in teams focusing on quality management or utilization management. **Additional Information** Reports to a Lead Medical Director. The Medical Director conducts Utilization Management of the care received by members in an assigned market, member population, or condition type. May participate on project teams or organizational committees. \#physiciancareers **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $223,800 - $313,100 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 05-31-2025 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************

div class="iCIMS_JobContent" h2 class="iCIMS_InfoMsg iCIMS_InfoField_Job" /h2 div class="iCIMS_InfoMsg iCIMS_InfoMsg_Job" div class="iCIMS_Expandable_Container" div class="iCIMS_Expandable_Text" p style="margin-bottom: .0001pt;"span style="font-family: calibri, sans-serif; font-size: 10pt;"strong Bonus Potential! Monthly and Quarterly Bonus Incentives!/strong/span/pp style="margin-bottom: .0001pt;" /pp style="margin-bottom: .0001pt;"span style="font-size: 10pt; font-family: calibri, sans-serif;"Are you looking for a physician practice with a family environment, but with the benefits and support a large organization can provide? Where daily patient care is backed by evidenced based medicine and career options are limitless, then look no further!/span/pp style="margin-bottom: .0001pt;" /pp style="margin-bottom: .0001pt;"span style="font-size: 10pt; font-family: calibri, sans-serif;"At Concentra, our Medical Directors spend most of their time clinically treating patients; the remaining time is focused on quality improvements and building the center business with the Center Leadership Team. This role offers an opportunity for physicians to blend their love of patient care with their management skills, working for the leader in the workplace health industry./span/pp style="margin-bottom: .0001pt;" /pp style="margin-bottom: .0001pt;"span style="font-size: 10pt; font-family: calibri, sans-serif;"Concentra is recognized as the nation's leading occupational health care company and one of “America's Greatest Workplaces," as noted in Newsweek./span/p /div /div /div h2 class="iCIMS_InfoMsg iCIMS_InfoField_Job" Responsibilities /h2 div class="iCIMS_InfoMsg iCIMS_InfoMsg_Job" div class="iCIMS_Expandable_Container" div class="iCIMS_Expandable_Text" p style="margin: 0px;"span style="font-size: 10pt; font-family: calibri, sans-serif;"strong Responsibilities/strong/span/pullispan style="font-family: calibri, sans-serif; font-size: 10pt;"This clinic-based position provides direct patient care, leading by example, and creating an exceptional patient experience/span/lilispan style="font-family: calibri, sans-serif; font-size: 10pt;"Provides leadership in healthcare management to ensure day-to-day execution of medical model collaborating with therapists and specialists to drive optimal clinical outcomes and case closure/span/lilispan style="font-family: calibri, sans-serif; font-size: 10pt;"Manages clinicians, support staff, and complies with APC supervisory requirements/span/lilispan style="font-family: calibri, sans-serif; font-size: 10pt;"Creates a professional and collaborative working environment/span/lilispan style="font-family: calibri, sans-serif; font-size: 10pt;"Works with leaders to identify and implement changes to ensure continuous medical clinic improvement/span/lilispan style="font-family: calibri, sans-serif; font-size: 10pt;"Maintains relationships with center clients and payers/span/lilispan style="font-family: calibri, sans-serif; font-size: 10pt;"Works with medical clinic leadership team to manage clinical and support staffing levels/span/lilispan style="font-family: calibri, sans-serif; font-size: 10pt;"Promotes, cultivates, and exemplifies Concentra values for all clinic colleagues/span/lilispan style="font-family: calibri, sans-serif; font-size: 10pt;"Fosters an environment of collaboration, professionalism, patient/colleague safety, quality care, continuous improvement and reward and recognition/span/lilispan style="font-family: calibri, sans-serif; font-size: 10pt;"Possesses financial awareness and provides input to clinic budget and key business metrics/span/li/ulp style="margin-bottom: .0001pt;"span style="font-size: 10pt; font-family: calibri, sans-serif;"strong Why Choose Us /strong/span/pp style="margin-bottom: .0001pt;"span style="font-family: calibri, sans-serif; font-size: 10pt;"With more than 40 years of experience, Concentra is dedicated to our mission to improve the health of America's workforce, one patient at a time. With a wide range of services and proactive approaches to care, Concentra colleagues provide exceptional service to employers and exceptional care to their employees./span/pp style="margin-bottom: .0001pt;" /pp style="margin-bottom: .0001pt;"span style="font-family: calibri, sans-serif; font-size: 10pt;"This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice./span/ph3 style="margin-top: 0in;"span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;"./span/h3 /div /div /div h2 class="iCIMS_InfoMsg iCIMS_InfoField_Job" Qualifications /h2 div class="iCIMS_InfoMsg iCIMS_InfoMsg_Job" div class="iCIMS_Expandable_Container" div class="iCIMS_Expandable_Text" p style="margin-bottom: .0001pt;"span style="font-family: calibri, sans-serif; font-size: 10pt;"strong Qualifications/strong/span/pulli style="margin-bottom: .0001pt;"span style="font-family: calibri, sans-serif; font-size: 10pt;"Active and unrestricted medical license/span/lili style="margin-bottom: .0001pt;"span style="font-family: calibri, sans-serif; font-size: 10pt;"Unrestricted DEA license and dispensing license for state of jurisdiction (required prior to start date)/span/lili style="margin-bottom: .0001pt;"span style="font-family: calibri, sans-serif; font-size: 10pt;"Must be eligible to participate in Medicare /span/lili style="margin-bottom: .0001pt;"span style="font-family: calibri, sans-serif; font-size: 10pt;"Board Certification or Eligibility in an ABMS or AOA recognized specialty preferred/span/lili style="margin-bottom: .0001pt;"span style="font-family: calibri, sans-serif; font-size: 10pt;"FMCSA NRCME certification preferred or willingness to obtain/span/li/ul /div /div /div h2 class="iCIMS_InfoMsg iCIMS_InfoField_Job" Additional Data /h2 div class="iCIMS_InfoMsg iCIMS_InfoMsg_Job" div class="iCIMS_Expandable_Container" div class="iCIMS_Expandable_Text" p style="margin-left: .5in;"span style="font-family: 'times new roman', times; font-size: 12pt;"strong Benefits:/strong/span/pulli style="list-style-type: none;"ul style="margin-top: 0in;"lispan style="font-size: 12pt; font-family: 'times new roman', times;"Many of our clinics offer working hours M-F, 8 to 5, no nights, no weekends, no holidays, no call /span/lilispan style="font-size: 12pt; font-family: 'times new roman', times;"Compensation package:/spanullispan style="font-size: 12pt; font-family: 'times new roman', times;"Competitive base salary with annual merit increase opportunity/span/lilispan style="font-size: 12pt; font-family: 'times new roman', times;"Monthly Medical Director Stipend/span/lilispan style="font-size: 12pt; font-family: 'times new roman', times;"Monthly RVU Bonus Incentive/span/lilispan style="font-size: 12pt; font-family: 'times new roman', times;"Quarterly Quality Care Bonus Incentive/span/li/ul/li/ul/li/ululli style="list-style-type: none;"ul style="margin-top: 0in;"lispan style="font-size: 12pt; font-family: 'times new roman', times;"Generous Paid Time Off package for new colleagues include:/spanullispan style="font-size: 12pt; font-family: 'times new roman', times;"24 days of Paid Time Off (annually, with roll-over)/span/lilispan style="font-size: 12pt; font-family: 'times new roman', times;"5 days of Paid CME Time (annually)/span/lilispan style="font-size: 12pt; font-family: 'times new roman', times;"6 Paid Holidays/span/li/ul/lilispan style="font-size: 12pt; font-family: 'times new roman', times;"Medical Malpractice Coverage/span/lilispan style="font-size: 12pt; font-family: 'times new roman', times;"Reimbursement for dues upon approval, for the renewal of applicable licensure, certifications, memberships, etc./span/lilispan style="font-size: 12pt; font-family: 'times new roman', times;"401(k) with Employer Match/span/lilispan style="font-size: 12pt; font-family: 'times new roman', times;"Tuition Reimbursement opportunity /span/lilispan style="font-size: 12pt; font-family: 'times new roman', times;"Medical/Vision/Prescription/Dental Plans/span/lilispan style="font-size: 12pt; font-family: 'times new roman', times;"Life/Disability Insurance: /span/lilispan style="font-size: 12pt; font-family: 'times new roman', times;"Colleague Referral Bonus Program/span/lilispan style="font-size: 12pt; font-family: 'times new roman', times;"Opportunity to teach residents and students /span/lilispan style="font-size: 12pt; font-family: 'times new roman', times;"Training provided in Occupational Medicine /span/lilispan style="font-size: 12pt; font-family: 'times new roman', times;"Supplemental health benefits (accident, critical illness, hospital indemnity insurance)/span/lilispan style="font-size: 12pt; font-family: 'times new roman', times;"Pre-tax spending accounts (health care and dependent care FSA) /span/lilispan style="font-size: 12pt; font-family: 'times new roman', times;"Concentra accredited CME courses/span/lilispan style="font-size: 12pt; font-family: 'times new roman', times;"Occupational Health University/span/lilispan style="font-size: 12pt; font-family: 'times new roman', times;"Leadership development programs/span/lilispan style="font-size: 12pt; font-family: 'times new roman', times;"Relocation assistance (when applicable)/span/lilispan style="font-size: 12pt; font-family: 'times new roman', times;"Commuter benefits/span/lilispan style="font-size: 12pt; font-family: 'times new roman', times;"Identity theft services/span/lilispan style="font-size: 12pt; font-family: 'times new roman', times;"Colleague discount program /span/lilispan style="font-family: 'times new roman', times; font-size: 12pt;"Unmatched opportunities for advancement locally and nationally /span/li/ul/li/ulp style="margin: 5.0pt 0in .0001pt .25in;"span style="font-size: 12pt; font-family: 'times new roman', times;"This job requires access to confidential and critical information, requiring ongoing discretion and secure information management./span/pp style="margin: 5.0pt 0in .0001pt .25in;"span style="font-size: 12pt; font-family: 'times new roman', times;"We will ensure that individuals with disabilities are provided reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. Please contact us to request accommodation./span/pp style="margin: 5.0pt 0in .0001pt .25in;"span style="font-size: 12pt; font-family: 'times new roman', times;"Concentra is an Equal Opportunity Employer, including disability/veteran/span/pp style="margin: 0px;"span#LI-ES2/span/p /div /div /div /div

The Field Medical Outcomes is a field medical colleague responsible for informing customer decision-making and improving population health through real-world data analytics, pharmacoeconomic analyses, outcomes evaluations and medical presentations. The role is responsible for educating customers on the clinical and economic impact of Pfizer medicines and products. The colleague may also be responsible for providing disease area/therapeutic area/product-based expertise for designated TA areas with a a primary focus on integrated health care organizations, including but not limited to Integrated Delivery Systems, Payer customers and Specialty Pharmacy Providers (SPPs). The responsibilities of the role are to contribute to Pfizer's ability to (a) Plan and execute the independent Medical strategy and engagement for appropriate assigned customers within a territory, compliantly coordinating with other Pfizer colleagues as needed to achieve Medical objectives (b) Understand the priorities of Pfizer Medical Affairs in order to contribute to Medical educational content strategy development and execute aligned Field Medical tactics (c). Maintain effective and appropriate communication and collaboration among headquarters Medical colleagues, Medical Information, and other Pfizer Field Medical colleagues (d) Demonstrate expertise in scientific communication across multiple channels, including, but not limited to, live and virtual presentations in small or large settings, written communication, and telephone or virtual conversations (e) Compliantly integrate understanding of clinical, Health Information Technology (HIT), market, and account considerations to develop and execute mutually beneficial customer-specific projects, collaborations, strategic medical partnerships, and non-interventional studies with the goal of advancing quality of care and improving patient outcomes (f) Optimize patient care improvements in centricity of Medical communications and deliverables, incorporating Health Literacy and cultural awareness principles to ensure that patients remain the ultimate focus. The role may interact with accounts in the region including Healthcare Decision Makers (HCDM) affiliated with organized customers. The colleague will respond to medical questions regarding Pfizer products for the designated therapeutic area and other Pfizer medicines as appropriate. The individual may be involved in presentations to payers, managed care organizations, formulary decision makers and regional medical advisory boards in accordance with the designated therapeutic area medical strategy. The Medical Outcomes colleague will also facilitate communication between regional and national HCOs and headquarters Medical Affairs colleagues and provide customer insights that contribute to the development of brand medical strategies as appropriate. The role may facilitate Pfizer sponsored research projects/studies which could include collaborative projects, quality improvement research and non-interventional studies. The colleague will maintain required level of knowledge of relevant TA/disease states and Pfizer medicines, providing therapeutic area/product information to both internal and external stakeholders as needed, and serve as a conduit and resource for Medical Information and customer insights, providing requested information to medical stakeholders as allowed by Pfizer guidance and sharing customer viewpoints with Pfizer as appropriate. **ROLE RESPONSIBILITIES** + Ensure compliance with all internal/external SOPs/Rules/Regulations. + Provide objective and scientifically sound medical information regarding Pfizer's medicines and the disease states they treat through use of pharmacoeconomic models, outcomes tools, educational programs, Health Outcomes Projects and Evaluations (HOPEs), non-interventional studies, and collaborations. + Appropriately prioritize the needs of the customer and of Pfizer to develop and implement objective and scientifically sound Real World Evidence-based outcomes tools (such as HOPEs and educational programs) which identify the greatest opportunities for improving patient care, closing quality gaps, and addressing population health management. + Serve as the Field Medical Outcomes lead for assigned customers, developing and executing a Medical account plan while representing Medical Affairs, sharing insights from the customer, and identifying opportunities for collaboration to improve patient care. + Understand the principles of study design, methodology, data analysis, and interpretation and communicate these concepts with customers. + Appropriately engage with key stakeholders within the market, such as Quality Improvement Organizations, Advocacy Groups, Coalitions, and other medical/healthcare associations, to understand their population health priorities and identify opportunities that align with the strategic Medical objectives of Pfizer. + Provide Medical support and guidance for HIT initiatives including initial assessment, triaging opportunities for review, assessing organizational capabilities and feasibility, and providing clinical relevance to proposed HIT methodologies. + Analyze workflows in the context of clinical healthcare information systems to facilitate care processes to reduce care gaps, improve care efficiencies, and maximize quality and population health. + Facilitate development of clinical content that embodies the clinical perspective while effectively using information technology to develop strategy and build innovative tools and resources. + Provide expertise on e-data collection and planning for Field Medical colleagues. + Work cross-functionally within Pfizer guidance to identify, design, and deploy HIT solutions aligned with Pfizer Medical goals for Field Medical use. + Support development of HIT/clinical informatics specific resources for new product and new indication launches. + Maintain, continually develop, and utilize Clinical Informatics capabilities to enable effective collaborations with external customers. + Serve as members of internal teams to further the impact of Field Medical Outcomes by creating tools, resources, and educational materials for use both internally and externally. + Represent Pfizer Medical Affairs leadership with clinical/professional associations and/or societies, consistently demonstrating medical professionalism in all interactions. + Enhance customer recognition of Pfizer Medical through collaborative projects, publications and healthcare awards. + Providing approved medical content on Pfizer's products in the designated therapeutic area, with a primary focus on organized customers, including but not limited to National Payers, Regional Payers, and Specialty Pharmacy Providers (SPPs). + Demonstrate Pfizer Scientific Leadership by keeping abreast of medical and scientific developments in the designated therapeutic area by continuously reviewing literature in the field, evolving competitive landscape, networking with experts and attending assigned conferences. + Respond to unsolicited requests from customers regarding scientific interpretation of clinical information and pharmacoeconomic impact of product selection to further advance formulary decision-making or patient outcomes through appropriate pharmaceutical care. + Compliantly collaborate with internal Pfizer colleagues (including Key Account Managers, Account Directors, PHI, Field Medical, Headquarters Medical, CI, AME, and HEOR) to understand the outcomes of interest and data analysis needs of assigned customers. + Maintain significant market and customer knowledge in an increasingly complex and dynamic marketplace. + Manage a significant volume of projects developed in a field-based environment, while exhibiting the ability to prioritize, successfully implement, and demonstrate excellent judgment skills and work in a continuous improvement environment. + Maintain an up-to-date status for internal training requirements. + Conduct all activities in accordance with all relevant policies, procedures and compliance guidance. + Educate HCOs based on patient care gaps and aligned to medical strategy with the goal of enhancing understanding of disease state and guideline-based care. + Achieve leadership-defined expectations regarding the number of medical stakeholders engaged + Understand the priorities of PFE Medical Affairs in order to contribute to medical content strategy development and aligned field medical tactics. + Provides strong territory/customer leadership. + Serve on Medical, TA or cross-functional committees as appropriate. + Mentorship and Onboarding partner. + Maintain professional licensure and continually learn and grow in profession. **BASIC QUALIFICATIONS** + PharmD, PhD, or equivalent terminal doctoral degree required. + Relevant experience required: 5+ years with terminal doctorate degree (PharmD, PhD). Experience should be in any of the following: + Clinical, formulary, and/or other management experience. + Managed Care, pharmaceutical industry, and/or Quality Improvement. + Data Analytics and/or HEOR activities, with demonstrated strong methodological skills (study design, data analysis, and interpretation) in health services research. + Significant experience in interacting with payers and other organized customers required. + Excellent oral and written communication skills required. + Excellent and demonstrated interpersonal skills: ability to understand and respond to multiple external and internal customers' demands, manage and handle conflict constructively required. + Breadth of diverse leadership experiences and capabilities including the ability to influence and collaborate with peers and create business impact. + Strong analytic skills including creativity and effectiveness in proactively identifying and addressing challenges. + Strong comprehension and communication skills, including ability to communicate large amounts of scientific information in a manner that is clear and concise. + Well-organized with the ability to be flexible, prioritize multiple demands, and employ strong situational leadership skills. + Ability to travel, including overnight travel for internal and external meetings (customer, industry, and professional society meetings). + Ability to operate a Pfizer company car with a valid US Driver's License and regularly fly on airplanes; must be within a 2-hour drive of a major airport; flexibility to potentially travel 40 - 50% of time. **PREFERRED QUALIFICATIONS** + Previous experience in field-based medical/outcomes role. + Experience analyzing health care data (claims, electronic health records, other health care data). + Expertise in Clinical Informatics or Health Information Technology (HIT), including working with claims data sets or Electronic Health Record (EHR) systems. + Residency or Fellowship experience. + Microsoft Access, statistics software, and/or data programming experience. + Experience in the clinical, functional, and technical application of health information technology used in the U.S. + Experience with optimization/customization of EHR platforms, including developing EHR clinical solutions. + Leadership in innovative project start-up and management. + Understanding of the complex business environment within the US healthcare system as well as emerging healthcare trends. **NON-STANDARD WORK SCHEDULE, TRAVEL OR ENVIRONMENT REQUIREMENTS** + Flexibility to travel 40-50% of time. + Reasonable proximity to airline 'hub' city. + Ability to work on weekends occasionally (e.g. attend advisory boards and congress meetings). + Ability to operate a Pfizer company car and regularly fly on airplanes (i.e. attend medical stakeholder meetings; attend HQ meetings, regional and national scientific meetings, etc.) required. **Other Job Details** + Last day to apply: March 27, 2025 + Additional Location Information: LA, MS, AK, West TN + Eligible for Relocation Package: No \#LI-PFE The annual base salary for this position ranges from $169,700.00 to $282,900.00. In addition, this position is eligible for participation in Pfizer's Global Performance Plan with a bonus target of 20.0% of the base salary and eligibility to participate in our share based long term incentive program. We offer comprehensive and generous benefits and programs to help our colleagues lead healthy lives and to support each of life's moments. Benefits offered include a 401(k) plan with Pfizer Matching Contributions and an additional Pfizer Retirement Savings Contribution, paid vacation, holiday and personal days, paid caregiver/parental and medical leave, and health benefits to include medical, prescription drug, dental and vision coverage. Learn more at Pfizer Candidate Site - U.S. Benefits | (uscandidates.mypfizerbenefits.com). Pfizer compensation structures and benefit packages are aligned based on the location of hire. The United States salary range provided does not apply to Tampa, FL or any location outside of the United States. Relocation assistance may be available based on business needs and/or eligibility. **Sunshine Act** Pfizer reports payments and other transfers of value to health care providers as required by federal and state transparency laws and implementing regulations. These laws and regulations require Pfizer to provide government agencies with information such as a health care provider's name, address and the type of payments or other value received, generally for public disclosure. Subject to further legal review and statutory or regulatory clarification, which Pfizer intends to pursue, reimbursement of recruiting expenses for licensed physicians may constitute a reportable transfer of value under the federal transparency law commonly known as the Sunshine Act. Therefore, if you are a licensed physician who incurs recruiting expenses as a result of interviewing with Pfizer that we pay or reimburse, your name, address and the amount of payments made currently will be reported to the government. If you have questions regarding this matter, please do not hesitate to contact your Talent Acquisition representative. **EEO & Employment Eligibility** Pfizer is committed to equal opportunity in the terms and conditions of employment for all employees and job applicants without regard to race, color, religion, sex, sexual orientation, age, gender identity or gender expression, national origin, disability or veteran status. Pfizer also complies with all applicable national, state and local laws governing nondiscrimination in employment as well as work authorization and employment eligibility verification requirements of the Immigration and Nationality Act and IRCA. Pfizer is an E-Verify employer. This position requires permanent work authorization in the United States. Medical \#LI-Remote #LI-PFE

**Your Future Evolves Here** Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones. Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business. Join Evolent for the mission. Stay for the culture. **What You'll Be Doing:** As a FMD, Radiology you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in patients lives, in a non-clinical environment. You can enjoy better work- life balance on a team that values collaboration and continuous learning while providing better health outcomes. **Collaboration Opportunities:** + Routinely interacts with leadership and management staff, other Physicians, and staff whenever a physician`s input is needed or required. **What You Will Be Doing:** + Serve as the Physician match reviewer in Imaging cases, that do not initially meet the applicable medical necessity guidelines, as well as other imaging requests when providers, clients, or state laws require specialty reviews to be completed by the subject matter expert. + Discusses determinations (peer to peer phone calls) with requesting physicians or ordering providers, when available, within the regulatory timeframe of the request and provides clinical rationale for standard and expedited appeals. + Utilizes medical/clinical review guidelines and parameters to assure consistency in the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality Assurance (NCQA) guidelines. + Aids and acts as a resource to Initial Clinical Reviewers. + Ensures documentation of all communications with medical office staff and/or MD provider is recorded in a timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + Participates in on-going training per inter-rater reliability process. **Qualifications:** + MD/DO/MBBS + Minimum of five (5) years' experience in the practice of Medicine, post residency and Active Clinical practice within the last 2 years is preferred + Current, unrestricted clinical license in medicine or required specialty- + Obtaining and maintaining medical licenses in the state you reside, as well as, any license required per business needs + Active Board Certification by an accredited organization + Strong clinical, management, communication, and organizational skills + Energetic and curious with a passion for quality and value in health care + Computer Proficiency + Not under current exclusion or sanction by any state or federal health care program, including Medicare or Medicaid, and is not identified as an "excluded person" by the Office of Inspector General of the Department of Health and Human Services or the General Service Administration (GSA), or reprimanded or sanctioned by Medicare. + No history of a major disciplinary or legal action by a state medical board **Technical Requirements:** We require that all employees have the following technical capability at their home: High speed internet over 10 Mbps and, specifically for all call center employees, the ability to plug in directly to the home internet router. These at-home technical requirements are subject to change with any scheduled re-opening of our office locations. **Evolent is an equal opportunity employer and considers all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or disability status.** **If you need reasonable accommodation to access the information provided on this website, please contact** ************************** **for further assistance.** The expected base salary/wage range for this position is $94-99/hr. This position is also eligible for a bonus component that would be dependent on pre-defined performance factors. As part of our total compensation package, Evolent is proud to offer comprehensive benefits (including health insurance benefits) to qualifying employees. All compensation determinations are based on the skills and experience required for the position and commensurate with experience of selected individuals, which may vary above and below the stated amounts. Don't see the dream job you are looking for? Drop off your contact information and resume and we will reach out to you if we find the perfect fit!

SERC, a brand partner of Upstream Rehabilitation, is growing! We are looking for a Clinic Director and Partner to lead a NEW team in the Little Rock, AR area! What makes someone a fit? * Demonstrate and live our mission, vision, values, and operational standards * Desire for mentorship and guidance by successful Partners and key leaders through the Upstream Family * Seek to have a direct impact on patient care, referral relations, and community outreach initiatives * Commitment to providing high-quality, individualized, evidence-based care to patients while enjoying autonomy when making clinical decisions * Aspiration for an active role within the hiring process, to ensure you choose the right team members for all positions * Emphasis on empowering, motivating, and developing your team to provide exceptional care and remarkable patient experiences * Experience in the management of day-to-day clinical operations and the inclination to be involved with setting business targets, analyzing financial performance, patient outcome data Qualifications * Graduate of an accredited Physical Therapy program * Current or pending state licensure * Demonstrated operational leadership and performance is a plus, preferably working independently in an outpatient setting What is special about this role? Our unique equity ownership model allows Partners the ability to open your own clinic with unparalleled back-office support, minimizing your overall risk and allowing for personal, professional, and financial success. You will have access to the Upstream library of professional development, as well as support from our various business development departments: Legal and Financial services, Credentialing, Human Resources and Payroll, Recruiting, and Regulatory Compliance. Why Upstream? Upstream has grown to be the largest dedicated outpatient rehabilitation provider nationwide. We proudly serve patients in over 1200 clinics from coast to coast, and we operate as 26+ brand partners within the Upstream family including Results, Benchmark, Drayer, PT&RS, and more. As the leader in pure-play outpatient physical therapy, being a part of the Upstream family offers something for every clinician. Additionally, we offer: * Customizable compensation packages based on experience * Flexible Work Schedules * Clinic and Clinical Care Bonus Opportunities * Medical, Dental, and Vision Benefits * 401k with company match * Paid Time Off and Holidays * Company Paid Life Insurance (1x base salary) * Voluntary Short-Term and Long-Term Disability Offerings Continuing Education Offerings * Annual CE allowance with unlimited use of MedBridge * Partnership with IAMT for training in Manual Therapy * Orthopedic and Sports Residencies available in-house * Leadership development program Follow @Lifeatupstream on Instagram, and check out our LinkedIn company page to learn more about what it's like to be part of the #upstreamfamily CLICK HERE TO LEARN MORE ABOUT UPSTREAM Upstream Rehabilitation is an Equal Opportunity Employer that strives to provide an inclusive work environment where our differences are celebrated for the value they bring to our communities, our patients and our teammates. Upstream Rehabilitation does not discriminate on the basis of race, color, national origin, religion, gender (including pregnancy), sexual orientation, age, disability, veteran status, or other status protected under applicable law. Upstream Rehabilitation is an Equal Opportunity Employer that strives to provide an inclusive work environment where our differences are celebrated for the value they bring to our communities, our patients and our teammates. Upstream Rehabilitation does not discriminate on the basis of race, color, national origin, religion, gender (including pregnancy), sexual orientation, age, disability, veteran status, or other status protected under applicable law.

**Become a part of our caring community and help us put health first** The Long-term services and supports (LTSS) Medical Director's primary responsibility is the review of medical authorizations to determine the medical necessity of a given service, level of care, or medical item/supply. The Medical Director's work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors that rely on clinical experience and knowledge of both medicine and social determinants of health. Candidates must have current/active Florida license and be willing to work East Coast hours. Please see position requirements for licensing details. **Candidates must have current/active Florida medical license and be willing to work East Coast hours. Please see position requirements for licensing details.** The LTSS Reviewing Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, requested site of service, and/or medical supply should be authorized. All work occurs within a context of regulatory compliance, and work is assisted by diverse resources, which may include national clinical guidelines, state policies, CMS policies and determinations, clinical reference materials, internal teaching conferences, and other reference sources. Medical Director will learn National LTSS State Medicaid requirements (currently FL; IN; and other states as needed) and understand how to operationalize this knowledge into their daily work. The LTSS Reviewing Medical Director's work includes computer-based review of moderately complex to complex clinical scenarios, review of all submitted clinical records, prioritization of daily work, communication of decisions to internal associates, Grievance & Appeal reviews, participation in ICT's (Intra Collaborative Team meetings); and attend Fair Hearings. The clinical scenarios arise from outpatient, post-acute care; acute inpatient; LTC (Long Term Care); and HCBS (home and community based services) environments. Reviews include, but not limited to, home health services, therapy services, consumable medical supplies (CMS); home or vehicle modifications, and durable medical equipment (DME). Other duties include, but may not be limited to, an overview of clinical documentation, Letter of Agreements, coding practices, Clinical Integration, Long Term Services & Supports, and Case Management. The Medical Director, as indicated, could need to have discussions with external physicians, providers, Care Coaches, and UM Team associates by phone or internal messaging to gather additional clinical information or discuss determinations, and in some instances these discussions may require conflict resolution skills. The LTSS Reviewing Medical Director may occasionally speak with contracted external physicians, provider groups, health care facilities, or community groups to support regional market priorities, which may include an understanding of Humana processes, as well as a focus on collaborative business relationships, value based care, population health, or disease or care management. **Use your skills to make an impact** **Responsibilities** The Medical Director provides medical interpretation and determinations whether services provided by other healthcare professionals are in agreement with national guidelines, CMS requirements, Humana policies, clinical standards, and (in some cases) contracts. The ideal candidate supports and collaborates with other team members, other departments, Humana colleagues and the Regional VP Health Services. After completion of mentored training, daily work is performed with minimal direction. Enjoys working in a structured environment with expectations for consistency in thinking and authorship. Exercises independence in meeting departmental expectations, and meets compliance timelines. **Required Qualifications** + 5+ years of clinical experience + Must have a current License in Florida and able to obtain License/s in Indiana, Virginia, Georgia, and/or other LTSS Medicaid states as needed + MD or DO degree + Board Certified in an approved ABMS Medical Specialty + Excellent communication skills with 5+ years of established clinical experience + Knowledge of the managed care industry including Medicare or Medicaid products + Possess analysis and interpretation skills with 5+ years of experience focusing on quality management, utilization management, discharge planning, rehabilitation services, and/or home health services **Preferred Qualifications** + LTSS medical management organizations, Skilled Nursing Facilities, Long Term Care Facilities, Hospice, PACE, or Home Health Agencies and experience, working with health insurance other healthcare providers, patient interaction, etc. + Internal Medicine, Physiatry, Family Practice, Geriatrics, Pediatrics, or Hospitalist experience + Previous Medicare, Medicaid, and/or Commercial with 5+ years of experience + Long Term Services & Supports or LTC/SNF with 5+ years of experience preferred + Call on average is 10 weekends per year. **Additional Information** + The Medical Director conducts clinical reviews of the care received by members in assigned LTSS Medicaid states, member population, or condition type. Must hold a MD or DO and be board certified and typically reports to a Lead or Regional or Corporate Medical Director, depending on size of region/line of business. No direct supervisory responsibility is expected though it may occur. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $223,800 - $313,100 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 03-31-2025 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************

**Your Future Evolves Here** Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones. Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business. Join Evolent for the mission. Stay for the culture. **What You'll Be Doing:** **Associate Medical Director - Cardiovascular Medicine (Cardiologist) | Evolent Health** Are you looking to leverage your expertise in cardiovascular medicine to drive meaningful change beyond the bedside? Evolent Health is seeking an **Associate Medical Director - Cardiovascular Medicine** to play a critical role in **Performance Suite risk** **arrangements with payers** **and** **strategic** **utilization** **management** **initiatives** **.** This is an opportunity for a **Cardiologist** to shape high-value patient care through evidence-based strategies, enhancing peer-to-peer discussions, and strategic collaboration-all while enjoying a **better work-life balance** in a **non-clinical setting.** **What** **You'll** **Do:** + Serve as a **specialty-matched expert** for cardiovascular utilization management and next generation idea and value creation. + Provide **clinical** **expertise** **in** **utilization** **management (UM),** ensuring high-value care aligned with national guidelines. + Process improvement and enhancement of **peer-to-peer discussions** with requesting physicians to guide appropriate clinical decision-making. + Offer **clinical rationale for standard and expedited appeals,** ensuring compliance with UM policies and regulatory requirements. + Collaborate with cross-functional teams, including **clinical reviewers, management, and senior leadership,** to improve decision-making and care outcomes. + Assist in **research, policy interpretation, and guideline development** to refine the UM process. + Support **special projects** as needed, including potential oversight of utilization management for select health plans or regions. **What We Offer:** + A unique opportunity to **impact** **patient care beyond direct clinical practice.** + A **collaborative and innovative** work environment. + The ability to **influence** **utilization** **management strategies** in cardiovascular medicine. + A role that fosters **continuous learning, professional development, and leadership growth.** **Qualifications - Required & Preferred:** + **MD/DO/MBBS Degree** with active **ABIM** **Board Certification in Cardiology** (with Cardiology training and clinical experience). + **Unrestricted medical license** in the state of residence and willingness to obtain additional state licensure as needed. + **Minimum 5 years of clinical experience** in cardiology (preferred). + **3+ years UM experience preferred, 1 year minimum required.** + Strong **clinical judgment, communication, and organizational skills.** + Passion for **value-based care and improving healthcare quality.** + **Computer** **proficiency** and ability to navigate electronic medical review platforms. + No current exclusions, sanctions, or disciplinary actions by **state or federal healthcare programs (Medicare, Medicaid, OIG, or GSA).** Join us at **Evolent Health** and be part of a team that is transforming healthcare delivery. If you're ready to apply your cardiovascular expertise in a way that maximizes impact while enhancing your work-life balance, we'd love to hear from you! **Technical Requirements:** We require that all employees have the following technical capability at their home: High speed internet over 10 Mbps and, specifically for all call center employees, the ability to plug in directly to the home internet router. These at-home technical requirements are subject to change with any scheduled re-opening of our office locations. **Evolent is an equal opportunity employer and considers all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or disability status.** **If you need reasonable accommodation to access the information provided on this website, please contact** ************************** **for further assistance.** The expected base salary/wage range for this position is $275,000-290,000. This position is also eligible for a bonus component that would be dependent on pre-defined performance factors. As part of our total compensation package, Evolent is proud to offer comprehensive benefits (including health insurance benefits) to qualifying employees. All compensation determinations are based on the skills and experience required for the position and commensurate with experience of selected individuals, which may vary above and below the stated amounts. Don't see the dream job you are looking for? Drop off your contact information and resume and we will reach out to you if we find the perfect fit!

SERC, a brand partner of Upstream Rehabilitation, is growing! We are looking for a Clinic Director and Partner to lead a NEW team in the Little Rock, AR area! What makes someone a fit? Demonstrate and live our mission, vision, values, and operational standards Desire for mentorship and guidance by successful Partners and key leaders through the Upstream Family Seek to have a direct impact on patient care, referral relations, and community outreach initiatives Commitment to providing high-quality, individualized, evidence-based care to patients while enjoying autonomy when making clinical decisions Aspiration for an active role within the hiring process, to ensure you choose the right team members for all positions Emphasis on empowering, motivating, and developing your team to provide exceptional care and remarkable patient experiences Experience in the management of day-to-day clinical operations and the inclination to be involved with setting business targets, analyzing financial performance, patient outcome data Qualifications Graduate of an accredited Physical Therapy program Current or pending state licensure Demonstrated operational leadership and performance is a plus, preferably working independently in an outpatient setting What is special about this role? Our unique equity ownership model allows Partners the ability to open your own clinic with unparalleled back-office support, minimizing your overall risk and allowing for personal, professional, and financial success. You will have access to the Upstream library of professional development, as well as support from our various business development departments: Legal and Financial services, Credentialing, Human Resources and Payroll, Recruiting, and Regulatory Compliance. Why Upstream? Upstream has grown to be the largest dedicated outpatient rehabilitation provider nationwide. We proudly serve patients in over 1200 clinics from coast to coast, and we operate as 26+ brand partners within the Upstream family including Results, Benchmark, Drayer, PT&RS, and more. As the leader in pure-play outpatient physical therapy, being a part of the Upstream family offers something for every clinician. Additionally, we offer: Customizable compensation packages based on experience Flexible Work Schedules Clinic and Clinical Care Bonus Opportunities Medical, Dental, and Vision Benefits 401k with company match Paid Time Off and Holidays Company Paid Life Insurance (1x base salary) Voluntary Short-Term and Long-Term Disability Offerings Continuing Education Offerings Annual CE allowance with unlimited use of MedBridge Partnership with IAMT for training in Manual Therapy Orthopedic and Sports Residencies available in-house Leadership development program Follow @Lifeatupstream on Instagram, and check out our LinkedIn company page to learn more about what it's like to be part of the #upstreamfamily CLICK HERE TO LEARN MORE ABOUT UPSTREAM Upstream Rehabilitation is an Equal Opportunity Employer that strives to provide an inclusive work environment where our differences are celebrated for the value they bring to our communities, our patients and our teammates. Upstream Rehabilitation does not discriminate on the basis of race, color, national origin, religion, gender (including pregnancy), sexual orientation, age, disability, veteran status, or other status protected under applicable law.