19 Medical Assistants jobs in Cheyenne

Medical Account Manager (2063)

• Title:Medical Account Manager

• Group Company: Mitsubishi Chemical Advanced Materials

• Location:Remote

• Employment Type:Full time

Group Company:

• Mitsubishi Chemical Advanced Materials

Mitsubishi Chemical Advanced Materials is a leading global manufacturer of high-performance thermoplastic materials in the form of semi-finished products and finished parts. The company has locations in 20 countries and more than 2,800 employees. Its specialty engineering thermoplastics and composites are superior in performance to metals and other materials and are used in a wide range of applications, primarily in the capital goods industry. The company is continuously developing new areas of applications in close cooperation with industry leaders in a broad variety of customer markets. The Mitsubishi Chemical Advanced Materials Group is well prepared to further expand its market leadership position.

Supporting the vision of our holding company, Mitsubishi Chemical Holdings Corporation (MCHC) ( , Mitsubishi Chemical Advanced Materials is committed to the realization of KAITEKI, “a sustainable condition which is comfortable for people, society and the Earth”. To realize this vision, the MCHC Group engages in corporate activities that provide products, technologies and services based on the comprehensive capabilities of the Group in the Performance Products Domain, Industrial Materials Domain and Health Care Domain, with chemistry as the basis of our activities. We jointly express and promote our commitment under the corporate brand THE KAITEKI COMPANY.

Job Purpose

As an Account Manager, you are responsible for developing and maintaining profitable relationships with customers (existing and new) in the Medical Market space in order to identify opportunities to fuel growth. This role requires a deep understanding of the technical aspects of our products, as well as the ability to provide solutions that meet the needs of our clients in order to grow our business pipeline and ensure consistent revenue growth. The main responsibilities of this position include selling new accounts, upgrading and cross-selling existing accounts, renewing accounts, and providing exceptional customer service and support.

Principal Accountabilities

Client Relationship Management:

Build and maintain strong, profitable relationships with existing clients in the Medical Market

Identify new potential clients and create strategies to expand the customer base.

Understand clients' needs and provide them with tailored solutions.

Respond timely to all customer request and enquiries

Attending industry conferences to network and develop industry expertise.

Identifies and locates new clients through a variety of methods including networking and cold calls.Product Knowledge:

Develop a deep understanding of the company's products, which include materials specifically intended for use in medical applications. These include polymers in various forms, molded and machined parts, films and other medical materials

Stay updated on industry trends, technical advancements, and competitive products through written materials, networking and attendance at scientific sessions and industry trade shows

Sales and Revenue Generation:

Meet or exceed sales targets.

Prepare and deliver sales presentations to potential clients.

Negotiate contracts and participate in pricing agreements.

Including but not limited to quoting and estimating customers provided conceptual engineering prints.

Generate and follow up on sales leads.

Identify opportunities for upselling and cross-selling additional products and services.

Technical Support:

Collaborate with the technical team to provide clients with technical information and support.

Offer technical guidance and solutions to address client needs and challenges.

Market Research:

Conduct market research to identify potential clients and competitors.

Stay informed about industry regulations and standards.

Provide feedback to the company on market trends and customer preferences.

Gather competitive intelligence regarding pricing and other information.

Reporting and Documentation:

Maintain detailed records of client interactions, sales activities, and opportunities.

Prepare regular reports on sales performance and client feedback.

Self-Development and Initiatives

Maintain excellent product knowledge and attend all training sessions.

Continuous focus on self-improvement and skill building –

Foster a growth mindset and execute on areas of development for both managing your business and professional growth.

Knowledge / Skills / Experience

Requirements:

• Industry Knowledge:

Have a thorough working knowledge of the Medical Market in the Americas ranging from Large OEM’s, Medium and Small Companies, and Start Ups. Relationships with Universities and University incubators is desirable.

• Travel Requirement: This role demands extensive travel, approximately 60%-70%, with occasional international travel.

• Relationship Building: Strong interpersonal skills and exceptional networking abilities are essential in this role.

• Executive Interaction: Proficiency in engaging at the senior executive level is a necessity.

• Technical Versatility: Demonstrates a comprehensive technical background, capable of comprehending MCC's full portfolio.

• Sales Acumen: Possesses extensive experience in sales and sales management, ideally in a leadership capacity.

• Strategic Thinker: Capable of thinking strategically and providing innovative solutions to customer challenges

Qualifications:

• Educational Requirements: A minimum of a bachelor’s degree is required, preferably in Business, Marketing, Engineering or chemistry, chemical engineering. Possessing an MBA or MS is considered advantageous.

• Professional Experience: A minimum of 10 years of experience in sales, marketing, or technical roles, within in the medical industry is an advantage

• Software Proficiency: Proficient in the use of Microsoft Office applications.

• CRM Knowledge: Experience with Salesforce or other CRM systems is an asset.

• Technical Sales Expertise: Strong knowledge of medical materials, molding, extrusion and casting and their associated applications

• Exceptional Organizational Skills: Demonstrates excellent planning and organizational capabilities.

• Team Participation: Proven ability to mobilize, energize, influence, and be an active member of a diverse team of professionals toward a common goal.

• Effective Communication: Strong communication and presentation skills are essential for this role.

Pay Transparency (complete highlighted sections)

• The salary range for this position is $119,700 - $149,600. Factors such as scope and responsibilities of the position, candidate's work experience, education/training, job-related skills, internal peer equity, as well as market and business considerations may influence base pay offered. This salary will be subject to a geographic adjustment (according to a specific city and state), if an authorization is granted to work outside of the location listed in this posting.

• Competitive Benefits

• Benefits begin on DAY 1!

• Employee Assistance Programs

• Curated Self-Paced Learning & Development Programs for all Employees

Mitsubishi Chemical Group (MCGC) and any of our subsidiaries do not accept unsolicited resumes from individual recruiters or third-party agencies. No fee will be paid to third parties who submit unsolicited candidates directly to our hiring managers or HR team. No placement fees will be paid to any firm unless specifically invited on the search by the MCGC Talent Acquisition team and such candidate was submitted to the MCGC Talent Acquisition Team via our Applicant Tracking System.

EEO Statement

All qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, or other legally protected status.

Applicants with disabilities may be entitled to a reasonable accommodation under the Americans with Disabilities Act and/or other applicable laws. If you require accommodation due to a disability at any time during the recruitment and/or assessment process, please contact Talent Acquisition.

Become a part of our caring community and help us put health first

The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home health, SNF, DME, dual Medicare/Medicaid and Waiver requests. 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 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. All work occurs with a context of regulatory compliance, and work is assisted by diverse resources which may include national clinical guidelines, CMS policies and determinations, clinical reference materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements, and will understand how to operationalize this knowledge in their daily work. The Medical Director works in a structured environment with expectations for consistency in thinking, authorship, meeting departmental expectations, and compliance timelines.

Use your skills to make an impact

Required Qualifications

• MD or DO degree

• 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 license, as required, for various states in region of assignment

• 5+ years of direct clinical patient care experience post residency or fellowship

• No sanctions from Federal or State Governmental organizations

• The ability to pass credentialing requirements

• Excellent verbal and written communication skills with analytic and interpretative skills

• Participate in educational activities by attending required conferences and also create content to lead/teach/present for individual subject matter contribution

Preferred Qualifications

• Experience in an inpatient environment and/or related to care of a Medicare type population (disabled or >65 years of age)

• Internal Medicine, Family Practice, Geriatrics, Physiatry, Emergency Medicine, Critical Care or hospital based clinical specialists

• Ability to function in a dynamic fast paced environment

• Commitment to a culture of innovation

• Passionate about contributing to an organization’s focus on consistency in outcomes, consumer experiences, and a highly engaged team culture

• Knowledge and experience with national guidelines such as NCD/LCD, MCG® or InterQual

The Medical Director conducts clinical case reviews of requests received by members of the Medicare population and reports to the Lead Medical Director.

Other duties:

• Identify medical management operational improvements, including those within the medical director area

• Participate in call rotation which may include weekend coverage

• Develop collaborative relationships with Team and key partners within the Medicare Line of Business.

• Support Home Solutions as needed

• Other activities as assigned by the managing Medical Director

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

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: 08-31-2025

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 protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with 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

1 day ago Be among the first 25 applicants SYNERGY HomeCare focuses on creating connections and forward momentum in people's lives through compassionate care. Whether individuals need companion care, personal care, memory care, or specialized care, SYNERGY HomeCare strives to improve their lives within the comfort of their own homes. Role Description This is a part-time remote role for a Non-Medical Caregiver. The Non-Medical Caregiver will be responsible for providing compassionate care to individuals in need of assistance. Day-to-day tasks may include assisting with activities of daily living, providing companionship, and supporting overall well-being. Qualifications Experience in providing companion care and personal care Ability to assist individuals with memory care needs Experience in caring for individuals with physical or developmental disabilities Excellent communication and interpersonal skills Compassionate and empathetic nature Ability to work independently and remotely Experience in healthcare or caregiving field is beneficial Seniority level Seniority level Entry level Employment type Employment type Part-time Job function Job function Other Industries Hospitals and Health Care Referrals increase your chances of interviewing at SYNERGY HomeCare by 2x Get notified about new Caregiver jobs in Cheyenne, WY . Cheyenne, WY $300,000.00-$50,000.00 2 weeks ago National Accounts Manager - Farm & Regional Home Centers Cheyenne, WY 101,400.00- 205,400.00 1 week ago Cheyenne, WY 101,400.00- 205,400.00 2 weeks ago We’re unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI. #J-18808-Ljbffr

**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 actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized. All work occurs with a context of regulatory compliance, and work is assisted by diverse resources which may include national clinical guidelines, CMS policies and determinations, clinical reference materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements, and will understand how to operationalize this knowledge in their daily work. The 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, and possible participation in care management. The clinical scenarios predominantly arise from inpatient or post-acute care environments. Has discussions with external physicians by phone to gather additional clinical information or discuss determinations regularly, and in some instances these may require conflict resolution skills. Some roles include an overview of coding practices and clinical documentation, grievance and appeals processes, and outpatient services and equipment, within their scope. The Medical Director may speak with contracted external physicians, physician groups, 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. **Occasional weekends and holidays are required.** **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 participate on project teams or organizational committees. #physiciancareers Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **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: 09-30-2025 **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 protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with 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:** As a Field Medical Director, Oncology, 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 Advanced 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 Adult Medical Oncology · Strong clinical, management, communication, and organizational skills · Energetic and curious with a passion for quality and value in health car · 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 disciplinary or legal action by a state medical board **To comply with HIPAA security standards (45 C.F.R. sec. 164.308 (a) (3)), identity verification may be required as part of the application process. This is collected for compliance and security purposes and only reviewed if an applicant advances to the final interview state. Reasonable accommodations are available upon request.** **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 $110-$125. 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!

Patients are at the heart of everything we do. As the Senior Director, THV Medical Affairs, you will drive strategy development, evidence generation initiatives, and scientific communication activities to advance key organizational objectives that positively impact patient lives and advance the quality of care. Your scientific curiosity and passion for patients will help us grow our reach and develop innovative solutions for people fighting cardiovascular disease. Aortic stenosis impacts millions of people globally, yet it often remains under-diagnosed and under-treated. Edwards' groundbreaking work in transcatheter aortic heart valve replacement (TAVR) pioneered an innovative, life-changing solution for patients by offering heart valve replacement without the need for open heart surgery. Our Transcatheter Heart Valve (THV) business unit continues to partner with cardiologists and clinical teams to transform patient care with devices supported by clinical evidence. It's our driving force to help patients live longer and healthier lives. Join us and be part of our inspiring journey. **You will make an impact by.** + Leading the development and execution of strategies to address key evidence gaps and support expanded indications in alignment with the overall mission and vision of the organization + Facilitating effective collaboration across senior leadership stakeholders, including clinical, regulatory, marketing, health economics and outcomes research teams ensuring seamless integration of medical affairs initiatives into broader organizational efforts. + Building and maintaining strong relationships with external partners, including key scientific thought leaders to gather insights and collaborate on mutual goals + Managing and inspiring a team responsible for generating impactful new data using large real world data sets in collaboration with external experts (e.g., physician investigators, KOLs), driving visibility and influence + Providing strategic direction and supervisory oversight to Biostatisticians and data programmers to achieve timely and accurate data generation and analysis + Planning and directing podium and publication efforts in collaboration with internal teams and external experts to amplify Edwards' scientific presence at major conferences + Serving as strategic thought partner to Physician training team by identifying and leading new content creation for KOL speaker programs + Leading medical information efforts including managing and responding to disease and product information requests from internal and external stakeholders + Analyzing complex data, formulate strategic recommendations, and deliver high-impact communications to executive leadership + Maintaining deep scientific and product knowledge of the structural heart disease space, and distill key insights to inform strategy + Overseeing, planning, staffing, budgeting, managing expense priorities, recommending and implementing changes to methods. + Developing a robust talent development plan in alignment with the department's long-term growth strategy **What you'll need (Required):** + Advanced degree (e.g., Master's, PhD, MD) in a related field, plus professional leadership experience in the clinical, research, or healthcare industry + Extensive experience in evidence generation, development of scientific/medical conference proceedings and manuscript publication in major scientific journals + Demonstrated track record in people management **Position Location and Travel Requirements:** + This role may be based onsite at our Irvine, California campus or remote within the US, with frequent travel to the Irvine office required **What else we look for (Preferred):** + Experience working in a regulated industry + Expert scientific acumen, applied across diverse scenarios, including collaboration with internal stakeholders and physicians to identify evidence gaps and opportunities + Proven successful project management leadership skills + Excellent problem-solving, organizational, analytical and critical thinking skills including high discretion/judgment in decision making + Excellent written and verbal communication skills and interpersonal relationship skills including negotiating and relationship management skills with ability to drive achievement of objectives + Ability to work and excel within a fast paced, dynamic, and constantly changing work environment + Frequently interacts with internal and external management and senior-level stakeholders concerning projects, operational decisions, scheduling requirements, and/or contractual clarifications + Develop peer, cross functional and cross business relationships to maximize best practice sharing and team effectiveness + Provide leadership and direction to cross-functional teams to successfully implement global enterprise systems and related solutions + Adhere to all company rules and requirements (e.g., pandemic protocols, Environmental Health & Safety rules) and take adequate control measures in preventing injuries to themselves and others as well as to the protection of environment and prevention of pollution under their span of influence/control Aligning our overall business objectives with performance, we offer competitive salaries, performance-based incentives, and a wide variety of benefits programs to address the diverse individual needs of our employees and their families. For California, the base pay range for this position is $204,000 to $289,000 (highly experienced). The pay for the successful candidate will depend on various factors (e.g., qualifications, education, prior experience). Applications will be accepted while this position is posted on our Careers website. Edwards is an Equal Opportunity/Affirmative Action employer including protected Veterans and individuals with disabilities. **COVID Vaccination Requirement** Edwards is committed to protecting our vulnerable patients and the healthcare providers who are treating them. As such, all patient-facing and in-hospital positions require COVID-19 vaccination. If hired into a covered role, as a condition of employment, you will be required to submit proof that you have been vaccinated for COVID-19, unless you request and are granted a medical or religious accommodation for exemption from the vaccination requirement. This vaccination requirement does not apply in locations where it is prohibited by law to impose vaccination.

Job Details

This position presents an opportunity to join an elite team of passionate physicians and nurses within the Medical Surgical (MS) unit. This unit sees a wide variety of conditions including endocrine, wound care, neurology and gerontology as well as patients undergoing basic recovery care. Your expertise will be utilized for high level care within the traditional Medical Surgical unit setting. MS RN's can expect to enhance their professional experience while providing top notch patient care to those most needing it.

Benefits

At AMN Healthcare we take care of our travelers! We offer:

• Competitive pay rates
• Free, quality, private housing
• Medical, Dental, Vision
• 401(k) and Flex Spending
• Life Insurance
• Accident and Short-term Disability Coverage
• Free Continuing Education
• Refer a friend and earn extra cash!

**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:** Job Description 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 **To company with HIPAA security standards (45 C.F.R. sec. 164.308 (a) (3)), identity verification may be required as part of the application process. This is collected for compliance and security purposes and only reviewed if an applicant advances to the final interview state. Reasonable accommodations are available upon request.** **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 $95-110/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!

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 Field Medical Director, MSK Surgery 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 Hip/Knee/Shoulder Surgery 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 highly 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 Orthopedic Surgery

• 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

To comply with HIPAA security standards (45 C.F.R. sec. 164.308 (a) (3)), identity verification may be required as part of the application process. This is collected for compliance and security purposes and only reviewed if an applicant advances to the final interview state. Reasonable accommodations are available upon request.

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 . 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.

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