55,642 Medical Professionals jobs in the United States

Apply today and meet our recruiter, Karen , who's been a Recruitment and Engagement Coordinator for years 15+ years and understands the importance of having financial stability, a flexible schedule, and a workplace that cares.

Starting at $17 /hr - $strong>20 /hr. with an excellent work environment (including 24/7 support) and full-time or part-time available for caregiving positions in Guilford / Shoreline and the surrounding areas!

Benefits

• Competitive wages: 17 /hr to 20 /hr
• Comprehensive support, 24/7
• Paid training, ongoing education, and orientation
• 401(k) plan, healthcare plans, including dental, and more*
• Referral bonuses, paid time off, and performance incentives*
• Career advancement opportunities in senior care
• *Certain benefits require tenure.

Our Mission
When our founder's parents developed dementia, she decided to drop everything and take care of them full-time. She doesn't want other families to feel under the same burden. We understand that caring for those most in need in our community lifts a huge burden.

Our Ideal Candidate
We're seeking compassionate individuals for caregiving roles. We offer a robust training program for both experienced and new caregivers. Enjoy a supportive work environment with full-time and part-time positions available in Guilford/Shoreline .

Job Responsibilities

• Companionship, light housekeeping, meal preparation
• Medication reminders, running errands, transportation to appointments
• Assisting with activities of daily living and specialized Alzheimers/Dementia care

Requirements

• Treat clients with dignity and respect
• Weekend availability (If applicable)
• Effective communication skills
• Valid driver's license and auto insurance (If applicable)
• Compliance with State of Connecticut regulations, DMV check, and drug screening.

Become a valued part of our team and help enhance the lives of aging adults in our community!

Job Types: Full-time, Part-time

Work Location: In person

Required qualifications:

• Legally authorized to work in the United States
• 21+ years or older
• Valid driver's license
• Background check
• Motor Vehicle Report (MVR) Review
• Drug screening
• Able to comfortably lift 30 lbs

Preferred qualifications:

• Own a personal vehicle
• Valid auto liability insurance
• Has (or willing to open) a checking account for direct deposit

Professional Medical Education Manager
Date:
Oct 17, 2025
Req ID:
5242
Location:
Somerset, NJ, US, 08873
Company:
Terumo Medical Corporation
Department:
TIS PACE
Terumo Medical Corporation (TMC) develops, manufactures, and markets a complete, solutions-based portfolio of high-quality medical devices used in a broad range of applications for numerous areas of the healthcare industry. TMC places a premium on providing customers with world-class products, training and education programs that drive clear economic value, better clinical outcomes and improved quality of life for patients. TMC is part of Tokyo-based Terumo Corporation; one of the world's leading medical device manufacturers with $6+ billion in sales, 30,000+ employees worldwide and operations in more than 160 nations. Terumo Medical Corporation is comprised of two strategic business divisions: Terumo Interventional Systems and Terumo Medical Products.
We believe that the future is bright for everyone at Terumo. We work with the future in mind to generate lasting change, create a bigger impact and produce greater outcomes for today, and for decades to come.
At Terumo we believe in the power of personal growth and will encourage you to get in the driver's seat - progressing in the direction you want to go by deepening your skills throughout your career. We want you to be bold, think outside the box, experiment, innovate and deliver what's next for quality healthcare. You will be part of a collaborative, respectful and resilient team of associates and leaders around the world, working together as partners to achieve more than you thought possible, providing real-world, impactful solutions for patients.
**Join us and help shape wherever we go next!**
**_Advancing healthcare with heart_**
**Job Summary**
The Professional Medical Education Manager is responsible for managing Terumo sponsored external health care professional (HCP) Professional Medical Education programs including CEU and CME accredited programs in This includes identifying relevant courses, developing curriculum, identifying qualified proctors, and coordinating delivery to key audiences (i.e. physicians, nurses, technicians, etc.). This also includes managing budget, building speakers programs and cultivating KOL relationships.
**Job Details/Responsibilities**
+ Works with other Medical Groups, Marketing, Sales, Regulatory and Compliance to assure business objectives are aligned and executed
+ Understand and apply market, industry, competitor, and health care compliance, legal, and regulatory knowledge. Understands the external marketplace including competitor offerings and strategy, changing stakeholders, and applies knowledge to shape Professional Education planning and anticipate future trends
+ Follows established standards and protocols to identify and evaluate courses and programs for quality and relevance. Evaluate proposed courses against these standards and protocols.
+ Follows established standards and protocols to identify, qualify and evaluate proctors. Identify and assess the qualifications of proctors and execute contractual agreements with proctors to teach courses.
+ Review course curriculum and assist in developing new and updated curriculums as necessary to ensure course content is up to date and relevant.in designated therapeutic area(s).
+ Work with physicians or other medical professionals to support course curriculum and oversee content is approved through internal asset review process
+ Develop, plan, and execute Professional Medical Education HCP programs, including identifying educational needs, and development of programs and formats that meet customer and business needs. This role owns the professional education strategy for a key therapeutic area(s) and will manage a budget and supporting resources involved in executing the strategy.
+ Develop and maintain key relationships with Healthcare Professionals in the area of therapeutic focus.
+ Responsible for execution of events, contracting of new speakers, maintenance of compliance standards, preparation of speaker materials, documentation and tracking.
+ Develop educational objectives and curricula / agenda for programs, including both CME and Non-CME accredited content.
+ Identify and contract of new training sites and physician speakers using qualification tools
+ Facilitate preparation of presentation materials and physician speaker coaching for podium presentations.
+ Contribute to the operations and continued improvement of processes, as well as the development and maintenance of speaker slide decks and appropriate compliance / approvals.
+ Partner with meeting planners to coordinate seamless execution of logistical details.
+ Act as an advisor and consult with the field organization to uncover HCP learning needs and develop educational solutions to meet those needs.
**Job Responsibilities (continued)**
+ Maintain records of training, contracting and payments of HCPs in accordance with internal and external compliance and regulatory requirements
+ Maintain feedback mechanisms to receive feedback on course/program quality and effectiveness from participants. Use feedback to continuously improve future offerings.
+ Maintain up-to-date knowledge of therapies, scientific literature, and products within areas of focus.
+ Develop and maintain annual budgets.
+ Network with global and regional Training & Education partners to consider best practices and implement them when appropriate.
+ Contribute to annual Needs Assessment Process and maintain compliance and reporting standards in line with TMC HCP education procedures and guidelines.
+ Demonstrate a commitment to patient safety and product quality by maintaining compliance with all TMC Quality Systems requirements. This includes but is not limited to the prompt recognition and forwarding of customer complaints (i.e. adverse events, product performance reports, etc.) to Quality Assurance (QA), and by ensuring all promotional messaging (i.e. branding strategies, product claims, etc.) and materials (i.e. literature) discussed or presented to customers are clinically accurate and adhere to AdvaMed guidelines and Terumo's policy on Interactions with Healthcare Professionals. Maintain strong knowledge of and adherence to regulations regarding promotional material content and control. Fully adhere to all applicable FDA regulations, international guidelines and Terumo's policies at all times.
+ Perform other job related duties as assigned.
**Working Conditions/Physical Requirements**
+ This position is field based. Approximately 30% overnight travel is required including occasional weekend travel.Entry to hospitals and other medical facilities is required. Many facilities have instituted vendor credentialing policies which require vendors to meet defined training, background check and proof of immunization requirements as a condition of entry. Terumo Associates entering these facilities are required to abide by these credentialing requirements.
+ When visiting hospitals and other medical facilities, must be able to gain access to and work in the IR suite, cath lab and operating room. Entry into these areas requires an ability to wear appropriate gowning, stand for long periods of time, comply with hospital policy/protocol and be aware of potential biohazards such as blood borne pathogens.
**Knowledge, Skills and Abilities (KSA)**
+ Strong knowledge of AdvaMed guidelines and ability to develop course content in compliance with these guidelines.
+ Outstanding verbal and written communication skills with all levels of management and demonstrated experience in public speaking and teaching/training.
+ Strong ability to provide education on complex scientific/medical issues in a clear manner to diverse audiences.
+ Ability to engage in clinical conversations regarding Terumo's products and competitor products with physicians.
+ Strong project management and organizational skills and ability to manage multiple projects simultaneously under tight deadlines.
+ Ability to work cross-functionally without direct reports and to influence without authority.
+ Ability to operate in a cross-functional team and independently, with adaptability to changing requirements.
+ Demonstrated willingness to make decisions and to take responsibility for such.
+ Demonstrated proficiency in Microsoft Office
**Qualifications/ Background Experiences**
+ Requires a Bachelor's degree and a minimum of 5 experience in training and education in clinical or medical topics or an equivalent combination of education, experience and relevant training.
+ Experience managing training programs to medical professionals (i.e. physicians, nurses, technicians) or equivalent experience
+ Experience proctoring CEU or CME accredited programs is preferred.
It is Terumo's policy to provide equal employment opportunity to all its employees and applicants for employment regardless of their race, creed, color, national origin, age, ancestry, nationality, marital or domestic partnership or civil union status, sex, pregnancy, gender identity or expression, disability status, liability for military service, protected veteran status, sexual orientation, atypical cellular or blood trait, genetic information (including the refusal to submit to genetic testing), or any other category protected by law. As a Company, we value diversity of background and opinion, and prohibit discrimination or harassment on the basis of any legally protected class in the areas of hiring, recruitment, promotion, transfer, demotion, training, compensation, pay, fringe benefits, layoff, termination or any other terms and conditions of employment.
Final compensation packages may be higher or lower than what is listed, and will ultimately depend on factors including relevant experience, internal equity, skillset, knowledge, geography, education, business needs and market demand. We provide competitive and comprehensive benefit options which include: annual bonus, paid vacation, paid holidays, health, dental and vision benefits, 401(k), with matching contributions, tax advantage savings accounts, legal plan, voluntary life and AD&D insurance, voluntary long-term disability, short term disability, critical illness and accident insurance, parental leave, personal leave, tuition reimbursement, travel assistance, and an employee assistance program. Pay range: $02,400 - 140,800
**Nearest Major Market:** New Jersey

Allied Universal®, North America's leading security and facility services company, offers rewarding careers that provide you a sense of purpose. While working in a dynamic, welcoming, and collaborative workplace, you will be part of a team that contributes to a culture that positively impacts the communities and customers we serve. We offer a comprehensive benefits package that may include medical, dental, and vision coverage, life insurance, a retirement plan, employee assistance programs, company discounts, and other perks, depending on the position and eligibility.
As a **Security Professional - Medical Services** in **Las Vegas, NV** , you will serve and safeguard clients in a range of industries such as Healthcare, and more.
Join a leading team where flexibility meets opportunity. As a Part-Time Security Officer, you'll use our exclusive Claim a Shift platform to view and Pick up open shifts based on your availability-giving you the freedom to build a schedule that works for you, while gaining valuable site experience across various industries. Whether you're looking to supplement your income or take the first step toward a full-time role, this position offers unmatched access to hands-on experience and growth opportunities. As a Patrol Unarmed Officer with Allied Universal in a healthcare location, you will monitor and patrol designated areas, helping to deter security-related incidents and providing peace of mind to staff, patients, and visitors. Your visible presence and commitment to exceptional customer service will help create a welcoming environment. You will be part of a team that values agility, reliability, and innovation, always putting people first and acting with integrity. Join us to make a meaningful impact while supporting a caring culture.
**Position Type: Part Time**
**Pay Rate: $18.00 / Hour**
**Job Schedule:**
**Day** **Time**
Sat12:00 PM - 08:00 PM
Sun12:00 PM - 08:00 PM
**What You'll Do:**
+ Use our proprietary scheduling platform to claim open shifts at client sites
+ Support operations across a range of environments including commercial real estate, healthcare, and education
+ Receive site-specific training and guidance from experienced teams
+ Deliver consistent, professional security presence and customer service
+ Be ready to fill in at short notice when urgent needs arise
**Responsibilities:**
+ Assist hospital staff with de-escalation of situations involving patients; **restrain combative individuals as necessary (within company and customer guidelines)**
+ Transport deceased patients to the morgue, as needed
+ Assist in escorting patients from helicopter pad (high elevation) to the emergency room
+ Provide customer service by carrying out security-related procedures and following site-specific policies within a healthcare location.
+ Respond to incidents and critical situations in a calm, problem-solving manner, assisting staff, patients, and visitors as needed.
+ Conduct regular and random patrols of the facility and its perimeter to help to deter unauthorized activity and/or potential disruptions.
+ Maintain detailed records and logs of patrols, incidents, and observations as required by Allied Universal and site protocols.
+ Support emergency response activities, including guiding individuals during evacuations and assisting first responders when appropriate.
+ Monitor entrances, exits, and restricted areas to help to deter unauthorized access within the healthcare environment.
+ Communicate professionally with staff, visitors, and/or law enforcement as needed to address concerns or report incidents.
**What We're Looking For:**
+ **At least 1 year of security-related experience is required.**
+ Availability across various days and shifts
+ Reliability and ability to adapt to different post assignments
+ A desire to gain broad experience and grow within the company
+ Interest in transitioning into full-time roles when available
**Minimum Requirements:**
+ **At least 1 year of security-related experience is required.**
+ Ability to lift up to 20 pounds is preferred.
+ Customer service experience is preferred.
+ A valid Guard Card or license is preferred.
+ CPR certification is preferred.
+ Be at least 18 years of age for unarmed roles; 21+ years of age for armed roles.
+ Possess a high school diploma or equivalent.
+ As a condition of employment, applicants will be subject to a background investigation in accordance with all federal, state, and local laws.
+ Allied Universal will consider qualified applications with criminal histories in a manner consistent with applicable laws.
+ As a condition of employment, applicants will be subject to a drug screen to the extent permitted by law.
+ Licensing requirements are subject to state and/or local laws and regulations and may be required prior to employment.
+ A valid driver's license will be required for driving positions only.
**Why Join Us:**
+ Flexible Scheduling: Choose from a variety of open shifts that align with your availability and lifestyle.
+ Career Growth: Clear path to full-time roles and ongoing advancement through paid training programs.
+ Smart Tools: Access exclusive technology for real-time shift visibility and claiming.
+ Full-Time Benefits: Health insurance, 401(k) plans, and a comprehensive benefits package for full-time employees.
+ Employee Perks: Enjoy discounts at restaurants, entertainment venues, and more through our perks program.
**Allied Universal® is an Equal Opportunity Employer.** All qualified applicants will receive consideration for employment without regard to race/ethnicity, age, color, religion, sex, sexual orientation, gender identity, national origin, genetic information, disability, protected veteran status or relationship/association with a protected veteran, or any other basis or characteristic protected by law. For more information: .
If you have any questions regarding Equal Employment Opportunity, have difficulty using the online system and require an alternate method to apply, or require an accommodation at any time during the recruitment and/or employment process, please contact our local Human Resources department. To find an office near you, please visit: .
**Allied Universal® is an Equal Opportunity Employer.** All qualified applicants will receive consideration for employment without regard to race/ethnicity, age, color, religion, sex, sexual orientation, gender identity, national origin, genetic information, disability, protected veteran status or relationship/association with a protected veteran, or any other basis or characteristic protected by law. For more information: .
If you have any questions regarding Equal Employment Opportunity, have difficulty using the online system and require an alternate method to apply, or require an accommodation at any time during the recruitment and/or employment process, please contact our local Human Resources department. To find an office near you, please visit: .
**Job ID:**
**Location:** United States-Nevada-Las Vegas
**Job Category:** Security Officer, Part Time Security

**D&S Community Services** , a part of the Sevita family, provides community-based services for individuals with intellectual and developmental disabilities. Here we believe every person has the right to live well, and everyone deserves to have a fulfilling career. You'll join a mission-driven team and create relationships that motivate us all every day. Join us today, and experience a career well lived.
*MUST HAVE A VALID DRIVER'S LICENSE AND NO TRAFFIC VIOLATIONS WITHIN THE PAST YEAR
DUTIES INCLUDE:
+ Provide transportation for individuals to and from dr appointments and attend appointments as needed.
+ Assist with office administrative duties as needed.
+ Be able to lift in order to assist individuals with loading and unloading in vehicles.
+ Communicate effectively and professionally and serve as a company representative in the community.
+ All other duties as described below as a Caregiver
**THRIVE AS A CAREGIVER AT SEVITA. EACH DAY, YOU'LL**
+ Be proud of rewarding work helping people grow, learn, and live well
+ Develop real, meaningful relationships with the individuals you serve
+ Experience ownership and trust from your leaders to do what's right for participants
+ Take initiative to help participants be part of the community and enjoy their favorite activities
+ Support participants with developmental goals like budgeting, exercise, and nutrition
You'll assist people with their personal hygiene and support individuals who can have behavioral challenges and other complex needs. If you're compassionate, patient, and find meaning in this type of work, you'll find a promising future at Sevita.
**EVERY PERSON DESERVES A FULFILLING CAREER**
+ **Competitive Pay:** Pay on Demand **,** Full benefits package for full-time employees, including a 401(k) with a 3% company match
+ **Time Off:** Paid time off plus holiday pay to recharge so you can be your best at work
+ **Network of Support:** Supervisors who care deeply about the participants and your wellbeing
+ **Job Security:** A stable job at an established, growing company
+ **Learning and Development:** We invest in your development and provide the tools and training you need to have a fulfilling career
**WHAT YOU'LL BRING TO SEVITA**
+ **Education:** High School Diploma or equivalent
+ **Experience:** Six months of experience in human services, direct care, or care coordination preferred
+ **Skills:** Communication, adaptability, multi-tasking, teamwork, time-management
+ **Behaviors:** Patient, compassionate, reliable, responsible
+ **Vehicle:** Valid Driver's license and access to a registered vehicle with proof of insurance
**Apply today and explore careers, well lived at Sevita.**
Sevita is a leading provider of home and community-based specialized health care. We believe that everyone deserves to live a full, more independent life. We provide people with quality services and individualized supports that lead to growth and independence, regardless of the physical, intellectual, or behavioral challenges they face.
We've made this our mission for more than 50 years. And today, our 40,000 team members continue to innovate and enhance care for the 50,000 individuals we serve all over the U.S.
_As an equal opportunity employer, we do not discriminate on the basis of race, color, religion, sex (including pregnancy, sexual orientation, or gender identity), national origin, age, disability, genetic information, veteran status, citizenship, or any other characteristic protected by law._

**Become a part of our caring community and help us put health first**
The Learning Facilitation Professional conducts or facilitates training courses for organization employees or external audiences. The Learning Facilitation Professional 1 work assignments are often straightforward and of moderate complexity.
The Certified or Registered Medical Assistant is the first point of contact for patient care. Responsible for administrative duties in addition to patient care. The Medical Assistant assumes ownership and leads advanced and highly specialized administrative, operational, and customer support duties that require independent initiative and judgment.
The Learning Facilitation Professional plans, coordinates, and implements all aspects of training programs for participants throughout the organization, including but not limited to instructor-led and virtual instructor-led training. Selects appropriate materials. Creates an environment that is conducive to learning and exchanging information, engages the learner, and produces the desired outcomes. Monitors training personnel records to ensure that employees have met all company training requirements for company, quality, and regulatory compliance. Analyzes course evaluations in order to judge effectiveness of training sessions and to implement suggestions for improvements. Evaluates the relevance of online resources to complement the facilitated experience in the fields as appropriate. Understands own work area professional concepts/standards, regulations, strategies and operating standards. Makes decisions regarding own work approach/priorities, and follows direction. Work is managed and often guided by precedent and/or documented procedures/regulations/professional standards with some interpretation.
The Certified or Registered Medical Assistant performs clinical duties, including but not limited to: discussing symptoms, obtaining vital signs, medication/vaccine administration, phlebotomy, collecting specimens, performing diagnostic screening tests, sterilizing/cleaning equipment, maintaining examination rooms, and documenting information into the electronic medical records system. Collaborates closely with Physicians and Advanced Practice Providers. Delivers direct patient care dependent on what active certification allows. Decisions are regarding the daily priorities for an administrative work group and/or external vendors including coordinating work activities and monitoring progress towards schedules/goals and often oversees work of others and/or is the primary administrative owner of a main process, program, product, or technology. Works within broad guidelines with little oversight. The Medical Assistant 4 possesses advanced skills and knowledge, contributes to process improvement, delivers in-depth education/training, and provides advanced guidance/mentoring to other Medical Assistants.
**Use your skills to make an impact**
**Additional Information**
**Required Qualifications**
+ High School diploma
+ 3+ years of training or learning development experience
+ Preceptor experience with the acumen to teach and meet people where they are
+ Certified or Registered Medical Assistant
+ Phlebotomy Experience
+ Medication/vaccine administration experience
+ 3+ years MA Experience
+ EMR Experience
+ CPR Certified
+ Must be passionate about contributing to an organization focused on continuously improving consumer experiences
+ Proficiency in Microsoft Office applications including Outlook, PowerPoint, Excel, Microsoft Project
+ This role is considered patient facing and is part of the company's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB
+ Value Based Care / Managed Care experience including knowledge of HEDIS, CPT/ICD coding, and CAHPS/HOS Patient Experience
**Preferred Qualifications**
+ Experience using a wide variety of training tools to effectively facilitate to a wide audience
+ Bachelors degree
+ Experience managing projects or processes
+ 1+ years MA experience in PCO center
**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.
$48,900 - $66,200 per year
**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.
**About Us**
About CenterWell Senior Primary Care: CenterWell Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. Our unique care model focuses on personalized experiences, taking time to listen, learn and address the factors that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more time with patients, providing compassionate, personalized care that brings better health outcomes. We go beyond physical health by also addressing other factors that can impact a patient's well-being.
About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one.

**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.
Centerwell, a wholly owned subsidiary of 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 full accessibility rights information and language options

**Company :**
Highmark Inc.
**Job Description :**
**JOB SUMMARY**
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: J

**Company :**
Highmark Inc.
**Job Description :**
**JOB SUMMARY**
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: J

**Company :**
Highmark Inc.
**Job Description :**
**JOB SUMMARY**
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: J

**Company :**
Highmark Inc.
**Job Description :**
**JOB SUMMARY**
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: J