This Medical Director role is primarily responsible for Utilization Management, including prior authorization, precertification, and concurrent review for inpatient and outpatient cases. The director also ensures timely responses to members and providers regarding precertification, review, and appeal requests, participating in a rotating on-call schedule.

Capricor is seeking a Senior Director of Medical Affairs with deep expertise in biotechnology, ideally in rare diseases or cell therapies. This position will play a pivotal role in building the medical affairs function as we advance our lead programs following recent clinical mil...

The Regional Medical Scientific Director engages in bidirectional exchange of scientific or medical information with Scientific Leaders, acting as a therapeutic and disease expert for the Gastrointestinal Immunology program. This role supports scientific exchange, research initiation, scientific congress support, and gathering scientific insights.

The Medical Director provides medical interpretation and determinations regarding whether services align with national guidelines, CMS and state Medicaid requirements, Company policies, and clinical standards. The role involves computer-based review of clinical scenarios, prioritizing daily work, communicating decisions, and potentially participating in care management.