Top 285 Medical director Jobs in Appleton, Wi

RN Coordinator Utilization Management
Network Health, Inc —Menasha, WI
- Full-time
- Remote
- Nursing
- RN License
- Bachelor of Science
9d
Physician - ADHD Diagnosis and Treatment
ADHD Advisor —Wisconsin
- $150 - $200 an hour
- Contract
- Mid-level
- In-person
- Communication skills
Quick Apply
Physician Assistant or Nurse Practitioner
Alleviate Pain and Spine —De Pere, WI
- $100,000 - $150,000 a year
- Full-time
- Private practice
- Nursing
- RN License
- 401(k)
- Paid time off
Quick Apply
Physician Assistant - Allergy & Immunology
Jackson Physician Search Dallas/STL —Appleton, WI
- $175,000 - $200,000 a year
- Full-time
- Mid-level
- Bachelor's degree
- In-person
- Health insurance
- 401(k)
Quick Apply
Child Care Director in Training
Play & Grow Learning Center —Appleton, WI
- $36,000 - $44,000 a year
- Full-time
- Mid-level
- Education
- In-person
Quick Apply
3d
Physician***PRN***Multi Sites***
Altea Healthcare —Green Bay, WI
- $1,100 - $1,400 a day
- Part-time
- Skilled nursing facility
- Management
- Primary Care
- Referral program
Quick Apply
8d
Medical Assistant (Parttime)
Northeast Wisconsin Foot and Ankle Associates —Appleton, WI
- From $26 an hour
- Part-time
- Background check
- Anatomy knowledge
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
4d
Infectious Disease Physician - Appleton, WI
Vohra Physicians —Appleton, WI
- $200,000 - $350,000 a year
- Full-time
- Medicine
- Skilled nursing facility
- Mid-level
- Paid training
- Mileage reimbursement
Quick Apply
Physician***PRN**
Altea Healthcare —Green Bay, WI
- $1,100 - $1,200 a day
- Part-time
- Skilled nursing facility
- Management
- Primary Care
- Referral program
Quick Apply
9d
Family Medicine Physician - Oshkosh, WI
Vohra Physicians —Oshkosh, WI
- $200,000 - $350,000 a year
- Full-time
- Medicine
- Skilled nursing facility
- Mid-level
- Paid training
- Mileage reimbursement
Quick Apply
Physician Assistant - Endocrinology
Jackson Physician Search Dallas/STL —Appleton, WI
- $175,000 - $200,000 a year
- Full-time
- Mid-level
- Bachelor's degree
- In-person
- Health insurance
- 401(k)
Quick Apply
Emergency Medicine Physician - Oshkosh, WI
Vohra Physicians —Oshkosh, WI
- $200,000 - $350,000 a year
- Full-time
- Medicine
- Skilled nursing facility
- Doctoral degree
- Paid training
- Mileage reimbursement
Quick Apply
Urgent Care Physician - Appleton, WI
Vohra Physicians —Appleton, WI
- $200,000 - $350,000 a year
- Full-time
- Medicine
- Skilled nursing facility
- Urgent Care
- Paid training
- Mileage reimbursement
Quick Apply
Locum | Physician Gastroenterology
CompHealth —Wisconsin
- $335 - $425 an hour
- Mid-level
- Outpatient experience
- Clinic
Locum | Physician Pediatrics
CompHealth —Wisconsin
- $105 - $130 an hour
- Inpatient
- Mid-level
- Pediatrics
Internal Medicine Physician - Oshkosh, WI
Vohra Physicians —Oshkosh, WI
- $200,000 - $350,000 a year
- Full-time
- Medicine
- Skilled nursing facility
- Internal Medicine
- Paid training
- Mileage reimbursement
Quick Apply
Emergency Medicine Physician - Appleton, WI
Vohra Physicians —Appleton, WI
- $200,000 - $350,000 a year
- Full-time
- Medicine
- Skilled nursing facility
- Doctoral degree
- Paid training
- Mileage reimbursement
Quick Apply
Locum | Physician Gastroenterology
CompHealth —Wisconsin
- $335 - $425 an hour
- Hospital
- Inpatient
- Senior level
Locum | Physician Neurology
CompHealth —Wisconsin
- $200 - $275 an hour
- 12 hour shift
- BLS Certification
- Mid-level
- Outpatient experience
Locum | Physician Gastroenterology
Weatherby Healthcare —Wisconsin
- $335 - $425 an hour
- Multiple hires
- Hospital
- Inpatient
- Mid-level
- Travel reimbursement

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medical director jobs near appleton, wi

RN Coordinator Utilization Management

Network Health, Inc -
Menasha, WI

Apply Now

Job Details

Full-time
9 days ago

Qualifications

Nursing
RN License
Associate's degree
Associate Degree in Nursing
Nursing

Full Job Description

The RN Coordinator Utilization Management to review submitted authorization requests for medical necessity, appropriateness of care and benefit eligibility. This position reviews applicable guidelines regarding payment and coverage, and makes determinations for authorization/payment.

Location: Candidates must reside in the state of Wisconsin for consideration. This position is eligible to work at your home office (reliable internet is required). Travel to the corporate office in Menasha is required occasionally for the position, including on first day. Training is required in person at our Menasha location for the first 6-8 weeks.

Hours: 1.0 FTE, 40 hours per week, 8am - 5pm Monday through Friday

Check out our 2025 Community Report (https://www.youtube.com/watch?v=Oea3uHW0EV0) (https://networkhealth.com/__assets/pdf/2025_annual_report.pdf) to learn a little more about the difference our employees make in the communities we live and work in. As an employee, you will have the opportunity to work hard and have fun while getting paid to volunteer in your local neighborhood. You too, can be part of the team and making a difference. Apply to this position to learn more about our team.

Job Responsibilities:

Evaluate and process prior authorization requests/referrals submitted from contracted and non-contracted providers
Follow Network Health process, policies, and procedures in authorization review of all membership on a pre-service, concurrent and post-service basis. This process includes verifying eligibility and benefits, as well as documenting all utilization management communication
Provide education regarding utilization management activities and processes to members, caregivers, providers, and their administrative staff
Participate in Utilization Management auditing (i.e. Utilization Management Inter-reviewer reliability and denial files)
Refer all members with complex health problems and needs to Network Health Case Management to reduce medical costs while providing a higher quality of life and an ability to take charge of their diseases. This requires an extensive holistic approach to care management assessment
Collaborate with other NH departments to develop interdepartmental operational processes
Support Utilization Management department programs and goals through active participation
Identify and screen candidates for Case Management intervention and determines appropriate level of care from Utilization Management criteria
Complete assessments and plans of care including need for medication regime, treatment plans, practitioner follow-up appointments, knowledge of red flags, disease management, Advance Directives, life planning, and self-management of illness to the best of member ability
Evaluate cases for cost savings/quality improvement potential
Other duties and responsibilities as assigned

Job Requirements:

Bachelor of Science in Nursing, preferred
Associate Degree in Nursing, required
Current registered nurse licensure in Wisconsin required
Minimum of four (4) years clinical health care experience as a Registered Nurse (RN) required
Experience in insurance, managed care and utilization management preferred

Network Health is an Equal Opportunity Employer

Licenses & Certifications

Preferred

Registered Nurse

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights (https://www.eeoc.gov/poster) notice from the Department of Labor.

Apply Now

Refine Your Search

medical director jobs in appleton, wi

RN Coordinator Utilization Management

Physician - ADHD Diagnosis and Treatment

Physician Assistant or Nurse Practitioner

Physician Assistant - Allergy & Immunology

Child Care Director in Training

PhysicianPRNMulti Sites***

Medical Assistant (Parttime)

Infectious Disease Physician - Appleton, WI

Physician*PRN

Family Medicine Physician - Oshkosh, WI

Physician Assistant - Endocrinology

Emergency Medicine Physician - Oshkosh, WI

Urgent Care Physician - Appleton, WI

Locum | Physician Gastroenterology

Locum | Physician Pediatrics

Internal Medicine Physician - Oshkosh, WI

Emergency Medicine Physician - Appleton, WI

Locum | Physician Gastroenterology

Locum | Physician Neurology

Locum | Physician Gastroenterology

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