- Humana (Raleigh, NC)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members ... **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement… more
- Humana (Raleigh, NC)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an… more
- Humana (Raleigh, NC)
- …us put health first** The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The Corporate ... Medical Director works on problems of diverse scope and complexity...focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience, + working with… more
- Affordable Care (Morrisville, NC)
- …in AR resolution, and claims processing + Will help develop relationships with medical health plans as ACI moves into medical billing + Perform other duties ... **Overview** **Position Summary:** he Insurance Relations Director is responsible for coordinating and communicating with...each plan, and help tactically on all things insurance; claims , rates, and credentialing on behalf of our 700+… more
- Takeda Pharmaceuticals (Raleigh, NC)
- …to bring life-changing therapies to patients worldwide. Join Takeda as Associate Director , Global Labeling Lead where you will be responsible for the development ... guidance. **How you will contribute:** With guidance from leadership: Management of Labeling Cross-Functional Teams + Independently leads Labeling cross-functional… more
- Sedgwick (Raleigh, NC)
- …Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Director Marketing Campaign Strategy and Execution **PRIMARY PURPOSE OF THE ROLE:** ... The Director , Marketing Campaign Strategy and Execution is responsible for...improve client satisfaction. **QUALIFICATIONS** + 8+ years B2B Campaign Management leadership experience. + Solid experience with campaign technologies… more
- CVS Health (Raleigh, NC)
- …health care more personal, convenient and affordable. **Position Summary:** **The Lead Director , Operations (hiring for two positions)** plays a key role by leading ... executive, providers, and administrative staff. + Relationship building + Medical cost, risk, and quality analysis + Transforming data...in a care delivery setting, population health and care management + 5+ years of strong Medicare and clinical… more
- IQVIA (Durham, NC)
- …complex incentive programs, delivering end-to-end speaker bureau strategy and management , or optimizing every HCP interaction, IQVIA Technologies enable healthcare ... insights from advanced analytics and artificial intelligence in the management , coordination, and optimization of resources in support of...& Rules based Analytics + HCP Behavioral Data + Claims Data + Patient Lab Data + Next Best… more
- Robert Half Office Team (Durham, NC)
- …determinations that require a clinical review to a nurse or Medical Director . * Utilize various systems including RX Claims MHR Care Radius FACETS ... reviews. * Maintain accurate customer credit records, ensuring accuracy to avoid impacting claims payment. * Support the care management department by making… more
- HomeSafe Alliance (Raleigh, NC)
- **Title:** Operations Supervisor - Move Management (International Alaska) **_HomeSafe Alliance_** is the single global household goods movement manager of over ... directly or through PPM options + Provide consolidated oversight and management of coordinators under supervision + Monitor international operations performing… more
- Motion Recruitment Partners (Durham, NC)
- …refers organization determinations that require a clinical review to a nurse or Medical Director . * Conducts reviews of authorizations entered to ensure accuracy ... to avoid impacting claims payment. * Supports the care management ...background check** **You will receive the following benefits:** + Medical Insurance - Four medical plans to… more
- Stantec (Raleigh, NC)
- …and forecasting. + Experience with scheduling large, complex projects. + Experience with claims management for design projects. + Sound knowledge and experience ... Claims /Risk mitigation. + Oversee and approve development and management of the Project Scope WBS. + Oversee and...Internal (PGC) Monthly Reports; issue following review with Design Director . + Responsible for the formulation of the Project… more
- Prime Therapeutics (Raleigh, NC)
- …and program impact measurement using eligibility, medical , and pharmacy administrative claims and external data, (eg, care management , disease management ... advanced scientific model design, including advanced predictive modeling, with health claims data, applying statistical theories and methods to solve complex… more
- Crowder Constructors Inc (Apex, NC)
- …Division Safety & Health Director + Daily support/interaction with Project Management & Superintendent(s) + Assist Claims Manager regarding all Workers' ... Health Coordinator: Assist Corporate and Division Safety & Health Director in maintaining the Company's Safety Program in a...access to the following benefits: + Health Plans, including Medical , Dental and Vision + Healthcare Savings and Flexible… more
- UNC Health Care (Chapel Hill, NC)
- …well-being of the unique communities we serve. **Job Summary:** Reporting to the Director of Clinical Risk Management , the Clinical Risk Manager is responsible ... for administering the risk management program and ensuring effective loss prevention/control and compliance...approaches intended to reduce the frequency and severity of medical malpractice and patient injury claims . 3.… more
- UNC Health Care (Chapel Hill, NC)
- …Facilitates the Final rating clinic in collaboration with the NC Jaycee Burn center medical director monthly to review and close workers' compensation claims ... Abilities Requirements:** **Job Details** Legal Employer: STATE Entity: UNC Medical Center Organization Unit: Surgery Inpatient Management Work… more
- Intermountain Health (Raleigh, NC)
- …Director of Physician Compensation, Manager of Physician Compensation, Medical Group, region/market, service line, Provider Recruiting, Professional Staff ... of compensation programs and performs other duties as assigned by the Director - Physician Compensation and/or Physician Compensation Manager. **Skills** + Attention… more
- Perdue Farms, Inc. (Raleigh, NC)
- …health/ medical ; to improve associate safety, wellness, and case management for supported sites. Actively involved in worker's compensation, assisting the ... occupational health nurse/third party administrator in effectively managing all open claims . + Keeps the management team informed of any safety, health, and… more
- Intermountain Health (Raleigh, NC)
- …a liaison in order to facilitate the prompt resolution of complex benefit, claims or enrollment issues for external, internal and team contacts. Handles service ... the task resolution process in Salesforce by utilizing task management with other departments and complaint tasks to seek...Assists in the design of marketing literature for unique medical and dental plans. SALES SYSTEMS: Is committed to… more
- Fujifilm (Raleigh, NC)
- …limited management oversight. The position will report to the Director of Corporate Compliance. **Duties and responsibilities** + Develop and implement elements ... needs of healthcare across prevention, diagnosis, and treatment. Fujifilm's medical imaging portfolio includes solutions for digital radiography, mammography,… more