- Humana (Raleigh, NC)
- …our caring community and help us put health first** Job Description Summary The Medical Director relies on fundamentals of CMS Medicare Guidance on following and ... episodic, home health per diem, DME, and waiver requests. The Medical Director provides medical interpretation and determinations whether services provided… more
- Humana (Raleigh, NC)
- **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...data requires an in-depth evaluation of variable factors. The Medical Director actively uses their medical… more
- Conviva (Raleigh, NC)
- **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...data requires an in-depth evaluation of variable factors. The Medical Director actively uses their medical… more
- Humana (Raleigh, NC)
- …a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews preauthorization requests ... for services. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth… more
- Humana (Raleigh, NC)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to complex clinical… more
- Humana (Raleigh, NC)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all submitted medical records,… more
- BluePearl (Cary, NC)
- …located in** **Raleigh Durham, NC market** is seeking a **Specialty Market Medical Director ** who is collaborative, engaged, and passionate veterinary leader ... experience to lead our team of specialty clinicians in the role of ** Medical Director ** for **three of our Raleigh Durham hospitals (Raleigh, Durham, and Cary)**… more
- CVS Health (Raleigh, NC)
- …a North Carolina medical license or be willing to obtain one. In the Medical Director role you will provide oversight for medical policy implementation. ... ensuring timely and consistent responses to members and providers. As a Medical Director you will focus primarily on overseeing utilization review / quality… more
- CVS Health (Raleigh, NC)
- …have Internal Medicine or Internal Medicine/Pediatrics (Med/Peds) Board Certification. In the Medical Director role, you will provide oversight for medical ... staff ensuring timely and consistent responses to members and providers. As a Medical Director you will focus primarily on review appeal cases for denied … more
- Evolent (Raleigh, NC)
- …the mission. Stay for the culture. **What You'll Be Doing:** As a Cardiology, Field Medical Director you will be a key member of the utilization management team. ... on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization… more
- CenterWell (Raleigh, NC)
- …a part of our caring community and help us put health first** The Associate Medical Director has similar job duties as a Physician, namely focusing on outpatient ... medicine, continuity of care, health maintenance, and disease prevention. The Associate Medical Director is also responsible for administrative oversight and… more
- ICON Clinical Research (Raleigh, NC)
- Senior Medical Director -US-Remote ICON plc is a world-leading healthcare intelligence and clinical research organization. We're proud to foster an inclusive ... to shape the future of clinical development. We are currently seeking a **Senior Medical Director ** to join our dynamic Medical Imaging team within ICON. As… more
- Elevance Health (Durham, NC)
- **Clinical Ops Associate Medical Director ** **Location:** **This is a virtual position. Candidates must reside within 50 miles of an Elevance Health Pulse Point ... analytics to improve the delivery of care. The **Clinical Ops Associate Medical Director ** is responsible for supporting the medical management staff… more
- Humana (Raleigh, NC)
- …a part of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims. The ... Corporate Medical Director works on problems of diverse scope and complexity...and complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation… more
- Takeda Pharmaceuticals (Raleigh, NC)
- …knowledge. **Job Description** **About the role:** Join Takeda as a Senior Medical Director , Pharmacovigilance in Gastrointestinal and Inflammation (GI2). You ... for presentations to the Takeda Safety Board and similar forums. The Senior Medical Director will be a key player in the preparation and presentation of… more
- Evolent (Raleigh, NC)
- …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** As a Field Medical Director you will be a key member of the utilization management team. ... a timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management process,… more
- Elevance Health (Durham, NC)
- **Clinical Ops Associate Medical Director - Ortho** **Location:** **This is a virtual position. Candidates must reside within 50 miles of an Elevance Health ... to improve the delivery of care. The **Clinical Ops Associate Medical Director - Ortho** is responsible for performing pre-authorizations and providing quality… more
- Veterans Affairs, Veterans Health Administration (Durham, NC)
- Summary The Medical Director of PARC (Psychiatric Acute Recovery Center)manages, directs, and oversees operation of the PARC, in the Durham VA Health Care System ... a learning site for psychiatry residents, NP residents, and medical , PA and NP students Responsibilities The DPARC optimizes...(1) Those approved by the Accreditation Council for Graduate Medical Education (ACGME), b) OR [(2) Those approved by… more
- University of North Carolina- Chapel Hill (Chapel Hill, NC)
- …fixed term, 0.5 FTE to 1.0 FTE faculty member who will serve as the Medical Director for the inpatient and outpatient child maltreatment consultation service. In ... will lead the growth of this service, supervise the medical team and direct the resident and medical... medical team and direct the resident and medical student child maltreatment education curriculum. Applicants should be… more
- VCA Animal Hospitals (Chapel Hill, NC)
- Join us as a ** Medical Director ** at **VCA Timberlyne Animal Hospital** in **Chapel Hill, North Carolina** and you'll quickly discover that you're well-supported ... + 401(k) retirement savings plan with company match. + Medical /dental/vision insurance, infertility benefits, gender affirmation services. + Paid parental,… more