- 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)
- … management or utilization management . **Additional Information** Reports to a Lead Medical Director . The Medical Director conducts Utilization ... a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews preauthorization requests… more
- Merck (Raleigh, NC)
- **Job Description** **Role Summary** The Regional Medical Scientific Director is a credentialed (ie, PhD, PharmD, DNP, MD) therapeutic and disease expert who ... SLs, including questions about Company products. The work of an Regional Medical Scientific Director is aligned to: Scientific Exchange, Research, Scientific… more
- Western Digital (Raleigh, NC)
- …of action. + Develop, formulate and coordinate property and casualty insurance claims control function at all locations. + Continue review of existing safety, ... environment, loss prevention, employment and security programs as related to the management of risk or accidental loss. + Maintain historical record of all losses,… more
- Humana (Raleigh, NC)
- …help us put health first** The Corporate Medical Director relies on medical background and reviews health claims . The Corporate Medical Director ... of diverse scope and complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions about the… more
- HomeSafe Alliance (Raleigh, NC)
- **Title:** Director of International, Global Household Goods Moving Services **_HomeSafe Alliance_** is the single global household goods movement manager of over ... the Role** HomeSafe Alliance is seeking a highly skilled and motivated Director of International, Household Goods Moving Services to drive optimization and improve… more
- Baylor Scott & White Health (Raleigh, NC)
- … claims data to uncover trends and assist in managing and understanding incurred medical and pharmacy cost. - The Director will design, develop, and support ... **Position Overview:** Reporting to the VP, Value-based Care Analytics, the Director of Healthcare Economics and Trend Analytics will support the Baylor Scott &… more
- Humana (Raleigh, NC)
- …our caring community and help us put health first** The Actuarial Director , Analytics/Forecasting analyzes and forecasts financial, economic, and other data to ... short, medium and long-term financial and competitive position. The Director , Actuarial Analytics/Forecasting requires an in-depth understanding of how organization… 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
- IQVIA (Durham, NC)
- …and support of IQVIA (TM) information assets - national, sub-national. patient claims data, channel & specialty offerings across multiple internal and external ... business issues, and creates a compelling support plan, including governance, change management , client education to meet the clients' needs. + Builds client… more
- IQVIA (Durham, NC)
- …(CDO, CAO, VP), Technology (CIO) and Business Areas (Pharmacy, Care Management , Care Coordination, other), with demonstrated success selling technology based ... success selling the following types of technology based professional services: Data Management (master data management , data governance, data quality, data… more
- ManpowerGroup (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 department by completing outreaches to members or providers to meet The Centers for Medicare &… 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
- Evolent (Raleigh, NC)
- …and LPCs, Clinical Reviewers. Opportunities to work collaboratively with other Utilization Management Leaders including our Director may also be available. ... culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management ** at Evolent will serve as a point of...also works with our clinical team, which includes our medical reviews: LVNs, LPNs, and RNs along with our… more
- Biomat USA, Inc. (Research Triangle Park, NC)
- …position for candidates in the central and east coast.** **Reporting to the Corporate Medical Director , the Corporate Medical Specialist will support the US ... Department. This includes the review of donor adverse events, management of donor claims , management ...generated at the donor center to assess for sound medical management and proper documentation + As… more
- Granville Medical Center (Oxford, NC)
- …of claims . Responsible for abstracting diagnoses and procedures from medical record into the Hospital Health Information system for timely billing. Performs ... to detect, observe and report compliance variances to the Director of Health Information Management or upward...have initiative and judgment involved in collecting and analyzing medical record data. Must have professional written and oral… more
- Granville Medical Center (Oxford, NC)
- …of claims . Responsible for abstracting diagnoses and procedures from medical record into the Hospital Health Information system for timely billing. Performs ... to detect, observe and report compliance variances to the Director of Health Information Management or upward...have initiative and judgment involved in collecting and analyzing medical record data. Must have the ability to work… more
- Granville Medical Center (Oxford, NC)
- …when staffing issues require it. Minimum Qualifications: Two year associates degree in medical management preferred. Two years experience in medical office ... conjunction with GHS policy and procedure. Experienced in all aspects of Medical Office Administration. Allscripts practice management system preferred. EHR… more
- Stantec (Raleigh, NC)
- …and forecasting. + Experience with scheduling large, complex projects. + Experience with claims management for design projects. + Sound knowledge and experience ... context of the communities we serve, we provide planning, engineering, and infrastructure management services that fit the needs of our clients and improve the… more