- Elevance Health (Durham, NC)
- The Children and Families Specialty Health Plan is looking to hire a Director of Care Management to lead the care management team in Medicaid ... more
- CVS Health (Raleigh, NC)
- …educational material to support market intelligence. + Engage with market clinical team, care management team, member services team; attend market level meetings ... more
- Humana (Raleigh, NC)
- …of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ ... more
- Humana (Raleigh, NC)
- …Information** + The Medical Director conducts clinical reviews of the care received by members in assigned LTSS Medicaid states, member population, ... more
- Humana (Raleigh, NC)
- …of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ ... more
- Humana (Raleigh, NC)
- …of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ ... more
- Humana (Raleigh, NC)
- …people management experience + Advanced experience working in compliance, risk management , or managed- care field. Providing oversight and auditing managed ... more
- Humana (Raleigh, NC)
- …skills + 5 years of established clinical experience + Knowledge of the managed care industry including Medicare, Medicaid and or Commercial products + Possess ... more
- UNC Health Care (Holly Springs, NC)
- …to join their leadership team to oversee Nursing Operations, along with Surgery, Pharmacy, Care Management , and Rehab Therapy. The ideal candidate will bring a ... more
- Evolent (Raleigh, NC)
- …impact on patient care in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your ... more
- CVS Health (Raleigh, NC)
- … will provide clinical, coding, and reimbursement expertise as well as directing case management when necessary. The Medical Director will act as a business and ... more
- Evolent (Raleigh, NC)
- … Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + On a requested ... more
- Humana (Raleigh, NC)
- …our caring community and help us put health first** The Associate Director , Cloud Architecture designs, builds, and maintains data processing architectures and ... more
- Evolent (Raleigh, NC)
- … Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + Participates in ... more
- Granville Medical Center (Oxford, NC)
- …regulations, institutional policies and procedures and Standards of Nursing Practice for patient care . Director must be a positive role model by demonstrating ... more
- Granville Health System (Oxford, NC)
- …regulations, institutional policies and procedures and Standards of Nursing Practice for patient care . Director must be a positive role model by demonstrating ... more
- Prime Therapeutics (Raleigh, NC)
- …Operations **Job Description Summary** This position provides administrative oversight and management of rebate operations team and is responsible for directing day ... more
- UNC Health Care (Chapel Hill, NC)
- …Manager will be responsible for ensuring the integrity of the UNC Health Care System Charge Description Master (CDM) and related processes. This position will lead ... more
- Mathematica (Raleigh, NC)
- …of data pipelines and analyses involving large administrative data sources such as state Medicaid claims and APCDs, as well as clinical data sources such as EHRs and ... more
- Prime Therapeutics (Raleigh, NC)
- …or PBM organization, or other highly regulated industry, including experience with Medicare, Medicaid , and the Affordable Care Act (ACA) + Must be eligible ... more