- 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
- Humana (Raleigh, NC)
- **Become a part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and ... reviewing home health, SNF, DME, dual Medicare/Medicaid and Waiver requests. The Medical Director provides medical interpretation and determinations whether… 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 ... 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
- UNC Health Care (Morrisville, NC)
- **Description** **Executive Medical Director - Eastern North Carolina** Become part of an inclusive organization with over 40,000 teammates, whose mission is to ... health and well-being of the unique communities we serve. **Summary:** The Executive Medical Director supports the Chief Medical Officer (CMO) for UNC Health… 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 to ... understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all submitted medical records,… more
- Parexel (Raleigh, NC)
- …we are expanding our esteemed Medical Sciences Team and seeking an Associate/ Medical Director to support the growth of our Global Immunology and Inflammation ... Therapeutic Franchise. As an Associate / Medical Director , you will work closely with some of the best and brightest in the industry and assist our clients in… 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
- Evolent (Raleigh, NC)
- …in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional ... on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization… more
- Evolent (Raleigh, NC)
- …mission. Stay for the culture. **What You'll Be Doing:** As a Vascular Surgery, Field Medical Director you will be a key member of the utilization management ... on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization… more
- Humana (Raleigh, NC)
- **Become a part of our caring community and help us put health first** The Medical Director relies on broad clinical expertise to review Medicare drug appeals ... (Part D & B). The Medical director work assignments involve moderately complex to complex issues where the analysis of situations or data requires a case by case… more
- Elevance Health (Durham, NC)
- **Plan Performance Medical Director ** Location: This role enables associates to work virtually full-time, with the exception of required in-person training ... unless an accommodation is granted as required by law. The **Plan Performance Medical Director ** serves as a lead clinician and oversees the administration of … more
- Elevance Health (Durham, NC)
- **Behavioral Health Medical Director - Psychiatrist - North Carolina Medicaid** **Location:** This role enables associates to work virtually full-time, with the ... Schedule: Part-time 28 hours a week. No weekends. The **Behavioral Health Medical Director ** is responsible for reviewing cases for NC Medicaid members including… more
- Otsuka America Pharmaceutical Inc. (Raleigh, NC)
- The Medical Director , Rheumatology and/or Dermatology Medical Strategy is a critical role responsible for shaping the strategic processes and planning for ... ability to balance competing priorities. This position reports directly to the Senior Director , Immunology Lead, who in turn reports to the Executive Director ,… more
- Parexel (Raleigh, NC)
- …Patients First, Quality, Respect, Empowerment & Accountability. **Parexel is looking for a Medical Director with a very strong background in Ophthalmology to ... role can be based remo** t **ely in the US or Canada.** The Medical Director is a medical expert with specialized therapeutic expertise and some experience… more
- Evolent (Raleigh, NC)
- …per inter-rater reliability process. + On a requested basis, may function as Medical Director for selecting health plans or regions, assuming overall ... accountability for utilization management while working in conjunction with the Senior Medical Director . May assist the Senior Medical Director in… more
- UNC Health Care (Fuquay Varina, NC)
- **Description** UNC Health Medical Group is hiring a Medical Director to support our Provider Float Pool. DETAILS ABOUT THE OPPORTUNITY: * Provider Float ... Provide in basket support * Perform annual provider reviews * Attend Medical Director meetings * $15K stipend in addition to current compensation Qualifications:… more
- Evolent (Raleigh, NC)
- …for the mission. Stay for the culture. **What You'll Be Doing:** As a Field Medical Director , Oncology, you will be a key member of the utilization management ... a timely and accurate manner. . May assist the Senior Medical Director in research activities/questions related to the Utilization Management process,… more
- Sumitomo Pharma (Raleigh, NC)
- …a dynamic, highly motivated, and experienced individual for the position of **Associate** ** Medical Director , Clinical Development - Oncology** . The associate ... medical director is responsible for the leadership, development, and management...of the overall product development plan, based on strong medical and scientific principles, knowledge of compliance and regulatory… more
- IQVIA (Durham, NC)
- **Senior Medical Director , Cardiologist** The IQVIA Cardiovascular Center of Excellence, a hub of Cardiovascular clinical innovation, is looking for ... **exceptional Board-Certified cardiologist** to join our team as a Medical Strategy Lead to help us expand our Cardiovascular portfolio and advance this dynamic and… more