- 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
- Conviva (Raleigh, NC)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Physician Leadership in Population Health Strategy at Primary Care Organization. The Medical Director conducts Utilization Management of the care received by… 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, he Director of Healthcare Economics and Trend Analytics will support the Baylor Scott & White… 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
- UNC Health Care (Rocky Mount, NC)
- …coverage and risk financing, clinical loss prevention, risk identification and evaluation, claims management , and litigation management . Duties also include ... management , performance improvement (quality) or professional liability claims management . **Additional Specialized Knowledge/Skills:** + Customer Focus,… 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)
- …Stay for the culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management ** at Evolent will serve as a point of contact for processing ... medical treatment requests in accordance with departmental policies, regulatory...contractual agreements. **Collaboration Opportunities** : The Coordinator, Intake Utilization Management reports directly to the Manager, Intake Utilization … 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
- 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
- Prime Therapeutics (Raleigh, NC)
- …+ Experience writing SQL queries + Prior PBM experience or experience working with medical claims , pharmacy claims , healthcare and/or benefits data + ... as assigned **Minimum Qualifications** + Bachelor's Degree in Business Administration, Management , Economics or related area of study, or equivalent combination of… more
- Brookdale Senior Living (Raleigh, NC)
- …policies and procedures! * The Brookdale Internal Travel Health and Wellness Director will provide subject matter expertise to our senior living communities. ... is identified, then supports newly assigned Health and Wellness Director . Travels within the division as assigned to support.... Travels within the division as assigned to support management vacancy, start up, vacations, etc. + Responsible for… more
- Prime Therapeutics (Raleigh, NC)
- …) experience + Experience conducting complex analysis on large sets of pharmacy, claims , medical , and/or financial data + Basic to intermediate SAS coding ... adjust focus **Reporting Structure** + Reports to Manager or Director in the Network Management , Consulting Analytics...to Manager or Director in the Network Management , Consulting Analytics or Operations & Planning department Potential… more