- Merck & Co. (Durham, NC)
- …complying with current Good Manufacturing Practices in the form of project management and ultimately shop floor leadership.-Key Responsibilities for a Drug Substance ... environment, and safety, not in that orderTactical and strategic Shift(s) management , including collaboration with indirect staffPromote the behaviors and principles… more
- Elevance Health (Durham, NC)
- ** Utilization Management Medical Director - NC Medicaid** Location: This role enables associates to work virtually full-time, with the exception of ... Alternate locations may be considered. The ** Medical Director ** will be responsible for utilization review case management for North Carolina Medicaid.… more
- CenterWell (Raleigh, NC)
- …**Additional Information** Will report to the Director of Physician Strategy at Utilization Management . The Medical Director conducts Utilization ... **Become a part of our caring community and help us put health first** The Medical Director , Primary Care relies on medical background and reviews health… more
- CVS Health (Raleigh, NC)
- …urgent cases can be done from your laptop. **Fundamental Components:** * Utilization management - The medical director will perform concurrent and prior ... services to its membership. Aetna is looking for a medical director to be part of a...state licensure a plus. **Preferred Qualifications:** Previous Experience in Utilization Management / Claims Determination with another… more
- Evolent (Raleigh, NC)
- …setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional cardiology ... per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management … more
- Humana (Raleigh, NC)
- … Director , depending on the line of business. The Medical Director conducts Utilization Management or clinical validation of the care received ... caring community and help us put health first** The Medical Director actively uses their medical...healthcare providers, clinical group practice management . + Utilization management experience in a medical… more
- Humana (Raleigh, NC)
- … Medical Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of the care received by members in the ... caring community and help us put health first** The Medical Director relies on medical ...healthcare providers, clinical group practice management . + Utilization management experience in a medical… more
- 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 in an ... caring community and help us put health first** The Medical Director relies on medical ...healthcare providers, clinical group practice management . + Utilization management experience in a medical… more
- 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 in an ... caring community and help us put health first** The Medical Director actively uses their medical...Integrated Delivery Systems, health insurance, other healthcare providers. + Utilization management experience in a medical… more
- UNC Health Care (Morrisville, NC)
- …and well-being of the unique communities we serve. **Summary** : The **Executive System Director of Utilization Management (UM)** is a strategic and ... Executive Director works closely with leaders from various departments-case management , physician advisors, revenue cycle, medical staff, nursing, and… more
- Elevance Health (Durham, NC)
- …responsibilities means that the medical director is directly involved in Utilization Management and Case Management . + Daily case reviews for both ... Director ** is responsible for serving as the Operational Medical Director for our care management...director provides clinical expertise in all aspects of utilization review and case management . Provides input… more
- Evolent (Raleigh, NC)
- …for utilization management while working in conjunction with the Senior Medical Director . May assist the Senior Medical Director in ... , you will be a key member of the utilization management team. We can offer you...process. + On a requested basis, may function as Medical Director for selecting health plans or… more
- Evolent (Raleigh, NC)
- …per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management ... you will be a key member of the utilization management team. We can offer you...management while working in conjunction with the Senior Medical Director . **Qualifications - Required and Preferred:**… more
- Evolent (Raleigh, NC)
- …per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management ... you will be a key member of the utilization management team. We can offer you...management while working in conjunction with the Senior Medical Director . **Qualifications - Required and Preferred:**… more
- Humana (Raleigh, NC)
- …relationships, value-based care, quality metrics, population health, and disease or care management . The Behavioral Health Medical Director may develop ... and help us put health first** The Behavioral Health Medical Director is responsible for behavioral health...healthcare providers, clinical group practice management + Utilization management experience in a medical… more
- Centene Corporation (Raleigh, NC)
- …the business unit. + Provides medical insights and/or interpretation for utilization management , cost containment, and medical quality improvement ... improvement initiatives for network providers. + May assist Chief Medical Director in planning and establishing goals... Medical Doctor or Doctor of Osteopathy. + Utilization Management experience and knowledge of quality… more
- Evolent (Raleigh, NC)
- …in a timely and accurate manner. . May assist the Senior Medical Director in research activities/questions related to the Utilization Management process, ... the culture. **What You'll Be Doing:** As a Field Medical Director , Oncology, you will be a...Oncology, you will be a key member of the utilization management team. We can offer you… more
- Humana (Raleigh, NC)
- …hospitals/ Integrated Delivery Systems, health insurance, or other healthcare providers. + Utilization management experience in a medical management ... caring community and help us put health first The Medical Director actively uses their medical...adaptability and willingness to learn evolving workflows, tools, and utilization management practices + **Willingness to work… more
- Highmark Health (Raleigh, NC)
- …:** **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and ... and DOL regulations at all times. In addition to utilization review, the incumbent participates as the physician member...DOL regulations, etc.). Ensure that all aspects of the medical management process are consistent with community… more
- Evolent (Raleigh, NC)
- …in a timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management process, ... Radiology you will be a key member of the utilization management team. We can offer you...Imaging cases, that do not initially meet the applicable medical necessity guidelines, as well as other imaging requests… more
