• Medical Director - Medicaid N.…

    Humana (Springfield, IL)
    **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 (05/14/25)
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  • Medical Director - Pacific SW Region

    Humana (Springfield, IL)
    **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 (05/10/25)
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  • Medical Director - Care Plus…

    Humana (Springfield, IL)
    **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 (04/24/25)
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  • Medical Director ( Medical

    CVS Health (Springfield, IL)
    …**Position Summary** CVS Health, a Fortune 6 company, has an outstanding opportunity for a Medical Director ( Medical Affairs). This is a remote based, work ... clinical product development, Enterprise Analytics, Compliance, Legal, Accreditation) and clients. The Medical Director ( Medical Affairs) will report into… more
    CVS Health (04/20/25)
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  • Medical Director , MSK Surgery

    Evolent (Springfield, IL)
    …business. Join Evolent for the mission. Stay for the culture. **What You'll Be Doing:** The Medical Director for MSK Surgery is a key member of the Medical ... development of questions. + Reviews statistical sample of cases for Field Medical Director audits and makes recommendations into the types of cases to review.… more
    Evolent (05/20/25)
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  • Medical Director ( Medical

    CVS Health (Springfield, IL)
    …day. **Position Summary** Aetna, a CVS Health company has an outstanding opportunity for a Medical Director . Ready to take your career to the next level with a ... and can be located anywhere in the United States. In this role as Medical Director MPO ( Medical Policy & Operations) you will be responsible for providing… more
    CVS Health (05/20/25)
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  • Medical Director , Global…

    Otsuka America Pharmaceutical Inc. (Springfield, IL)
    …medicines for those with CNS disorders, we are seeking a skilled and experienced Medical Director of CNS Early Assets, Global Medical Affairs, responsible ... Sr. Director , Franchise Lead CNS Early Assets. **Position Summary:** The Medical Director , Global Medical Affairs, CNS Early Assets will be responsible… more
    Otsuka America Pharmaceutical Inc. (04/17/25)
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  • Medical Director - Behavioral Health…

    CVS Health (Springfield, IL)
    …be based anywhere in the United States.** ** The Behavioral Health (BH) Medical Director (Special Investigations Unit) will be responsible for performing reviews ... as required, and as approved by Legal. The expectation is that the BH Medical Director will have a high level of knowledge when providing testimony during civil… more
    CVS Health (05/21/25)
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  • Medical Director - Commercial…

    CVS Health (Springfield, IL)
    …have Internal Medicine or Internal Medicine/Pediatrics (Med/Peds) Board Certification. In the Medical Director role, you will provide oversight for medical ... staff ensuring timely and consistent responses to members and providers. As a Medical Director you will focus primarily on review appeal cases for denied … more
    CVS Health (05/16/25)
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  • Corporate Medical Director

    Humana (Springfield, IL)
    …a part of our caring community and help us put health first** The Corporate Medical Director (CMD) relies on medical background to review health claims ... and preservice appeals. The Corporate Medical Director works on problems of diverse scope and complexity ranging from moderate to substantial. The Corporate … more
    Humana (04/24/25)
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  • Field Medical Director , Cardiology

    Evolent (Springfield, IL)
    …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 (05/16/25)
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  • Field Medical Director

    Evolent (Springfield, IL)
    …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 (04/30/25)
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  • Field Medical Director , MSK (Spine)…

    Evolent (Springfield, IL)
    …for the mission. Stay for the culture. **What You'll Be Doing:** As a Field Medical Director , MSK Surgery you will be a specialty match reviewer for Spine ... on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization… more
    Evolent (05/21/25)
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  • Medical Director - Illinois

    Centene Corporation (Springfield, IL)
    …including a fresh perspective on workplace flexibility. **Position Purpose:** Assist the Chief Medical Director to direct and coordinate the medical ... of performance improvement initiatives for capitated providers. + Assists Chief Medical Director in planning and establishing goals and policies to improve… more
    Centene Corporation (03/29/25)
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  • Medical Director - Medicare…

    Humana (Springfield, IL)
    …a part of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims and ... preservice appeals. The Corporate Medical Director works on problems of diverse scope and complexity ranging from moderate to substantial. The Corporate … more
    Humana (05/14/25)
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  • Medical Director - Medicaid (IL)

    CVS Health (Springfield, IL)
    …do it all with heart, each and every day. **Position Summary:** Ready to take your Medical Director skills to the next level with a Fortune 6 company? Checkout ... the Aetna Better Health Plan of Illinois. This UM (Utilization Management) Medical Director will be a "Work from Home" position primarily supporting the Aetna… more
    CVS Health (05/07/25)
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  • Associate Medical Director

    Sumitomo Pharma (Springfield, IL)
    …seeking a dynamic, highly motivated, and experienced individual for the position of **Associate Medical Director .** The Associate Medical Director will ... for SMPA investigational and commercial products. The incumbent will provide medical safety support for safety signal management throughout product lifecycle… more
    Sumitomo Pharma (05/16/25)
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  • Field Medical Director , Oncology

    Evolent (Springfield, IL)
    …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
    Evolent (05/20/25)
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  • Field Medical Director , Radiology…

    Evolent (Springfield, IL)
    …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** As a Field Medical Director you will be a key member of the utilization management team. ... a timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management process,… more
    Evolent (03/21/25)
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  • Associate Medical Director

    Evolent (Springfield, IL)
    …Stay for the culture. **What You'll Be Doing:** Evolent is seeking an **Associate Medical Director - Cardiovascular Medicine** to play a critical role in ... in Cardiology** (with Cardiology training and clinical experience). + **Unrestricted medical license** in the state of residence and willingness to obtain… more
    Evolent (03/04/25)
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