- 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...of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical … 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 ... improvement, and clinical excellence. + **This position is 100% Remote and can be completed from any state. Multiple...per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to… 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 ... will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to… 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 ... will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to… more
- Humana (Raleigh, NC)
- …home health, SNF, DME, dual Medicare/ Medicaid and Waiver requests. The Medical Director provides medical interpretation and determinations whether ... activities as assigned by the managing Medical Director ** Travel: While this is a remote ...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at… 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 ... to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all...of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical … 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... management review organization such as Medicare Advantage, managed Medicaid , or Commercial health insurance + Current and ongoing… more
- Centene Corporation (Raleigh, NC)
- …benefits including a fresh perspective on workplace flexibility. **We're Hiring: Full time Medical Director in North Carolina.** Centene Corporation is a leading ... for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering… more
- CenterWell (Raleigh, NC)
- …a part of our caring community and help us put health first** A ** Director of Authorizations & Eligibility** is a senior revenue cycle leader responsible for the ... payer approvals to protect revenue integrity and patient access. The Director partners closely with clinical leadership, operations, finance, compliance, and IT,… more
- Humana (Raleigh, NC)
- …our caring community and help us put health first** The Associate Director , Technology Solution Implementation delivers new technological solutions to meet business ... a specified scope while aligned to enterprise objectives. The Associate Director , Technology Solution Implementation requires a solid understanding of how… more
- Humana (Raleigh, NC)
- …part of our caring community and help us put health first** The Director , Product Management Conceives of, develops, delivers, and manages products for customer use. ... The Director , Product Management requires an in-depth understanding of how...**Additional Information** **Humana Perks:** Full time associates enjoy: + Medical , Dental, Vision and a variety of other supplemental… more
- Humana (Raleigh, NC)
- …part of our caring community and help us put health first** The Director , Product Management for CenterWell Pharmacy Digital leads the strategic vision, development, ... business objectives, including accelerating growth in payor agnostic markets. Additionally, the Director will lead a team of Product Owners (POs) and Product… more
- Humana (Raleigh, NC)
- …part of our caring community and help us put health first** The Director , Business Systems Analysis leads the strategic advancement, optimization, and integration of ... initiatives that enhance provider experiences and streamline workflows. The Director requires deep expertise in business systems analysis, systems lifecycle… more
- Humana (Raleigh, NC)
- …of our caring community and help us put health first** The Associate Director of Cloud Infrastructure Operations is responsible for leading Humana's enterprise cloud ... at the intersection of operations, technology, and AI innovation. The Associate Director of Cloud Infrastructure Operations will drive the evolution of Humana's… more
- Humana (Raleigh, NC)
- …of our caring community and help us put health first** The Associate Director , IT PMO is accountable for the overall effectiveness, maturity, and delivery outcomes ... enable predictable, high‑quality execution of complex initiatives. The Associate Director partners closely with Portfolio Management, Finance, Cybersecurity, and… more
- Humana (Raleigh, NC)
- …a part of our caring community and help us put health first** The Director of Finance Portfolio Management, Strategy, & Special Projects is a key leadership role ... focused on continuously improving consumer experiences Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may… more
- Humana (Raleigh, NC)
- …part of our caring community and help us put health first** The Associate Director of IT Disaster Recovery will lead DR operations and governance for all application ... PHI / HIPAA information Travel: While this is a remote position, occasional travel to Humana's offices for training...extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan,… more
- Guidehouse (Raleigh, NC)
- … medical billing and auditing experience + Associate's degree\#IndeedSponsored\#LI- Remote #LI-DNI The annual salary range for this position is ... None **Clearance Required** **:** None This position is fully remote **What You Will Do** **:** + Under the...Will Do** **:** + Under the direction of the Director of Revenue Integrity, the Revenue Integrity Coding Billing… more
- Danaher Corporation (Raleigh, NC)
- …which makes everything possible. The Senior Field Reimbursement Manager (US REMOTE ) position is a provider / customer facing role responsible for ... to customer inquiries. This position reports to the Senior Director Market Access Americas and is part of the...Value and Access team. This position will be a remote position ideally located in the South East part… more
- Humana (Raleigh, NC)
- …first** The Clinical Pharmacist Lead monitors drug development pipeline, and medical literature, while providing clinical support for internal stakeholders. Utilizes ... diverse scope and complexity ranging from moderate to substantial. The Pharmacy Director , internally known as a Clinical Pharmacy Lead, plans, directs, and monitors… more