- Humana (Atlanta, GA)
- …a Lead Medical Director , depending on the line of business. The Medical Director conducts Utilization Management or clinical validation of the care ... **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
- CenterWell (Atlanta, GA)
- …us put health first** The Medical Director , Primary Care relies on medical background and reviews health claims . The Medical Director , Primary ... The Medical Director relies on medical background and reviews health claims . The...the Director of Physician Strategy at Utilization Management . The Medical Director conducts… more
- Humana (Atlanta, GA)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Lead Medical Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of the care received by members in the… more
- Humana (Atlanta, GA)
- …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
- ABM Industries (Atlanta, GA)
- …Design and implement best practices, policies, and procedures to ensure efficient claims management and regulatory compliance. + Continuously assess the ... **Overview** The Director of Workers' Compensation Claims is...evaluate performance of external partners, including TPAs, legal firms, medical management vendors, and investigative services. +… more
- Elevance Health (Atlanta, GA)
- ** Director II, Digital Claims Operations (Dir II Digital Ops)** Location: This role requires associates to be in-office **3 days per week** , fostering ... considered if candidate resides within a commutable distance from an office._ The ** Director II, Digital Claims Operations** oversees a combined digital and… more
- BrandSafway (Atlanta, GA)
- …collaboration with the Senior Counsel for Insured Litigation and the Senior Director - Global Risk Management perform comprehensive internal claim/reserve ... direction of the Senior Counsel - Insured Litigation and Claims will (1) manage assist with managing "Insured Litigation...parties like actuaries, brokers and insurance carriers. Support Senior Director - Global Risk Management as needed… more
- Waystar (Atlanta, GA)
- **ABOUT THIS POSITION** This role reports to a Director , Product Management and work closely with User Experience team and Technology teams. The Sr. Product ... and product quality + Assisting your VP of Product Management in coordinating with sales, marketing, development, and customer...+ bonus, if applicable) + Customizable benefits package (3 medical plans with Health Saving Account company match) +… more
- Otsuka America Pharmaceutical Inc. (Atlanta, GA)
- …the asset lifecycle. This role reports directly into the Executive Director , Medical Excellence and Operations. **Job Description** **Key Responsibilities ... The Director , Strategic Planning & Operations is a pivotal...multi-year strategic roadmaps tailored to each therapeutic area **Budget Management ** + Oversee budgets for global medical … more
- CVS Health (Atlanta, GA)
- …cover urgent cases can be done from your laptop. **Fundamental Components:** * Utilization management - The medical director will perform concurrent and ... services to its membership. Aetna is looking for a medical director to be part of a...licensure a plus. **Preferred Qualifications:** Previous Experience in Utilization Management / Claims Determination with another Health… more
- Merck (Atlanta, GA)
- **Job Description** The Oncology Regional Medical Scientific Director , Oncology is a credentialed (ie, MD, PhD, PharmD, or DNP) therapeutic and disease expert ... about any drug, vaccine or biologic product. The Oncology Regional Medical Scientific Director provide to Scientific Leaders balanced, factual, scientific… more
- Otsuka America Pharmaceutical Inc. (Atlanta, GA)
- **Job Summary** The Senior Director , Mature Assets Lead within the CNS medical business unit (BU) is a critical role responsible for shaping the strategic ... to balance competing priorities. This position reports directly to the Executive Director , CNS Medical BU Lead. **Job Description** **Key Responsibilities… more
- Otsuka America Pharmaceutical Inc. (Atlanta, GA)
- The Director , Congress and Medical Education Strategy & Execution is responsible for developing and leading the global medical strategy and tactical ... outcomes through deep scientific understanding and collaborative partnerships. The Director partners closely with global and regional cross-functional stakeholders -… more
- Otsuka America Pharmaceutical Inc. (Atlanta, GA)
- The Senior Director , Medical Affairs Solutions & Analytics provides oversight and spearheads Global Medical Affairs (GMA) business enablement and analytic ... efficient Medical Affairs operations as needed, including Medical customer relationship management , insights management...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Molina Healthcare (Atlanta, GA)
- …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... claims and appeals and resolves grievances related to medical quality of care. + Attends or chairs committees...experience, including: + 2 years previous experience as a Medical Director in a clinical practice. +… more
- Humana (Atlanta, GA)
- …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...focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience, + working with… more
- Celestica (Atlanta, GA)
- Req ID: 129127 Remote Position: Hybrid Region: Americas Country: USA **Summary** The Director , Strategic Supply Chain Management is a global supply chain focal ... provides guidance to ensure capacity is installed as needed. + Supports E&O claims , shortage management and follow up escalations with customers for resolutions.… more
- Otsuka America Pharmaceutical Inc. (Atlanta, GA)
- …consistency, and compliance. This position reports directly to the Senior Director , CNS Medical Communications Lead. **Job Description** **Key Responsibilities ... plan for the relevant therapeutic area portfolio, in partnership with the Senior Director , Medical Communications Lead, CNS Lead, and cross-functional teams (eg,… more
- Sumitomo Pharma (Atlanta, GA)
- …a dynamic, highly motivated, and experienced individual for the position of **Associate Director , Commercial Data Management ** . This high impact role requires a ... technically skilled person to support our growing Commercial Data Management (CDM) function, serving as a key liaison between...(Salesforce, Veeva), syndicated data (IQVIA & Symphony sales and claims data, MMIT) The base salary range for this… more
- Otsuka America Pharmaceutical Inc. (Atlanta, GA)
- The Associate Director , Strategic Planning & Operations will support the assets of varying lifecycle stages in the relevant therapeutic area portfolio. This role is ... in driving operational excellence and innovation within our Global Medical Affairs organization, with a specific focus on the...are in place. This position reports directly into the Director , Strategic Planning Lead, who in turn reports into… more