• Director of Provider Services

    Humana (Raleigh, NC)
    …a part of our caring community and help us put health first** The North Carolina Medicaid Provider Services Director leads a team that is accountable ... and state reports are completed timely and accurately. The Provider Services Director requires an...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and… more
    Humana (07/10/25)
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  • Medical Director - South Central

    Humana (Raleigh, NC)
    …outpatient services and equipment, within their scope. The Medical Director may speak with contracted external physicians, physician groups, facilities, or ... Bold Goal mission, throughout all activities. **Responsibilities** The Medical Director provides medical interpretation and determinations whether services more
    Humana (07/11/25)
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  • Medical Director - Mid West Region

    Humana (Raleigh, NC)
    …outpatient services and equipment, within their scope. The Medical Director may speak with contracted external physicians, physician groups, facilities, or ... Bold Goal mission, throughout all activities. **Responsibilities** The Medical Director provides medical interpretation and determinations whether services more
    Humana (05/14/25)
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  • Medical Director - Medicare Grievances…

    Humana (Raleigh, NC)
    …are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. ​ ... and help us put health first** The Corporate Medical Director (CMD) relies on medical background to review health...sex, sexual orientation, gender identity or religion. We also provide free language interpreter services . See our… more
    Humana (04/24/25)
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  • Medical Director , MSK Surgery

    Evolent (Raleigh, NC)
    …by the Office of Inspector General of the Department of Health and Human Services or the General Service Administration (GSA), or reprimanded or sanctioned by ... for the culture. **What You'll Be Doing:** The Medical Director for MSK Surgery is a key member of...the Medical leadership team, providing timely medical review of service requests. Oversees the Surgery Field Medical Directors and… more
    Evolent (05/20/25)
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  • Medicare Grievances and Appeals Corporate Medical…

    Humana (Raleigh, NC)
    …are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. ​ ... and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims...sex, sexual orientation, gender identity or religion. We also provide free language interpreter services . See our… more
    Humana (06/18/25)
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  • Hospice Medical Director

    Gentiva (Raleigh, NC)
    **Overview** The **Medical Director ** will report directly to the National Medical Director and supervise, evaluate, and be responsible for the standards and ... overall quality of the hospice care services rendered to patients by physicians through the employing...rendered to patients by physicians through the employing hospice provider . + Oversee and assist with ensuring implementation of… more
    Gentiva (04/22/25)
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  • Director of Operations (BCBA) - ABA Therapy…

    Highlights Healthcare (Raleigh, NC)
    …skills, growth mentality, and strong business acumen to join us as BCBA - Director of Operations for our second learning center in Raleigh, NC. Why should you ... consider a Director of Operations (BCBA) position with Highlights? + Competitive...an employee assistance program + 401K plan + ACE provider - company provides 16 BACB CEU hours per… more
    Highlights Healthcare (05/22/25)
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  • Field Medical Director , Interventional…

    Evolent (Raleigh, NC)
    …by the Office of Inspector General of the Department of Health and Human Services or the General Service Administration (GSA), or reprimanded or sanctioned by ... setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional cardiology to… more
    Evolent (04/30/25)
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  • Senior Director Clinical Account Management…

    Prime Therapeutics (Raleigh, NC)
    …empowered, and rewarded for their achievements. We value new ideas and work collaboratively to provide the highest quality of care and service to our members. If ... our passion and drives every decision we make. **Job Posting Title** Senior Director Clinical Account Management - Remote **Job Description** The Sr Director more
    Prime Therapeutics (07/09/25)
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  • Field Medical Director , Cardiology

    Evolent (Raleigh, NC)
    …by the Office of Inspector General of the Department of Health and Human Services or the General Service Administration (GSA), or reprimanded or sanctioned by ... **What You'll Be Doing:** As a Cardiology, Field Medical Director you will be a key member of the...of all communications with medical office staff and/or MD provider is recorded in a timely and accurate manner.… more
    Evolent (07/02/25)
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  • Field Medical Director , MSK Surgery

    Evolent (Raleigh, NC)
    …by the Office of Inspector General of the Department of Health and Human Services or the General Service Administration (GSA), or reprimanded or sanctioned by ... culture. **What You'll Be Doing:** As a Field Medical Director , MSK Surgery you will be a key member...of all communications with medical office staff and/or MD provider is recorded in a timely and accurate manner.… more
    Evolent (07/04/25)
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  • Field Medical Director , Oncology

    Evolent (Raleigh, NC)
    …by the Office of Inspector General of the Department of Health and Human Services or the General Service Administration (GSA), or reprimanded or sanctioned by ... culture. **What You'll Be Doing:** As a Field Medical Director , Oncology, you will be a key member of...of all communications with medical office staff and/or MD provider is recorded in a timely and accurate manner.… more
    Evolent (05/20/25)
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  • Medical Director - Commercial Appeals

    CVS Health (Raleigh, NC)
    …Internal Medicine or Internal Medicine/Pediatrics (Med/Peds) Board Certification. In the Medical Director role, you will provide oversight for medical policy ... Hearings / Special Projects and Committee participation when needed. The Medical Director will provide clinical, coding, and reimbursement expertise as well… more
    CVS Health (07/04/25)
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  • IPA Coding Associate Director

    CenterWell (Raleigh, NC)
    …are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal ... age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services . See our full accessibility rights… more
    CenterWell (04/24/25)
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  • Associate Director , Identity and Access…

    Humana (Raleigh, NC)
    …are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. ​ ... sex, sexual orientation, gender identity or religion. We also provide free language interpreter services . See our… more
    Humana (07/08/25)
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  • Manager Rebate Pharmacy Operations

    Prime Therapeutics (Raleigh, NC)
    …empowered, and rewarded for their achievements. We value new ideas and work collaboratively to provide the highest quality of care and service to our members. If ... teamwork across all internal departments, as well as with Medicaid Clients, and an in-depth understanding of all rebate...auditors for yearly SOC-1 audit. + Works directly with Director to fulfill OIG and CMS audit requests. +… more
    Prime Therapeutics (05/07/25)
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  • Insurance Strategy Lead

    Humana (Raleigh, NC)
    …are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. ​ ... sex, sexual orientation, gender identity or religion. We also provide free language interpreter services . See our… more
    Humana (06/28/25)
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  • Sr Compliance RCM & Coding Auditor

    Humana (Raleigh, NC)
    …are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. ​ ... sex, sexual orientation, gender identity or religion. We also provide free language interpreter services . See our… more
    Humana (07/10/25)
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