• Merck & Co. (Durham, NC)
    Job DescriptionValue Chain Management (VCM) is accountable for our Company's Product Strategy in alignment with Manufacturing division and Human Health (HH) ... brand/franchise goals, integrated risk management , supply chain design, and continuous improvement of the...design, and continuous improvement of the product's supply chain.-The Director , Operations Research, Strategic Planning will lead a team… more
    HireLifeScience (06/05/25)
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  • Merck & Co. (Durham, NC)
    …Manager will play a critical role in supporting the Operations Management team, partnering with internal stakeholders, and building the operations team.Members ... complying with current Good Manufacturing Practices in the form of project management and ultimately shop floor leadership.- Key Responsibilities for a Drug Product… more
    HireLifeScience (06/04/25)
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  • National Utilization

    Humana (Raleigh, NC)
    **Become a part of our caring community and help us put health first** The Utilization Management (UM) Director , Clinical Strategy and Practice for Medicaid ... of how organization capabilities interrelate across the function or segment. The Utilization Management (UM) Director , Clinical Strategy and Practice… more
    Humana (06/06/25)
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  • AVP, Utilization Review & Pharmacy

    Zurich NA (Raleigh, NC)
    …+ Experience in development and implementation of cost containment programs + Case management , utilization review, catastrophic or disability experience + 5 or ... AVP, Utilization Review & Pharmacy 123092 Zurich Insurance is...recruiting and retaining team members. + Drive the performance management process by communicating job expectations, monitoring and evaluating… more
    Zurich NA (05/22/25)
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  • Divisional Director of Care…

    CenterWell (Raleigh, NC)
    …for managing populations and coordinating care to reduce acute and post-acute care utilization . The Divisional Director role is a hybrid with travel requirements ... solutions that will lead to acute and post-acute care utilization reductions aligned with the PCO's objectives and goals....impact** **Required Qualifications:** + **At least 5 years of Management experience required** ; _3-5 years of Director more
    CenterWell (05/23/25)
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  • Medical Director - Medicaid N. Central

    Humana (Raleigh, NC)
    …to the Lead Medical Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....with prior experience participating in teams focusing on quality management , utilization management , case … more
    Humana (05/14/25)
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  • Medical Director , MSK Surgery

    Evolent (Raleigh, NC)
    …classes as needed for new hires to educate and train on Utilization management system and Field Medical Director process, standards and resources. + Acts as ... for the culture. **What You'll Be Doing:** The Medical Director for MSK Surgery is a key member of...reviews appeal cases and/or attends hearings for discussion of utilization management decisions. + Strong partnership with… more
    Evolent (05/20/25)
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  • Field Medical Director , Interventional…

    Evolent (Raleigh, NC)
    …impact on patient care in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your ... Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. +… more
    Evolent (04/30/25)
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  • Medical Director - Care Plus - Florida

    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 ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....with prior experience participating in teams focusing on quality management , utilization management , case … more
    Humana (04/24/25)
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  • Medical Director - Florida

    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 ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....with prior experience participating in teams focusing on quality management , utilization management , case … more
    Humana (06/05/25)
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  • Medical Director - OneHome

    Humana (Raleigh, NC)
    …Medical Director , depending on size of team or line of business. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on...with prior experience participating in teams focusing on quality management , utilization management , case … more
    Humana (05/31/25)
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  • Field Medical Director , Vascular Surgery

    Evolent (Raleigh, NC)
    …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + ... you will be a key member of the utilization management team. We can offer you... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National more
    Evolent (06/06/25)
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  • Field Medical Director , Cardiology

    Evolent (Raleigh, NC)
    …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + ... you will be a key member of the utilization management team. We can offer you... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National more
    Evolent (05/16/25)
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  • Regional Field Director , RNS Program…

    United Therapeutics (Research Triangle Park, NC)
    …is innovative and inspiring where you can truly make a difference. The Regional Field Director , RNS Program Management serves as a director of all clinical ... the commercial non-promotional team. In addition, the Regional Field Director , RNS Program Management will: + Serve...initiation of a UT product, adverse effect mitigation, device utilization , and dosing upon request + Support the Clinical… more
    United Therapeutics (06/05/25)
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  • Capacity & Resource Management

    Grant Thornton (Raleigh, NC)
    …to share strategy, to implement process improvements and to roll out capacity management strategies to maximize utilization and drive operational excellence + ... Grant Thornton is seeking an Advisory Capacity & Resource Management (C&RM) Leader to join the team. Approved office...on yearly budget planning for headcount, gross charge hours, utilization , and leverage. You will lead your team to… more
    Grant Thornton (05/09/25)
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  • Medical Director -Payment Integrity

    Humana (Raleigh, NC)
    …interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , discharge ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a… more
    Humana (06/06/25)
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  • Cloud Economics - Program Director Business…

    IBM (Research Triangle Park, NC)
    …for areas such as effective network and asset utilization . * Technology utilization to optimize Cost Management - Saves Management Program. * ... and cost of Cloud Infrastructure services and products that incentivize effective utilization . * Partnering closely with Product Management , Engineering and… more
    IBM (04/29/25)
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  • Director Nursing - Blue Ridge Day Surgery…

    Surgery Care Affiliates (Raleigh, NC)
    …and the efficient flow of patients through the surgery center. In addition, the Director of Nursing will oversee management of clinical supplies and staff as ... He/she will also be a member of the Continuous Quality Improvement, Risk Management , Infection Control and Safety Committees. The Director of Nursing will… more
    Surgery Care Affiliates (05/15/25)
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  • Field Medical Director , Physical Medicine…

    Evolent (Raleigh, NC)
    …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + ... Rehab you will be a key member of the utilization management team. We can offer you... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National more
    Evolent (05/30/25)
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  • Field Medical Director , Oncology

    Evolent (Raleigh, NC)
    …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. . ... Oncology, you will be a key member of the utilization management team. We can offer you... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National more
    Evolent (05/20/25)
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