- Humana (Raleigh, NC)
- …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 ... or data requires an in-depth evaluation of variable factors. The Medical Director actively uses their medical background, experience, and judgement to make… more
- Humana (Raleigh, NC)
- …experience with national guidelines such as NCD/LCD, MCG(R) or InterQual** **The Medical Director conducts clinical case reviews of requests received by members ... part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home… more
- Humana (Raleigh, NC)
- …experience with national guidelines such as NCD/LCD, MCG(R) or InterQual The Medical Director conducts clinical case reviews of requests received by members of ... part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home… more
- Humana (Raleigh, NC)
- …Lead Medical Director , depending on the line of business. The Medical Director conducts Utilization Management or clinical validation of the care received by ... of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations… more
- Evolent (Raleigh, NC)
- …Medical Director . **Qualifications** + MD/DO/MBBS Degree + Current, unrestricted clinical license in medicine or required specialty + Obtaining and maintaining ... make a meaningful impact on patient care in a non- clinical setting? Join our Utilization Management team as a...Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional… more
- HCA Healthcare (Asheville, NC)
- …This position is incentive eligible. **Introduction** We are seeking a Division Director of Risk Management with North Carolina Division Office to promote growth ... preferred banking partnerships + Education assistance (tuition, student loan, certification support, dependent scholarships) + Colleague recognition program + Time… more
- Elevance Health (NC)
- …staff including Medical Director Associates. May be responsible for an entire clinical program. **How will you make an impact:** + Supports clinicians to ensure ... an entire clinical program and/or independently performs clinical reviews. The Medical Director typically has...**Minimum Requirements:** + Requires MD or DO and Board certification approved by one of the following certifying boards… more
- North Carolina Agriculture & Technical State Unive (Greensboro, NC)
- Description: This position is a 0.33 FTE position at the rank of Clinical Associate Professor or above, and reports to the Program Director . The Medical ... of the PA both the didactic instruction and supervised clinical experiences to develop program competencies that meet current...as the ARC -PA Standards of accreditations. The Medical Director will also serve as an advocate for the… more
- Humana (Raleigh, NC)
- …of our caring community and help us put health first The Medical Director actively uses their medical background, experience, and judgement to make determinations ... and work is assisted by diverse resources, which may include national clinical guidelines, CMS policies and determinations, clinical reference materials,… more
- Elevance Health (Durham, NC)
- **Utilization Management Medical Director - NC Medicaid** Location: This role enables associates to work virtually full-time, with the exception of required in-person ... Carolina but not required. Alternate locations may be considered. The **Medical Director ** will be responsible for utilization review case management for North… more