• Sr Analyst, Performance Suite Analytics

    Evolent (Raleigh, NC)
    …experience in claims-based healthcare analytics with a payer, provider, clinical vendor, managed care , or related healthcare consulting entity + Ability to ... people with most complex and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented health care … more
    Evolent (09/22/25)
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  • Regional SOC Outreach Coordinator-DSS Region 2

    Elevance Health (NC)
    …Specialty Plan (CFSP) is designed to be a single, statewide NC Medicaid Managed Care plan that will support Medicaid-enrolled children, youth, and families ... so that they receive seamless, integrated, and coordinated health care . Within the Children and Families Specialty Plan (CFSP),...is designed to advance our strategy but will also lead to personal and professional growth for our associates.… more
    Elevance Health (09/26/25)
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  • Value-Based Reimbursement Specialist

    Highmark Health (Raleigh, NC)
    …value streams, and population health management. **Preferred** + 7 years of experience in managed care , primary care management or other clinical setting. + ... for the Organization's value-based reimbursement programs and continuous improvement models. Lead or support key strategic initiatives across Enterprise and Markets… more
    Highmark Health (08/20/25)
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  • Sr Director Clinical Strategy and Oncology…

    Prime Therapeutics (Raleigh, NC)
    …work experience within medical and pharmacy drug management within a PBM or managed care organization, or oncology management experience if supporting oncology ... business initiatives and the delivery of innovative solutions. **Responsibilities** + Lead the vision, strategy, and implementation of integrating medical and… more
    Prime Therapeutics (10/02/25)
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  • Vice President, Cardiology

    Evolent (Raleigh, NC)
    …regulatoryexpertisein Medicare, Medicaid, and Commercial + Experience in health plan operations and/or managed care highly desirable + 7+ years managing teams to ... and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented...we seek to connect the pieces of fragmented health care system and ensure people get the same level… more
    Evolent (10/07/25)
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  • Vice President, Growth, Product Marketing…

    Evolent (Raleigh, NC)
    …discussions . Experience building and developing team members . Knowledge of the managed care and oncology market trends (both payers and risk-bearing ... and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented...& Enablement to join the growth team as a leader . Role Overview: The VP, Product Marketing & Enablement… more
    Evolent (09/18/25)
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  • Clinical Solutions VP - Remote

    Prime Therapeutics (Raleigh, NC)
    …12 years of work experience in medical and pharmacy drug management within a PBM or managed care organization + Must be eligible to work in the United States ... business initiatives and the delivery of innovative solutions. **Responsibilities** + Lead the development and assessment of innovative clinical solutions and the… more
    Prime Therapeutics (09/10/25)
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  • Medical Director - Medical Policy

    Elevance Health (Winston Salem, NC)
    …is filing a role required by a State agency. **Preferred Qualifications:** + Extensive managed care or Medicare knowledge. + MPH or MS in Epidemiology preferred, ... and implements clinical and non-clinical activities that impact health care quality cost and outcomes. + Supports the Medical...is designed to advance our strategy but will also lead to personal and professional growth for our associates.… more
    Elevance Health (10/04/25)
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  • Medicaid Data and Reporting Professional

    Humana (Raleigh, NC)
    …experience in Microsoft Excel including formulas, pivots, charts, and graphs + Experience in managed care or health care sector + Prior experience working ... Projects:** In addition to routine reporting, this role will lead larger scope projects related to clinical data needs...serve to achieve their best health - delivering the care and service they need, when they need it.… more
    Humana (10/07/25)
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  • Field Reimbursement Manager

    Amgen (Raleigh, NC)
    …in public or private third-party access arena or pharmaceutical industry in managed care , clinical support, and/or sales + Strong medical reimbursement ... across physician types + Strong collaboration and ability to lead cross functional partner meetings + Experience with commercial...us** As we work to develop treatments that take care of others, we also work to care… more
    Amgen (10/02/25)
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