• Medical Director - NorthEast Region

    Humana (Raleigh, NC)
    **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The ... situations or data requires an in-depth evaluation of variable factors. The Medical Director provides medical interpretation and decisions about the… more
    Humana (07/25/25)
    - Related Jobs

  • Inpatient Medical Coder - FT - Up to $5,000…

    Datavant (Raleigh, NC)
    Datavant is a data platform company and the world's leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the ... attention to detail and a depth of knowledge in medical terminology. This role is fully remote with a...reviewed by Datavant Human Resources and determined on a case -by- case basis. Depending on the state in… more
    Datavant (06/25/25)
    - Related Jobs

  • Associate Medical Director,…

    Sumitomo Pharma (Raleigh, NC)
    …FDA and/or EU ICH safety requirements** + Expertise in medical review of medical review of Individual case safety reports and aggregate safety reports + ... Sumitomo Pharma Co., Ltd. is a global pharmaceutical company based in Japan with key operations in...motivated, and experienced individual for the position of **Associate Medical Director.** The Associate Medical Director will… more
    Sumitomo Pharma (08/15/25)
    - Related Jobs

  • Medical Management Specialist I

    Elevance Health (Durham, NC)
    ** Medical Management Specialist I** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training ... **Location(s):** Durham, North Carolina and Winston Salem, North Carolina The ** Medical Management Specialist I** is responsible for providing non-clinical support… more
    Elevance Health (08/29/25)
    - Related Jobs

  • Utilization Management Medical Director- NC…

    Elevance Health (Winston Salem, NC)
    …The ** Medical Director** will be responsible for utilization review case management for North Carolina Medicaid. May be responsible for developing and ... external entities and/or serve on internal and/or external committees. + May chair company committees. + Interprets medical policies and clinical guidelines. +… more
    Elevance Health (08/29/25)
    - Related Jobs

  • Medical Director -Pharmacy Appeals

    Humana (Raleigh, NC)
    …a part of our caring community and help us put health first** The Medical Director relies on broad clinical expertise to review Medicare drug appeals (Part D ... & B). The Medical director work assignments involve moderately complex to complex...where the analysis of situations or data requires a case -by- case consideration of the Medicare rules, Humana… more
    Humana (08/22/25)
    - Related Jobs

  • Medical Director/Clinical Trial Physician…

    ThermoFisher Scientific (Wilmington, NC)
    …future. **Location/Division Specific Information** Join Thermo Fisher Scientific as a Medical Director/Clinical Trial Physician(FSP) based in the United States and ... 10-20% range(international maybe required). Our client, a global mid-sized biotech company , focuses on developing innovative treatments for patients with autoimmune… more
    ThermoFisher Scientific (08/13/25)
    - Related Jobs

  • Medical Director

    Grifols Shared Services North America, Inc (Research Triangle Park, NC)
    …want to enhance the lives of millions of people? Grifols is a global healthcare company that since 1909 has been working to improve the health and well-being of ... services in more than 110 countries and regions. **Position Overview:** The Medical Director will be responsible for clinical strategy relating to upcoming clinical… more
    Grifols Shared Services North America, Inc (08/23/25)
    - Related Jobs

  • Medical Director - Medicare Appeals

    CVS Health (Raleigh, NC)
    … Director will provide clinical, coding, and reimbursement expertise as well as directing case management when necessary. The Medical Director will act as a ... **Affordable medical plan options,** a **401(k) plan** (including matching company contributions), and an **employee stock purchase plan** . + **No-cost programs… more
    CVS Health (08/08/25)
    - Related Jobs

  • Sr VP Medical Director (Hourly)

    Sedgwick (Raleigh, NC)
    …to Work(R) Fortune Best Workplaces in Financial Services & Insurance Sr VP Medical Director (Hourly) The ideal candidate would work 8-20 hours per week. **PRIMARY ... PURPOSE** **:** To evaluate medical reports escalated due to deficient information utilizing evidence...+ Coordinating and evaluating the service delivery between the company , partners, and vendors. + Member of a client… more
    Sedgwick (08/22/25)
    - Related Jobs