- Humana (Raleigh, NC)
- …put health first** The Medical Director relies on broad clinical expertise to review Medicare drug appeals (Part D & B). The Medical director work ... rules, Humana policies and medical necessity. The Medical Director's work includes computer based review ...The Medical Director's work includes computer based review of moderately complex to complex appeals for coverage… more
- Humana (Raleigh, NC)
- …will understand how to operationalize this knowledge in their daily work. The Medical Director's work includes computer-based review of moderately complex to ... clinical group practice management. + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed… more
- Evolent (Raleigh, NC)
- …when available, within the regulatory timeframe of the request. + Utilizes medical /clinical review guidelines and parameters to assure consistency in the ... culture. **What You'll Be Doing:** As a Cardiology, Field Medical Director you will be a key member of...MD review process to reflect appropriate utilization and compliance with… more
- Evolent (Raleigh, NC)
- …when available, within the regulatory timeframe of the request. + Utilizes medical /clinical review guidelines and parameters to assure consistency in the ... setting? Join our Utilization Management team as a Field Medical Director, Cardiovascular Specialist and use your expertise in...MD review process to reflect appropriate utilization and compliance with… more
- Evolent (Raleigh, NC)
- …+ Provides clinical rationale for standard and expedited appeals. + Utilizes medical /clinical review guidelines and parameters to assure consistency in the ... **What You'll Be Doing:** As a Vascular Surgery, Field Medical Director you will be a key member of...MD review process to reflect appropriate utilization and compliance with… more
- Evolent (Raleigh, NC)
- …and provides clinical rationale for standard and expedited appeals. + Utilizes medical /clinical review guidelines and parameters to assure consistency in the ... Doing: + Serve as the Physician match reviewer in Medical Oncology and imaging cases, that do not initially...MD review process to reflect appropriate utilization and compliance with… more
- Evolent (Raleigh, NC)
- …and provides clinical rationale for standard and expedited appeals. . Utilizes medical /clinical review guidelines and parameters to assure consistency in the ... the culture. **What You'll Be Doing:** As a Field Medical Director, Oncology, you will be a key member...MD review process to reflect appropriate utilization and compliance with… more
- Evolent (Raleigh, NC)
- …when available, within the regulatory timeframe of the request. + Utilizes medical /clinical review guidelines and parameters to assure consistency in the ... reviewing cases that do not initially meet the applicable medical necessity guidelines, as well as other imaging requests...MD review process to reflect appropriate utilization and compliance with… more
- Cardinal Health (Raleigh, NC)
- … Medical Drug Information, including any MSL presentations and Medical /Safety Review Committees + Provides pharmacovigilance support through collaboration ... they can focus on their patients. **What a Senior Medical Science Liaison contributes to Cardinal Health** : The...other status protected by federal, state or local law._ _To read and review this privacy notice click_ here… more
- Humana (Raleigh, NC)
- …clinical group practice management. + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed ... **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 … more