- UNC Health Care (Chapel Hill, NC)
- …Team + Participate in practice provider recruitment & interviews + Attend Medical Director meetings + Review /approve provider PTO requests + Assistance ... **Description** UNC Health and UNCPN are currently seeking an Urgent Care Medical Director to lead 4 high performing Urgent Care clinics located in Chapel Hill,… more
- Humana (Raleigh, NC)
- …help us put health first** The Corporate Medical Director (CMD) relies on medical background to review health claims and preservice appeals. The Corporate ... diverse scope and complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions regarding the… more
- CVS Health (Raleigh, NC)
- …reviews to ensure compliance with coding practices through a comprehensive record review for medical , behavioral, transportation and other healthcare providers. ... the ability to determine correct coding and appropriate documentation during the review of medical records. The CPC must also ensure that the state, federal and… more
- UNC Health Care (Goldsboro, NC)
- …coordinates the implementation of system initiatives into Wayne UNC Health Care. 3. Assists Medical Staff in the review of the clinical practices at the hospital ... **Description** Summary: The Vice President, Medical Affairs and Chief Medical Officer...to drive inter-professional patient care. Participates in the establishment, review and revisions of policies, procedures and standards of… more
- LifePoint Health (Rutherfordton, NC)
- …mentors all staff in UR standards and LOS topics. Insures effective Utilization Review Process.1. Performs admission and concurrent medical record review .2. ... services in a caring, professional environment through the teamwork of our medical staff and employees. Rutherford Regional Health System's partnership with Duke… more
- Otsuka America Pharmaceutical Inc. (Raleigh, NC)
- …teams including providing oversight of integrated brand strategy and plans + Represents Global Medical Affairs on Copy Review governance committee + Is a core ... **Position Summary** : Reporting to the Vice President, Global Medical Affairs, the Executive Director, CNS Strategy, Global Medical Affairs is a leadership… more
- CVS Health (Raleigh, NC)
- … of fraud, waste, and abuse for individual Aetna member cases. **Expectations/Responsibilities:** + Review and prepare cases for medical necessity review of ... disorders. + Make recommendation for enhancements to current managed care, review guidelines, and clinical criteria based on extensive knowledge of health… more
- HCA Healthcare (Asheville, NC)
- …we encourage you to apply for our Registered Nurse - FT - Nights - Medical Surgical opening. We review all applications. Qualified candidates will be contacted ... home.** **About Our A7 West Med Surg Unit:** **A7 West is an 18-bed Medical -Surgical unit. We provide care to a diverse mix of patients, including post-surgical,… more
- Highmark Health (Raleigh, NC)
- …action to prevent further improper payments.Forwards case to the Credentialing and/or Medical Review Committee, law enforcement and regulatory agencies. + ... internal and external law enforcement and regulatory agencies, Credentialing or Medical Review Committee. + Engages in delivery of audit results and overpayment… more
- United Therapeutics (Raleigh, NC)
- …development + Knowledge of data entry processing, from start to finish (QC, medical review , regulatory submissions) + Prior clinical or post marketing experience ... process improvements, and strengthens overall ICSR quality including retrospective review and ensuring proactive corrective/preventive actions are implemented to… more