• Medical Director - Pharmacy…

    Humana (Annapolis, MD)
    …clinical expertise to review Medicare drug appeals (Part D & B). The Medical director work assignments involve moderately complex to complex issues where the ... requires a case by case consideration of the Medicare rules, Humana policies and medical necessity. The Medical Director will collaborate with clinicians and… more
    Humana (12/03/25)
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  • Medical Director - Medicaid N.…

    Humana (Annapolis, MD)
    **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 ... Medical Director work assignments involve moderately complex to complex issues...overview of coding practices and clinical documentation, grievance and appeals processes (including pharmacy ), and reviews for… more
    Humana (10/25/25)
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  • Medical Director (Hybrid)

    CareFirst (Baltimore, MD)
    **Resp & Qualifications** **PURPOSE:** The Medical Director oversees all activities of utilization review, care management and quality to determine the ... medical effectiveness of proposed treatments and approve care management...reviews, concurrent reviews of inpatient and post-acute care, and appeals . Serves as key resource for network physicians for… more
    CareFirst (11/20/25)
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