• Medical Director , Medical…

    Highmark Health (Atlanta, GA)
    …Inc. **Job Description :** **JOB SUMMARY** This role supports the Medical Policy team by bringing medical director level expertise, experience and ... **ESSENTIAL RESPONSIBILITIES** + Full-cycle ownership of commercial and Medicare Advantage medical policy creation process including writing clinical criteria… more
    Highmark Health (12/24/25)
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  • Cardiology Medical Director

    Elevance Health (Atlanta, GA)
    …decisions. + Brings to their supervisors attention, any case review decisions that require Medical Director review or policy interpretation. + Determine ... **Clinical Operations Medical Director ** **Carelon MBM** **Virtual:** This...which may include AIM Appropriateness Guidelines, client-specific health plan medical policy , well established evidenced based guidelines,… more
    Elevance Health (12/17/25)
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  • Medical Director - OneHome

    Humana (Atlanta, GA)
    **Become a part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and ... health, SNF, DME, dual Medicare/Medicaid and Waiver requests. The Medical Director provides medical interpretation...communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee… more
    Humana (12/18/25)
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  • Medical Director - Medicaid (remote)

    Humana (Atlanta, GA)
    **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...communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee… more
    Humana (12/07/25)
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  • OneHome - Medical Director - Part…

    Humana (Atlanta, GA)
    **Become a part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and ... health, SNF, DME, dual Medicare/Medicaid and Waiver requests. The Medical Director provides medical interpretation...communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee… more
    Humana (11/27/25)
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  • Medical Director - IP Claims…

    Humana (Atlanta, GA)
    **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of...communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee… more
    Humana (12/11/25)
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  • Medical Director -Payment Integrity

    Humana (Atlanta, GA)
    **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of...communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee… more
    Humana (12/11/25)
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  • Medical Director - Nat'l IP UM Team

    Humana (Atlanta, GA)
    …Become a part of our caring community and help us put health first The Medical Director actively uses their medical background, experience, and judgement to ... to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all...communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee… more
    Humana (11/15/25)
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  • Medical Director - Pharmacy Appeals

    Humana (Atlanta, GA)
    **Become 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...value based care in accordance with Medicare and Humana policy . All work occurs within a context of regulatory… more
    Humana (12/03/25)
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  • Director , Medical & Clinical…

    State of Georgia (Fulton County, GA)
    Director , Medical & Clinical Services Georgia - Fulton - Atlanta (https://ga.referrals.selectminds.com/jobs/73688/other-jobs-matching/location-only) Healthcare ... Job Responsibilities Under broad supervision, serves as the senior manager director within Division of Medical /Clinical Services. Directs or manages… more
    State of Georgia (10/30/25)
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