• Medical Director , Medical

    Highmark Health (Honolulu, HI)
    …URAC, CMS, DOH, and DOL regulations, etc.). Ensure that all aspects of the medical management process are consistent with community standards of care. + ... care (hospital, outpatient, or private practice) **Preferred** + 1 year in Medical Management in a Health Insurance Plan; strong knowledge of managed care… more
    Highmark Health (10/28/25)
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  • Medical Director - OneHome

    Humana (Honolulu, HI)
    …reports to the Lead Medical Director . **Other duties:** + Identify medical management operational improvements, including those within the medical ... part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home… more
    Humana (10/30/25)
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  • OneHome - Medical Director - Part…

    Humana (Honolulu, HI)
    …reports to the Lead Medical Director .** **Other duties:** + Identify medical management operational improvements, including those within the medical ... part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home… more
    Humana (10/17/25)
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  • Medical Director - Claims…

    Humana (Honolulu, HI)
    …a Lead Medical Director , depending on the line of business. The Medical Director conducts Utilization Management or clinical validation of the care ... **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement… more
    Humana (11/01/25)
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  • Field Medical Director , Pain…

    Evolent (Honolulu, HI)
    …accountability for utilization management while working in conjunction with the Senior Medical Director . May assist the Senior Medical Director ... Be Doing:** As a Physician Clinical Reviewer, Interventional Pain Management , you will be a key member of the...process. + On a requested basis, may function as Medical Director for selecting health plans or… more
    Evolent (09/25/25)
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  • Medical Director - Medicaid N.…

    Humana (Honolulu, HI)
    …to the Lead Medical Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of the care received by members ... **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
    Humana (10/25/25)
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  • Medical Director - Medicaid Team…

    Humana (Honolulu, HI)
    Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members ... **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
    Humana (10/28/25)
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  • Medical Director - Mid West Region

    Humana (Honolulu, HI)
    medical management operational improvements, including those within the medical director area + Participate in call rotation + Develop collaborative ... Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an… more
    Humana (09/16/25)
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  • Global Medical Excellence Director

    Merck (Honolulu, HI)
    …high-priority objectives. Internal strategic excellence: In coordination with those in Executive Director Medical Affairs (EDMA), Global Director Medical ... **Job Description** **Role Summary** The Global Medical Excellence Director (GMED) reports to the Sr. Director , Global Medical Excellence, and is an… more
    Merck (11/01/25)
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  • Precision Medicine - Medical Affairs…

    Merck (Honolulu, HI)
    …partnership with Precision Medicine Health Systems Oncology Medical Affairs Director (PM HSO-MADs), oncology account management , and precision medicine teams ... This role also serves as a resource for the Medical Affairs (MA) management team on strategic...resource for the PM MAD-HSO Team Lead, HSO Executive Director Medical Affairs, and other members of… more
    Merck (10/25/25)
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