• Medical Director - Claims

    Humana (St. Paul, MN)
    …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 (10/16/25)
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  • Director II, Digital Claims

    Elevance Health (Mendota Heights, MN)
    ** Director II, Digital Claims Operations (Dir II Digital Ops)** Location: This role requires associates to be in-office **3 days per week** , fostering ... considered if candidate resides within a commutable distance from an office._ The ** Director II, Digital Claims Operations** oversees a combined digital and… more
    Elevance Health (10/10/25)
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  • Clinical Nurse, Case and Disease Management

    Blue KC (Workman, MN)
    …in FACETS UM system in accord with UM concurrent review guidelines. Consults with Medical Director on cases outside medical policy, notifies providers and ... accord with medical policy. Opens case and follows NCQA case management standards. Documents transplant authorization, issues authorization letters, and follows… more
    Blue KC (09/17/25)
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  • Medical Director - Florida

    Humana (St. Paul, MN)
    …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... 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 (10/03/25)
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  • Medical Director , Global…

    Otsuka America Pharmaceutical Inc. (St. Paul, MN)
    …medicines for those with CNS disorders, we are seeking a skilled and experienced Medical Director of CNS Early Assets, Global Medical Affairs, responsible ... , Franchise Lead CNS Early Assets. **Position Summary:** The Medical Director , Global Medical Affairs,...for any assigned assets in development. + Support lifecycle management initiatives and planning for assigned assets as applicable.… more
    Otsuka America Pharmaceutical Inc. (10/14/25)
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  • Corporate Medical Director

    Humana (St. Paul, MN)
    …put health first** The Corporate Medical Director (CMD) relies on medical background to review health claims and preservice appeals. The Corporate ... Medical Director works on problems of diverse scope and complexity...focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience + Working with… more
    Humana (09/05/25)
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  • Lead Medical Director

    Blue KC (Workman, MN)
    …financial assistance** **Employee discount program** **Job Description Summary:** The Lead Medical Director actively uses their clinical training, experience, ... level of care, and/or requested site of service should be authorized. The Medical Director will apply various clinical policies, state and federal guidance,… more
    Blue KC (08/26/25)
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  • Medical Director - Medicare…

    Humana (St. Paul, MN)
    …us put health first** The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The Corporate ... Medical Director works on problems of diverse scope and complexity...focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience, + working with… more
    Humana (10/02/25)
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  • Senior Director , Global Clinical…

    Otsuka America Pharmaceutical Inc. (St. Paul, MN)
    …medicine and/or clinical pharmacology and associated disciplines (eg biostatistics, data management , medical writing). + An advanced understanding of clinical ... in support of domestic and international clinical development initiatives. The Senior Director , GCD works in a multidisciplinary matrix environment and supports the… more
    Otsuka America Pharmaceutical Inc. (10/14/25)
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  • Associate Director , Established Brands…

    Otsuka America Pharmaceutical Inc. (St. Paul, MN)
    **_Associate Director , Established Brands Marketing_** **Position Summary** The Associate Director , Established Brands Marketing is responsible for driving ... CNS portfolio. The individual will work closely with market access, sales, medical affairs, and finance to implement commercial strategies that sustain product… more
    Otsuka America Pharmaceutical Inc. (08/15/25)
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