- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- About The Role The Director , Utilization Management (UM) will manage the Utilization Management team consisting of Clinicians and Non-Clinical ... onboardings with time sensitive requirements. + Support and grow the utilization management team through strong professional relationships, mentorship, modelling… more
- Elevance Health (Winston Salem, NC)
- ** Utilization Management Medical Director - NC Medicaid** Location: This role enables associates to work virtually full-time, with the exception of required ... North Carolina. Alternate locations may be considered. The **Medical Director ** will be responsible for utilization review...The **Medical Director ** will be responsible for utilization review case management for North Carolina… more
- Humana (Raleigh, NC)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....with prior experience participating in teams focusing on quality management , utilization management , case … more
- Humana (Raleigh, NC)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....with prior experience participating in teams focusing on quality management , utilization management , case … more
- Elevance Health (Durham, NC)
- …clinical responsibilities means that the medical director is directly involved in Utilization Management and Case Management . + Daily case reviews for ... ** is responsible for serving as the Operational Medical Director for our care management models for...director provides clinical expertise in all aspects of utilization review and case management . Provides input… more
- Evolent (Raleigh, NC)
- …Clinical Reviewer, Interventional Pain Management , you will be a key member of the utilization management team. We can offer you a meaningful way to make a ... + On a requested basis, may function as Medical Director for selecting health plans or regions, assuming overall...selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with… more
- Evolent (Raleigh, NC)
- …impact on patient care in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your ... Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. +… more
- Elevance Health (Durham, NC)
- **Medical Director -Pain Management /Anesthesia Appeals** **Location:** This role enables associates to work virtually full-time, with the exception of required ... accommodation is granted as required by law. The **Medical Director Pain Management /Anesthesia Appeals** is responsible for...state or territory of the United States when conducting utilization review or an appeals consideration and cannot be… more
- Evolent (Raleigh, NC)
- …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + ... **What You'll Be Doing:** As a Vascular Surgery, Field Medical Director you will be a key member of the utilization management team. We can offer you a… more
- Evolent (Raleigh, NC)
- …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + ... culture. **What You'll Be Doing:** As a Cardiology, Field Medical Director you will be a key member of the utilization management team. We can offer you a… more