• Medical Director - Claims

    Humana (Raleigh, NC)
    …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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  • PCO Medical Director - UM - Part…

    CenterWell (Raleigh, NC)
    …us put health first** The Medical Director , Primary Care relies on medical background and reviews health claims . The Medical Director , Primary ... The Medical Director relies on medical background and reviews health claims . The...the Director of Physician Strategy at Utilization Management . The Medical Director conducts… more
    CenterWell (11/06/25)
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  • Medical Director - Medicaid N.…

    Humana (Raleigh, NC)
    …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Lead Medical Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of the care received by members in the… more
    Humana (10/25/25)
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  • Medical Director - Nat'l UM IP (4x10…

    Humana (Raleigh, NC)
    …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 (11/07/25)
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  • Director , Strategic Planning & Operations…

    Otsuka America Pharmaceutical Inc. (Raleigh, NC)
    …the asset lifecycle. This role reports directly into the Executive Director , Medical Excellence and Operations. **Job Description** **Key Responsibilities ... The Director , Strategic Planning & Operations is a pivotal...multi-year strategic roadmaps tailored to each therapeutic area **Budget Management ** + Oversee budgets for global medical more
    Otsuka America Pharmaceutical Inc. (11/14/25)
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  • Medical Director Aetna Duals Center…

    CVS Health (Raleigh, NC)
    …cover urgent cases can be done from your laptop. **Fundamental Components:** * Utilization management - The medical director will perform concurrent and ... services to its membership. Aetna is looking for a medical director to be part of a...licensure a plus. **Preferred Qualifications:** Previous Experience in Utilization Management / Claims Determination with another Health… more
    CVS Health (11/13/25)
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  • Division Director Risk Management

    HCA Healthcare (Asheville, NC)
    …Come build your career with us! **Job Summary and Qualifications** The Risk Management Director has broad responsibility for the protection of the institution ... and its staff from fortuitous loss. The Risk Management Director advises and consults with senior...A broad-based working knowledge of healthcare delivery systems, risk management , claims administration and clinical knowledge, strong… more
    HCA Healthcare (11/14/25)
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  • GYN Oncology, Regional Medical Scientific…

    Merck (Raleigh, NC)
    **Job Description** The Oncology Regional Medical Scientific Director , Oncology is a credentialed (ie, MD, PhD, PharmD, or DNP) therapeutic and disease expert ... about any drug, vaccine or biologic product. The Oncology Regional Medical Scientific Director provide to Scientific Leaders balanced, factual, scientific… more
    Merck (11/07/25)
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  • Senior Director , Medical Mature…

    Otsuka America Pharmaceutical Inc. (Raleigh, NC)
    **Job Summary** The Senior Director , Mature Assets Lead within the CNS medical business unit (BU) is a critical role responsible for shaping the strategic ... to balance competing priorities. This position reports directly to the Executive Director , CNS Medical BU Lead. **Job Description** **Key Responsibilities… more
    Otsuka America Pharmaceutical Inc. (11/14/25)
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  • Associate Director , Congress…

    Otsuka America Pharmaceutical Inc. (Raleigh, NC)
    The Associate Director , Congress and Medical Education Strategy & Execution is responsible for executing and contributing to the global medical strategy and ... through deep scientific understanding and collaborative partnerships. The Associate Director partners closely with global and regional cross-functional stakeholders… more
    Otsuka America Pharmaceutical Inc. (11/14/25)
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