• Medical Director - Medicaid…

    Humana (Raleigh, NC)
    **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...of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical … more
    Humana (10/28/25)
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  • Medical Director - Medicaid…

    Humana (Raleigh, NC)
    …to adapt and the courage to innovate **Additional Information** Reports to the Lead Medical Director - North Central Medicaid Markets. The Medical ... caring community and help us put health first** The Medical Director relies on medical ...Medical Directors will learn North Central region state Medicaid requirements (currently VA, KY, OH, IN, WI) and… more
    Humana (10/25/25)
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  • Associate Director , Medicaid…

    Humana (Raleigh, NC)
    …party reporting including notification, collection, analyze, storage, and distribution. + Team representative and presenter for various Medicaid committee ... caring community and help us put health first** The Associate Director , Procurement generates and implements efficient sourcing and category management strategies.… more
    Humana (10/29/25)
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  • Medical Director - Mid West Region

    Humana (Raleigh, NC)
    **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... and will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all submitted medical … more
    Humana (09/16/25)
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  • Medical Director - OneHome

    Humana (Raleigh, NC)
    …home health, SNF, DME, dual Medicare/ Medicaid and Waiver requests. The Medical Director provides medical interpretation and determinations whether ... caring community and help us put health first** The Medical Director relies on fundamentals of CMS...consistency in outcomes, consumer experiences, and a highly engaged team culture + Knowledge and experience with national guidelines… more
    Humana (10/30/25)
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  • OneHome - Medical Director - Part…

    Humana (Raleigh, NC)
    …home health, SNF, DME, dual Medicare/ Medicaid and Waiver requests. The Medical Director provides medical interpretation and determinations whether ... caring community and help us put health first** The Medical Director relies on fundamentals of CMS...consistency in outcomes, consumer experiences, and a highly engaged team culture** + **Knowledge and experience with national guidelines… more
    Humana (10/17/25)
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  • Field Medical Director…

    Evolent (Raleigh, NC)
    …meaningful impact on patient care in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and ... on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization… more
    Evolent (10/29/25)
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  • Field Medical Director , Cardiology

    Evolent (Raleigh, NC)
    …for the mission. Stay for the 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 meaningful way to...per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to… more
    Evolent (10/01/25)
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  • Field Medical Director , Oncology

    Evolent (Raleigh, NC)
    …for the mission. Stay for the culture. **What You'll Be Doing:** As a Field Medical Director , Oncology, you will be a key member of the utilization management ... team . We can offer you a meaningful way to...timely and accurate manner. . May assist the Senior Medical Director in research activities/questions related to… more
    Evolent (08/19/25)
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  • Medical Director , North Carolina

    Centene Corporation (Raleigh, NC)
    …of performance improvement initiatives for network providers. + May assist Chief Medical Director in planning and establishing goals and policies to ... 28 million members as a clinical professional on our Medical Management/Health Services team . Centene is a...healthcare coverage, providing access to affordable, high-quality services to Medicaid and Medicare members, as well as to individuals… more
    Centene Corporation (10/15/25)
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