• Utilization Management

    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 ... Alternate locations may be considered. The ** Medical Director ** will be responsible for utilization review case management for North Carolina Medicaid.… more
    Elevance Health (08/29/25)
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  • Field Medical Director

    Evolent (Raleigh, NC)
    …setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional cardiology ... per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management more
    Evolent (07/30/25)
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  • Medical Director - Southeast Region

    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 an ... caring community and help us put health first** The Medical Director relies on medical ...healthcare providers, clinical group practice management . + Utilization management experience in a medical more
    Humana (09/10/25)
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  • Medical Director - Northeast Region

    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 an ... caring community and help us put health first** The Medical Director relies on medical ...healthcare providers, clinical group practice management . + Utilization management experience in a medical more
    Humana (07/25/25)
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  • Field Medical Director , Pain…

    Evolent (Raleigh, NC)
    …for utilization management while working in conjunction with the Senior Medical Director . May assist the Senior Medical Director in ... , you will be a key member of the utilization management team. We can offer you...process. + On a requested basis, may function as Medical Director for selecting health plans or… more
    Evolent (08/20/25)
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  • National Accounts Medical Director

    Elevance Health (Durham, NC)
    …responsibilities means that the medical director is directly involved in Utilization Management and Case Management . + Daily case reviews for both ... Director ** is responsible for serving as the Operational Medical Director for our care management...director provides clinical expertise in all aspects of utilization review and case management . Provides input… more
    Elevance Health (08/27/25)
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  • Medical Director -Pain…

    Elevance Health (Durham, NC)
    ** Medical Director -Pain Management /Anesthesia Appeals** **Location:** This role enables associates to work virtually full-time, with the exception of ... an accommodation is granted as required by law. The ** Medical Director Pain Management /Anesthesia Appeals**...state or territory of the United States when conducting utilization review or an appeals consideration and cannot be… more
    Elevance Health (08/21/25)
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  • Field Medical Director , Cardiology

    Evolent (Raleigh, NC)
    …per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management ... you will be a key member of the utilization management team. We can offer you...management while working in conjunction with the Senior Medical Director . **Qualifications - Required and Preferred:**… more
    Evolent (08/15/25)
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  • Field Medical Director - Vascular…

    Evolent (Raleigh, NC)
    …per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management ... you will be a key member of the utilization management team. We can offer you...management while working in conjunction with the Senior Medical Director . **Qualifications - Required and Preferred:**… more
    Evolent (08/28/25)
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  • Behavioral Health Medical Director

    Humana (Raleigh, NC)
    …relationships, value-based care, quality metrics, population health, and disease or care management . The Behavioral Health Medical Director may develop ... and help us put health first** The Behavioral Health Medical Director is responsible for behavioral health...healthcare providers, clinical group practice management + Utilization management experience in a medical more
    Humana (08/09/25)
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