• Medical Director - Medicaid N.…

    Humana (Providence, RI)
    **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...data requires an in-depth evaluation of variable factors. The Medical Director actively uses their medical… more
    Humana (05/14/25)
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  • Medical Director - Florida

    Humana (Providence, RI)
    **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...data requires an in-depth evaluation of variable factors. The Medical Director actively uses their medical… more
    Humana (06/05/25)
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  • Medical Director - Care Plus…

    Humana (Providence, RI)
    **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...data requires an in-depth evaluation of variable factors. The Medical Director actively uses their medical… more
    Humana (04/24/25)
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  • Medical Director - OneHome

    Humana (Providence, RI)
    **Become a part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and ... home health, DME, skilled nursing facility and waiver requests. The Medical Director provides medical interpretation and determinations whether services… more
    Humana (05/31/25)
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  • Medical Director -Payment Integrity

    Humana (Providence, RI)
    **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to complex clinical… more
    Humana (06/06/25)
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  • Medical Director , MSK Surgery

    Evolent (Providence, RI)
    …business. Join Evolent for the mission. Stay for the culture. **What You'll Be Doing:** The Medical Director for MSK Surgery is a key member of the Medical ... development of questions. + Reviews statistical sample of cases for Field Medical Director audits and makes recommendations into the types of cases to review.… more
    Evolent (05/20/25)
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  • Medical Director , Global…

    Otsuka America Pharmaceutical Inc. (Providence, RI)
    …medicines for those with CNS disorders, we are seeking a skilled and experienced Medical Director of CNS Early Assets, Global Medical Affairs, responsible ... Sr. Director , Franchise Lead CNS Early Assets. **Position Summary:** The Medical Director , Global Medical Affairs, CNS Early Assets will be responsible… more
    Otsuka America Pharmaceutical Inc. (04/17/25)
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  • Medical Director - Medicare…

    Humana (Providence, RI)
    …a part of our caring community and help us 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 ranging from moderate to substantial. The Corporate … more
    Humana (04/24/25)
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  • Field Medical Director , Cardiology

    Evolent (Providence, RI)
    …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. ... on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization… more
    Evolent (05/16/25)
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  • Field Medical Director…

    Evolent (Providence, RI)
    …in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional ... on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization… more
    Evolent (04/30/25)
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