• Medical Director - Commercial

    CVS Health (Atlanta, GA)
    …have Internal Medicine or Internal Medicine/Pediatrics (Med/Peds) Board Certification. In the Medical Director role, you will provide oversight for medical ... and consistent responses to members and providers. As a Medical Director you will focus primarily on...will focus primarily on review appeal cases for denied medical services. This includes First Level Appeals more
    CVS Health (03/20/25)
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  • Corporate Medical Director

    Humana (Atlanta, GA)
    … (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 Medical Director provides medical interpretation and decisions regarding the… more
    Humana (04/10/25)
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  • Corporate Medical Director

    Humana (Atlanta, GA)
    …a part of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims. The ... Corporate Medical Director works on problems of diverse scope and complexity...the managed care industry including Medicare, Medicaid and or Commercial products + Possess analysis and interpretation skills with… more
    Humana (04/16/25)
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  • Medical Director - National Medicare

    Humana (Atlanta, GA)
    **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...managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations,… more
    Humana (04/15/25)
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  • Medical Director - Medicaid N.…

    Humana (Atlanta, GA)
    **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...managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations,… more
    Humana (03/11/25)
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  • Medical Director - Florida

    Humana (Atlanta, GA)
    **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...managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations,… more
    Humana (03/22/25)
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  • Patient Access Liaison

    Grifols Shared Services North America, Inc (Marietta, GA)
    …criteria, including technology options for electronic submission of PA, Letter of Medical Necessity, appeals , step edits, formulary exception requests and ... including HCPs and their staff, Market Access, the US Pulmonary National Sales Director and Regional Sales Directors and SP/Hub partners in the field, supporting… more
    Grifols Shared Services North America, Inc (02/25/25)
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