Search jobs > Winston-Salem, NC > Medical director clinical

Clinical Coverage Review Medical Director

VirtualVocations
Winston Salem, North Carolina, United States
Full-time

A company is looking for a Clinical Coverage Review Medical Director to support pharmacy operations and clinical review processes.

Key ResponsibilitiesReview and approve proposed pharmacist denials for outpatient medication requestsConduct coverage reviews and render determinations based on medical necessity and policy guidelinesCollaborate with clinical staff and providers to ensure accurate and timely benefit determinationsRequired QualificationsActive, unrestricted physician licenseCurrent board certification in an ABMS or AOA specialty5+ years of clinical practice experience post-residencyExperience with electronic clinical systemsAbility to participate in rotational call coverage

9 hours ago
Related jobs
Promoted
VirtualVocations
Winston-Salem, North Carolina

A company is looking for a Clinical Coverage Review Medical Director to support pharmacy operations and clinical review processes. ...

Genworth Financial
North Carolina
Remote

Claims Clinical Specialist – Medical Review Team. Bring your nursing knowledge and experience, and Genworth will provide the training necessary to succeed as a Medical Review Nurse. The Claims Clinical Specialist role is an excellent opportunity for a Registered Nurse seeking a career change. You wi...

Promoted
VirtualVocations
Winston-Salem, North Carolina

A company is looking for a Clinical Research Medical Director - Cardiology/Heart Failure, US - Remote. ...

Medical Facilities of America
King, North Carolina

We offer competitive salary and benefits, including 401(k), medical, dental, and vision health plans, short and long-term disability, payroll direct deposit, and paid vacation. Director of Admissions and Marketing will be responsible to maintain a desired census as established by the annual budget a...

Parexel
Remote, North Carolina, United States
Remote

The Senior Medical Director, Global Therapeutic Area Medical Head, Allergy provides medical and scientific leadership both internally and externally with clients in support of overall company objectives. The Senior Medical Director, Global Therapeutic Area Medical Head, Allergy is the functional lea...

CVS Health
North Carolina, Work At Home, US
Remote

In the Medical Director role you will provide oversight for medical policy implementation. The Medical Director will act as lead business and clinical liaison to network providers and facilities to support the effective execution of medical services programs by the clinical teams. You will participa...

Novant Health
Winston-Salem, North Carolina

Medical Director, LVAD Program-Winston Salem Market-Novant Health. The Novant Health network consists of more than 1,900 physicians and over 36,000 team members that provide care at more than 800 locations, including 16 medical centers and hundreds of outpatient facilities and physician clinics. The...

Thermo Fisher Scientific
North Carolina, United States of America
Remote

Provides medical consultation to team members and answer all study related medical questions. Discusses all medical concerns with principal investigators and clients (;discussion regarding interpretation of inclusion/exclusion criteria) raised during the course of a study, using proper medical judgm...

Promoted
DoorDash
Winston-Salem, North Carolina

Available in over 4,000 cities in the U.S, DoorDash connects local businesses and local drivers (called Dashers) with opportunities to earn, work, and live.All you need is a mode of transportation (bike, car, scooter) and a smartphone to start making money.You can even sign up and begin working that...

Promoted
DoorDash
Rural Hall, North Carolina

Available in over 4,000 cities in the U.S, DoorDash connects local businesses and local drivers (called Dashers) with opportunities to earn, work, and live.All you need is a mode of transportation (bike, car, scooter) and a smartphone to start making money.You can even sign up and begin working that...