Medical director jobs in Jackson, MS - 82 jobs

Supervises and coordinates patient care services of one or more nursing units on a 24-hour basis. The Dir, Nursing ensures that physicians' orders are followed; ensures that patient conditions and progress are accurately reported; ensures that patient care is administered by all professional and non-professional personnel in the unit according to organization and regulatory policies and guidelines; and has staffing and budget control responsibilities for the unit. Experience 2 years clinical experience as a Registered Nurse Education Bachelors of Science in Nursing Licensure BLS Certification; RN 1. Leadership a. Utilizes advanced clinical knowledge to develop and maintain a delivery system for individualized, appropriate, and compassionate patient care. Supports and encourages staff, patients, and significant others in the determination of treatment and rehabilitation goals for desired outcomes. Provides leadership and participates in emergency measures for sudden adverse patient developments. b. Provides leadership and demonstrates critical thinking ability in all areas of responsibility, treats all co-workers with respect, strives to enhance co-worker performance through cooperation and effective communication, and demonstrates hospitality and courtesy in all interactions. 2. Unit Management and Daily Operations a. Estimates future departmental personnel, equipment, and supply needs in order to ensure the attainment of operating goals. Develops, recommends, and implements the annual capital equipment, personnel, and operating budget for the department. Conducts periodic reviews of departmental performance, analyzes budget variances, and implements responsive action. b. Demonstrates clinical expertise in facilitating the timely availability, access, and utilization of multidisciplinary health care services, alternative levels of care, and community resources in a manner that ensures optimal continuity and expediency in the health care delivery process. c. Implements strategies that use current scientific knowledge to prevent and reduce the risk of infection transmission. Promptly and appropriately reports infections between and among staff, patients, and visitors in order to improve patient outcomes. d. Consults with nursing management, nursing staff, and Clinical Nurse Specialists in the development of instructional materials for patients and family members which will provide the specific knowledge and skill required to increase their understanding of the patient's illness, meet the patient's ongoing health care needs, and improve patient health outcomes. e. Develops and maintains documentation required for successful employee development and administrative and divisional communication. Supervises and participates in the efficient recording of pertinent patient care data utilizing the computerized medical record and manual documentation in order to promote timely and efficient access to required information throughout the organization. Preserves the confidentiality of data and information identified as sensitive in order to ensure the protection of patient dignity and privacy. f. Monitors and coordinates the effective use, maintenance, and repair of equipment, supplies, facilities, and resources that support patient care in order to maintain a functional and safe environment for patients, staff, and visitors. g. Maintains own clinical expertise and ensures the demonstrated clinical competency of staff members to deliver patient care services in accordance with the specific identified needs of adult and geriatric patients. Utilizes appropriate resources as needed for assistance in the planning and delivery of care to infant, pediatric, and adolescent patients. 3. Performance Improvement and Quality a. Provides ongoing assessments of the patient care delivery system in order to identify existing and potential health care needs within the scope of care for the unit. Evaluates and makes recommendations for current and potential unit staffing needs, assesses and introduces technological and procedural changes that enhance the efficiency and quality of patient care services and outcomes, and supervises the ongoing assessment of patients for physical, psychological, and social status needs and discharge planning. b. Coordinates and manages high quality health care services that recognize individual patient rights while acting as a role model for the nursing personnel. Educates staff and monitors care delivery in order to ensure that patients exercise their rights to be informed and to participate and make decisions in all aspects of their medical care. Ensures that patient care demonstrates respect for personal values and beliefs and is focused on the unique needs of each individual and their family. c. Utilizes continued analysis and evaluation of patient care outcomes to enhance the quality and efficiency of services and optimize the utilization of hospital resources. Participates actively in unit-specific and multidisciplinary continuous quality improvement and quality assurance studies in a manner that promotes compliance with hospital and divisional regulations and standards. d. Ensures that all staff members are oriented and continuously educated regarding their roles in sustaining and improving the overall environment. Assesses the learning and development needs of staff members and is responsible for the provision of appropriate educational services. e. Establishes departmental standards for the evaluation of personnel performance and monitors the performance of reporting personnel. Promotes and encourages the growth and development of staff members by encouraging their participation in approved continuing education activities such as professional conferences, seminars, and workshops. Advocates continuing education as a means of promoting the high quality services provided by all departmental personnel. f. Observes and adheres to all departmental and hospital policies and procedures, and follows all safety, quality assurance, and infection control standards. 4. Other Duties As Assigned a. Performs other duties as assigned or requested.

This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and most current clinical standards. The incumbent reviews escalated cases electronically and using Medical Policy criteria sets to evaluate the medical necessity and appropriateness of the requested treatment of service. Depending on the nature of the case, telephonic peer to peer discussions may be required. The incumbent ensures compliance to NCQA, URAC, CMS, DOH, and DOL regulations at all times. In addition to utilization review, the incumbent participates as the physician member of the multidisciplinary team for case and disease management. They will advise the multidisciplinary team on cases, particularly high-risk cases, through the team structure. Additionally, the incumbent may be assigned special projects to help support and improve the care of our members **ESSENTIAL RESPONSIBILITIES** + Conduct electronic review of escalated cases against medical policy criteria, which may include telephonic peer to peer discussions, to determine medical necessity and appropriateness. Complete initial determination of cases, review of appeals and grievances, and other reviews as assigned. Compose clear and concise rationales for member and provider determination notifications all while adhering to required compliance standards (NCQA, URAC, CMS, DOH, and DOL regulations, etc.). Ensure that all aspects of the medical management process are consistent with community standards of care. + Participate as a member of the CMDM multidisciplinary team. Attend huddles and grand rounds. Advise multidisciplinary team on cases that require physician expertise. + Participate in protocol and guidelines development to ensure consistency in the review process. + Actively manage projects and/or participate on project teams that require a physician subject matter expert. + Other duties as assigned. **EDUCATION** **Required** + Medical Doctor (MD) or Doctor of Osteopathic Medicine (DO) **Substitutions** + None **Preferred** + Master's Degree in Business Administration/Management or Public Health **EXPERIENCE** **Required** + 5 years in Clinical, Direct Patient care (hospital, outpatient, or private practice) **Preferred** + 1 year in Medical Management in a Health Insurance Plan; strong knowledge of managed care industry **LICENSES AND CERTIFICATION** **Required** + Medical Doctor or Doctor of Osteopathic Medicine (DO) + Awarded Board Certification at least once in specialty recognized by the American Board of Medical Specialties or the American Osteopathic Association Specialty Certifying Boards + Active medical state licensure required. Additional specific state licensure(s) may be required based on business need. **Preferred** + None **SKILLS** + Critical Thinking + Case Management + Customer Service + Oral & Written Communication Skills + Collaboration + Listening + Telephone Skills + General Computer Skills + Clinical Software + Managed Care **Language (Other than English)** None **Travel Required** 0% - 25% **PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS** Position Type Office-Based Teaches / trains others regularly Occasionally Travel regularly from the office to various work sites or from site-to-site Rarely Works primarily out-of-the office selling products/services (sales employees) Never Physical work site required No Lifting: up to 10 pounds Constantly Lifting: 10 to 25 pounds Rarely Lifting: 25 to 50 pounds Rarely **_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._ **_Compliance Requirement_** _: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies._ _As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy._ _Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements._ **Pay Range Minimum:** $170,000.00 **Pay Range Maximum:** $352,500.00 _Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets._ Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at ***************************** California Consumer Privacy Act Employees, Contractors, and Applicants Notice Req ID: J267780

During the last five years, Parexel has participated in more than 1,000 Oncology and Hematology clinical projects. The range of services includes compound clinical development planning, collaboration with feasibility, protocol writing or optimization, medical monitoring and pharmacovigilance. Parexel has global presence in every phase of clinical research and expertise in virtually every indication and mechanism of action, including novel Immuno-oncology agents, cellular based therapy, and cancer stem cell targeted treatment. Join our growing team of Oncologists/Hematologists and make a difference in the lives of patients searching for more effective and better tolerated cancer therapies. **Parexel's continued success has positioned us for significant North American growth in the coming year. As we prepare for this expansion, we're seeking to connect with Board-Certified Oncologists who are passionate about advancing clinical research and interested in learning more about the Medical Director role.** As a **Medical Director** at Parexel, you will provide medical monitoring for assigned projects, function as medical representative on the project team, provide medical consultation as required or requested to client/sponsor or to other Parexel service groups, and assume the role of Senior Technical Lead in selected circumstances. **In addition, you will also:** + Review all individual adverse experience reports for accuracy and clinical importance, and characterize their relationship to the study drug, severity and seriousness. + Provide reports to FDA or other regulatory agencies and the sponsor on a periodic and regular basis, summarizing adverse experiences as required by FDA or the sponsor, depending on the contract. + Review data listings of safety data, including adverse experiences, laboratory data, and vital signs data, to establish the presence or absence of abnormal trends, and if noted, follow up as appropriate with the project team, sponsor, investigator, and FDA. + Review documents written by various Parexel divisions for safety issues. + Review coding of adverse events and concomitant medications for accuracy and consistency. + Provide support for the preparation of clinical protocols, integrated clinical and statistical summary reports, journal articles, and other documents for clients/sponsors or in conjunction with clients/sponsors and in conjunction with other Parexel divisions. + Attend and present material, as requested, at meetings within Parexel as well as extra-company external meetings and conferences Successful applicants will be medically qualified based on successful completion of training at an accredited medical school and be US or Canada Board-certified in Oncology with experience in adult or pediatric clinical patient care. Past experience as a Medical Monitor, Physician in Industry, or as a Clinical Trial Primary Investigator or Sub-Investigator is highly preferred. **Successful applicants will also have:** + Excellent interpersonal skills including the ability to interact well with sponsor/client counterparts. + Excellent time management skills + Excellent verbal and written medical communication skills + Excellent standard of written and spoken English + A flexible attitude with respect to work assignments and new learning + The ability to manage multiple and varied tasks with enthusiasm and prioritize workload with attention to detail. + A willingness to work in a matrix environment and to value the importance of teamwork. + The ability to travel 10% domestically and/or internationally as needed. \#LI-REMOTE EEO Disclaimer Parexel is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to legally protected status, which in the US includes race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.

Supervises and coordinates patient care services of one or more nursing units on a 24-hour basis. The Dir, Nursing ensures that physicians' orders are followed; ensures that patient conditions and progress are accurately reported; ensures that patient care is administered by all professional and non-professional personnel in the unit according to organization and regulatory policies and guidelines; and has staffing and budget control responsibilities for the unit. Responsibilities 1. Leadership a. Utilizes advanced clinical knowledge to develop and maintain a delivery system for individualized, appropriate, and compassionate patient care. Supports and encourages staff, patients, and significant others in the determination of treatment and rehabilitation goals for desired outcomes. Provides leadership and participates in emergency measures for sudden adverse patient developments. b. Provides leadership and demonstrates critical thinking ability in all areas of responsibility, treats all co-workers with respect, strives to enhance co-worker performance through cooperation and effective communication, and demonstrates hospitality and courtesy in all interactions. 2. Unit Management and Daily Operations a. Estimates future departmental personnel, equipment, and supply needs in order to ensure the attainment of operating goals. Develops, recommends, and implements the annual capital equipment, personnel, and operating budget for the department. Conducts periodic reviews of departmental performance, analyzes budget variances, and implements responsive action. b. Demonstrates clinical expertise in facilitating the timely availability, access, and utilization of multidisciplinary health care services, alternative levels of care, and community resources in a manner that ensures optimal continuity and expediency in the health care delivery process. c. Implements strategies that use current scientific knowledge to prevent and reduce the risk of infection transmission. Promptly and appropriately reports infections between and among staff, patients, and visitors in order to improve patient outcomes. d. Consults with nursing management, nursing staff, and Clinical Nurse Specialists in the development of instructional materials for patients and family members which will provide the specific knowledge and skill required to increase their understanding of the patient's illness, meet the patient's ongoing health care needs, and improve patient health outcomes. e. Develops and maintains documentation required for successful employee development and administrative and divisional communication. Supervises and participates in the efficient recording of pertinent patient care data utilizing the computerized medical record and manual documentation in order to promote timely and efficient access to required information throughout the organization. Preserves the confidentiality of data and information identified as sensitive in order to ensure the protection of patient dignity and privacy. f. Monitors and coordinates the effective use, maintenance, and repair of equipment, supplies, facilities, and resources that support patient care in order to maintain a functional and safe environment for patients, staff, and visitors. g. Maintains own clinical expertise and ensures the demonstrated clinical competency of staff members to deliver patient care services in accordance with the specific identified needs of adult and geriatric patients. Utilizes appropriate resources as needed for assistance in the planning and delivery of care to infant, pediatric, and adolescent patients. 3. Performance Improvement and Quality a. Provides ongoing assessments of the patient care delivery system in order to identify existing and potential health care needs within the scope of care for the unit. Evaluates and makes recommendations for current and potential unit staffing needs, assesses and introduces technological and procedural changes that enhance the efficiency and quality of patient care services and outcomes, and supervises the ongoing assessment of patients for physical, psychological, and social status needs and discharge planning. b. Coordinates and manages high quality health care services that recognize individual patient rights while acting as a role model for the nursing personnel. Educates staff and monitors care delivery in order to ensure that patients exercise their rights to be informed and to participate and make decisions in all aspects of their medical care. Ensures that patient care demonstrates respect for personal values and beliefs and is focused on the unique needs of each individual and their family. c. Utilizes continued analysis and evaluation of patient care outcomes to enhance the quality and efficiency of services and optimize the utilization of hospital resources. Participates actively in unit-specific and multidisciplinary continuous quality improvement and quality assurance studies in a manner that promotes compliance with hospital and divisional regulations and standards. d. Ensures that all staff members are oriented and continuously educated regarding their roles in sustaining and improving the overall environment. Assesses the learning and development needs of staff members and is responsible for the provision of appropriate educational services. e. Establishes departmental standards for the evaluation of personnel performance and monitors the performance of reporting personnel. Promotes and encourages the growth and development of staff members by encouraging their participation in approved continuing education activities such as professional conferences, seminars, and workshops. Advocates continuing education as a means of promoting the high quality services provided by all departmental personnel. f. Observes and adheres to all departmental and hospital policies and procedures, and follows all safety, quality assurance, and infection control standards. 4. Other Duties As Assigned a. Performs other duties as assigned or requested. Qualifications Experience 2 years clinical experience as a Registered Nurse Education Bachelors of Science in Nursing Licensure BLS Certification; RN

Sumitomo Pharma Co., Ltd., is a global pharmaceutical company based in Japan with operations in the U.S. (Sumitomo Pharma America, Inc.), focused on addressing patient needs in oncology, urology, women's health, rare diseases, cell & gene therapies and CNS. With several marketed products and a diverse pipeline of early- to late-stage investigational assets, we aim to accelerate discovery, research, and development to bring novel therapies to patients sooner. For more information on SMPA, visit our website ********************************** or follow us on LinkedIn. **Job Overview** We are currently seeking a dynamic, highly motivated, and experienced individual for the position of **Medical Director, Clinical Development - Oncology** . The medical director is responsible for the leadership, development, and management of clinical studies while building and maintaining relationships with investigators and key opinion leaders. **Job Duties and Responsibilities** + Lead and demonstrate ownership of the design and implementation of a clinical development program or programs in support of the overall product development plan, based on strong medical and scientific principles, knowledge of compliance and regulatory requirements, markets, business operations, and emerging issues. + Oversee project-related education of investigators, study site personnel, and study staff. + Responsible for leading clinical study teams, monitoring overall study integrity, and review, interpretation, and communication of safety and efficacy data. + Present at scientific, medical, and regulatory meetings globally. + Develop and maintain relationships with academic investigators, pharmaceutical partners/sponsors, KOL's, and patient advocacy groups. + Contribute to company's planned regulatory filings including authoring clinical sections for INDs, NDAs, and other related documents. + Partner with Drug Safety & Pharmacovigilance to assess the safety profile of compounds. + Maintain a high level of clinical and scientific expertise in the disease area(s) by reviewing the literature, attending medical/scientific meetings, and through personal interchanges with consultants, thought leaders, investigators, and internal stakeholders. + Author manuscripts and collaborate with cross-functional colleagues and thought leaders to meet publication plan objectives. + Maintain ethical standards of the highest level and have the knowledge and ability to comply with all relevant ethical, regulatory, and legal standards. + May participate in or lead clinical development contributions to due diligence or other business development activity. + As required by program needs, contribute in partnership with Discovery colleagues to the design and implementation of translational strategies. + Participate in meetings and committees of parent company or other affiliates. + Establish collaborative and productive relationships with the parent company, internal/external partners, and relevant affiliates. + Work in close collaboration with the late-stage development group. + Perform other duties as requested. **Key Core Competencies** + Ability to run a complex clinical research program with minimal direction + Extensive knowledge of clinical trial methodology, regulatory and compliance requirements governing clinical trials, and experience in development of clinical strategy and the design of study protocols + Proven leadership skills and ability to bring out the best in others on a cross-functional team; highly collaborative, team-oriented, and decisive + Able to lead through influence + Excellent communication and presentation skills are essential. + Identify the key competencies or attributes required to excel in the role. + Examples may include problem-solving, teamwork, communication, etc. + Highlight any specific qualities or traits that are important for success in the role. + These could include attention to detail, adaptability, creativity, etc. **Education and Experience** + Medical Doctor (MD), Doctor of Osteopathy (DO), or non-US equivalent of MD required + Completion of a residency program strongly preferred + Completion of a subspecialty fellowship is desirable + Experience in blood cancers or solid tumors desirable + At least 3 years of pharmaceutical drug development experience required. The base salary range for this role is $236,100 to $295,100. Base salary is part of our total rewards package which also includes the opportunity for merit-based salary increases, short incentive plan participation, eligibility for our 401(k) plan, medical, dental, vision, life and disability insurances and leaves provided in line with your work state. Our robust time-off policy includes flexible paid time off, 11 paid holidays plus additional time off for a shut-down period during the last week of December, 80 hours of paid sick time upon hire and each year thereafter. Total compensation, including base salary to be offered, will depend on elements unique to each candidate, including candidate experience, skills, education and other factors permitted by law. Disclaimer: The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. All personnel may be required to perform duties outside of their normal responsibilities from time to time, as needed. **Confidential Data** : All information (written, verbal, electronic, etc.) that an employee encounters is considered confidential. **Compliance** : Achieve and maintain Compliance with all applicable regulatory, legal and operational rules and procedures, by ensuring that all plans and activities for and on behalf of Sumitomo Pharma America (SMPA) and affiliates are carried out with the "best" industry practices and the highest ethical standards. It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability. **Mental/Physical Requirements** : Fast paced environment handling multiple demands. Must be able to exercise appropriate judgment as necessary. Requires a high level of initiative and independence. Excellent written and oral communication skills required. Requires ability to use a personal computer for extended periods of time. **Sumitomo Pharma America (SMPA)** **is an Equal Employment Opportunity (EEO) employer** Qualified applicants will receive consideration for employment without regard to race; color; creed; religion; national origin; age; ancestry; nationality; marital, domestic partnership or civil union status; sex, gender; affectional or sexual orientation; disability; veteran or military status or liability for military status; domestic violence victim status; atypical cellular or blood trait; genetic information (including the refusal to submit to genetic testing) or any other characteristic protected by law. Sumitomo Pharma Co., Ltd., is a global pharmaceutical company based in Japan with operations in the U.S. (Sumitomo Pharma America, Inc.), focused on addressing patient needs in oncology, urology, women's health, rare diseases, cell & gene therapies and CNS. With several marketed products and a diverse pipeline of early- to late-stage investigational assets, we aim to accelerate discovery, research, and development to bring novel therapies to patients sooner. For more information on SMPA, visit our website ********************************** or follow us on LinkedIn. Sumitomo Pharma America (SMPA) endeavors to make its application process accessible to all. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact SMPA at ********************************************** This contact information is for accommodation requests only and cannot be used to inquire about the status of applications. At Sumitomo Pharma America, our work is guided by the Sumitomo Pharma mission, vision and values, which tie closely to our company's cultural pillars. **Our** **Mission** _To broadly contribute to society through value creation based on innovative research and development activities for the betterment of healthcare and fuller lives of people_ _worldwide_ **Our** **Vision** _For Longer and Healthier Lives, we unlock the future with cutting edge technology and_ _ideas_

**Your Future Evolves Here** Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones. Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business. Join Evolent for the mission. Stay for the culture. **What You'll Be Doing:** **Lead the Transformation in Oncology Care** At Evolent, we're redefining how care is delivered for individuals facing cancer. As a Performance Suite Medical Director in Medical Oncology, you will play a pivotal role in advancing value-based care models that prioritize clinical excellence, patient-centered outcomes, and system-wide impact. This role offers the opportunity to collaborate with top-tier clinicians, influence care pathways, and drive innovation in one of the most critical areas of health care. If you're passionate about making a measurable difference in oncology, this is your platform to lead with purpose. In this role, you will combine your clinical oncology expertise with a focus on **value-based strategy and transformation** . Unlike traditional medical review roles that emphasize volume throughput, this position integrates utilization management with collaborative engagement and innovation. **Core Responsibilities** + **Clinical Review & Peer Collaboration** + Serve as the physician reviewer for oncology cases that do not initially meet medical necessity criteria, applying evidence-based guidelines to ensure high-quality and cost-effective care. + Conduct peer-to-peer discussions with requesting oncologists-not only to explain determinations but to **partner in driving practice patterns aligned with value and quality outcomes** . + Support clinical reviewers as a subject matter expert and resource. + **Practice & Physician Engagement** + Actively participate in **engagement sessions with oncology practices** , sharing best clinical practices and supporting broader adoption of evidence-based pathways. + Foster trusted peer relationships with oncologists to encourage **sustainable behavior change** that improves patient outcomes. + Support practice-level transformation initiatives that reduce unwarranted variation and enhance quality. + **Internal Strategy & Value Initiatives** + Collaborate with Evolent's clinical leadership on the **design, build, and execution of new value initiatives in oncology** . + Provide input on innovation opportunities, clinical algorithms, and models of care that support transformation in specialty care. + Partner with operational and analytic teams to assess the impact of interventions and identify opportunities for continuous improvement. + Participate in audit processes to validate accuracy of advance payment model payouts, ensuring alignment with clinical documentation, performance metrics, and contractual expectations. + **Compliance & Quality** + Ensure all reviews and engagements align with URAC, NCQA, and internal quality standards. + Document peer interactions and clinical decisions in a timely and accurate manner. + Participate in training and inter-rater reliability processes. **Qualifications** + MD/DO/MBBS with board certification in **Medical Oncology** . + Minimum five (5) years' post-residency experience, with active clinical practice preferred within the past 2 years. + Current, unrestricted medical license (multiple state licenses preferred or willingness to obtain). + Demonstrated **leadership in practice transformation, value-based care, or clinical quality improvement** . + Strong communication, collaboration, and organizational skills, with proven ability to influence physician behavior. + Energetic, curious, and passionate about **shaping the future of oncology care delivery** . + Not under sanction or exclusion from Medicare/Medicaid programs. To ensure a secure hiring process we have implemented several identity verification steps, including submission of a government issued photo ID. We conduct identity verification during interviews, and final interviews may require onsite attendance. All candidates must complete a comprehensive background check, in-person I-9 verification, and may be subject to drug screening prior to employment. The use of artificial intelligence tools during interviews is prohibited and monitored. Misrepresentation will result in immediate disqualification from consideration. **Technical Requirements:** We require that all employees have the following technical capability at their home: High speed internet over 10 Mbps and, specifically for all call center employees, the ability to plug in directly to the home internet router. These at-home technical requirements are subject to change with any scheduled re-opening of our office locations. **Evolent is an equal opportunity employer and considers all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or disability status.** **If you need reasonable accommodation to access the information provided on this website, please contact** ************************** **for further assistance.** The expected base salary/wage range for this position is $120-130/hr. This position is also eligible for a bonus component that would be dependent on pre-defined performance factors. As part of our total compensation package, Evolent is proud to offer comprehensive benefits (including health insurance benefits) to qualifying employees. All compensation determinations are based on the skills and experience required for the position and commensurate with experience of selected individuals, which may vary above and below the stated amounts. Don't see the dream job you are looking for? Drop off your contact information and resume and we will reach out to you if we find the perfect fit!

The Medical Director, Rheumatology and/or Dermatology Medical Strategy is a critical role responsible for shaping the strategic processes and planning for assets in early development (e.g., pre-Phase 3) within the Nephrology and Immunology portfolio. This position manages the unique challenge of establishing an emerging portfolio, incorporating newly acquired assets, which requires significant scientific and strategic agility and a strong ability to balance competing priorities. This position reports directly to the Senior Director, Immunology Lead, who in turn reports to the Executive Director, Nephrology & Immunology Lead. **** **Key Responsibilities Include:** **Medical Strategy & Narrative** + Provide key medical input into the initial development of the Target Reimbursable Product Profile as well as early development plans ensuring scientific consistency and alignment across R&D, Clinical, Global Medical Affairs, and Early Commercialization functions + Provide high-quality scientific/clinical input and review of early asset plans, ensuring content aligns with the overarching Medical Narrative + Serve as a primary scientific resource, providing guidance on the disease state and mechanism of action for the early Nephrology and Immunology portfolio helping to translate science into value for patients and stakeholders + Lead the Strategy and Tactical Planning Process, identifying critical data needs for the emerging portfolio **Evidence Generation Process** + Oversee the Medical Evidence Generation Process, translating strategic data gaps into clear research priorities and providing expert input into the design and feasibility of clinical trials and data generation initiatives + Support the planning and execution of Medical Affairs evidence generation activities relevant to early assets **External Stakeholder Engagement** + Identify and engage Medical experts to support collection, curation and communication of clinical Medical and methodological insights to inform understanding of unmet medical needs, emerging standard of care and development opportunities + Develop Key Intelligence Topics & Questions (KITs/KIQs) for relevant assets, serving as the blueprint for insight collection from Medical Experts + Lead the strategic planning, content development, and successful facilitation of consulting activities including Advisory Boards, ensuring objectives align with data gap analyses and asset/portfolio strategy + Lead scientific exchange with Medical Experts to gather insights and validate development hypotheses + Support the development of scientific publications, abstracts, and presentations related to early assets **Cross-functional Integration & Planning** + Collaborate within the Nephrology & Immunology Medical Business Unit with the Nephrology & Immunology Medical Communications and Field Medical Affairs sub-teams + Partner with and serve as a scientific and clinical resource for cross-functional colleagues including Clinical Development, Global Integrated Evidence & Innovation, Regulatory and Global Marketing and Market Access + Support indication prioritization and portfolio planning for early assets + Consider technology and AI to support workflow improvement **Qualifications** **Education and Experience:** + Advanced scientific degree is required (PharmD, MD, PhD, or equivalent) with expertise in **Rheumatology and/or Dermatology** + Preference for previous experience in Clinical Development, Research, or early-stage Medical Affairs + Expertise in Rheumatology or Dermatology is strongly preferred + Experience supporting BD evaluations for potential acquisitions + Experience contributing to the integration and strategic planning for newly acquired or in-licensed assets + Proven experience managing Evidence Generation processes and executing scientific Advisory Boards **Skills and Competencies:** + Motivated and solution-oriented with the ability to work collaboratively across the organization, particularly with R&D and Clinical teams + Strategic agility required to build and adapt scientific strategy for an emerging portfolio + Excellent communication and interpersonal skills, including experience presenting complex development strategies to large internal groups and engaging a limited number of highly specialized external experts + Full understanding of rules and regulations in pharma, with the ability to apply knowledge of guidelines and regulations to early-stage Medical Affairs activities + Ability to work in a fast-paced, dynamic environment, with a proactive and problem-solving mindset + Strong understanding of drug development processes, especially early-stage development + \#LI-PG1 **Competencies** **Accountability for Results -** Stay focused on key strategic objectives, be accountable for high standards of performance, and take an active role in leading change. **Strategic Thinking & Problem Solving -** Make decisions considering the long-term impact to customers, patients, employees, and the business. **Patient & Customer Centricity -** Maintain an ongoing focus on the needs of our customers and/or key stakeholders. **Impactful Communication -** Communicate with logic, clarity, and respect. Influence at all levels to achieve the best results for Otsuka. **Respectful Collaboration -** Seek and value others' perspectives and strive for diverse partnerships to enhance work toward common goals. **Empowered Development -** Play an active role in professional development as a business imperative. Minimum $209,599.00 - Maximum $313,375.00, plus incentive opportunity: The range shown represents a typical pay range or starting pay for individuals who are hired in the role to perform in the United States. Other elements may be used to determine actual pay such as the candidate's job experience, specific skills, and comparison to internal incumbents currently in role. Typically, actual pay will be positioned within the established range, rather than at its minimum or maximum. This information is provided to applicants in accordance with states and local laws. **Application Deadline** : This will be posted for a minimum of 5 business days. **Company benefits:** Comprehensive medical, dental, vision, prescription drug coverage, company provided basic life, accidental death & dismemberment, short-term and long-term disability insurance, tuition reimbursement, student loan assistance, a generous 401(k) match, flexible time off, paid holidays, and paid leave programs as well as other company provided benefits. Come discover more about Otsuka and our benefit offerings; ********************************************* . **Disclaimer:** This job description is intended to describe the general nature and level of the work being performed by the people assigned to this position. It is not intended to include every job duty and responsibility specific to the position. Otsuka reserves the right to amend and change responsibilities to meet business and organizational needs as necessary. Otsuka is an equal opportunity employer. All qualified applicants are encouraged to apply and will be given consideration for employment without regard to race, color, sex, gender identity or gender expression, sexual orientation, age, disability, religion, national origin, veteran status, marital status, or any other legally protected characteristic. If you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation, if you are unable or limited in your ability to apply to this job opening as a result of your disability. You can request reasonable accommodations by contacting Accommodation Request (EEAccommodations@otsuka-us.com) . **Statement Regarding Job Recruiting Fraud Scams** At Otsuka we take security and protection of your personal information very seriously. Please be aware individuals may approach you and falsely present themselves as our employees or representatives. They may use this false pretense to try to gain access to your personal information or acquire money from you by offering fictitious employment opportunities purportedly on our behalf. Please understand, Otsuka will **never** ask for financial information of any kind or for payment of money during the job application process. We do not require any financial, credit card or bank account information and/or any payment of any kind to be considered for employment. We will also not offer you money to buy equipment, software, or for any other purpose during the job application process. If you are being asked to pay or offered money for equipment fees or some other application processing fee, even if claimed you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to exercise caution when you receive such an offer of employment. Otsuka will also never ask you to download a third-party application in order to communicate about a legitimate job opportunity. Scammers may also send offers or claims from a fake email address or from Yahoo, Gmail, Hotmail, etc, and not from an official Otsuka email address. Please take extra caution while examining such an email address, as the scammers may misspell an official Otsuka email address and use a slightly modified version duplicating letters. To ensure that you are communicating about a legitimate job opportunity at Otsuka, please only deal directly with Otsuka through its official Otsuka Career website ******************************************************* . Otsuka will not be held liable or responsible for any claims, losses, damages or expenses resulting from job recruiting scams. If you suspect a position is fraudulent, please contact Otsuka's call center at: ************. If you believe you are the victim of fraud resulting from a job recruiting scam, please contact the FBI through the Internet Crime Complaint Center at: ******************* , or your local authorities. Otsuka America Pharmaceutical Inc., Otsuka Pharmaceutical Development & Commercialization, Inc., and Otsuka Precision Health, Inc. ("Otsuka") does not accept unsolicited assistance from search firms for employment opportunities. All CVs/resumes submitted by search firms to any Otsuka employee directly or through Otsuka's application portal without a valid written search agreement in place for the position will be considered Otsuka's sole property. No fee will be paid if a candidate is hired by Otsuka as a result of an agency referral where no pre-existing agreement is in place. Where agency agreements are in place, introductions are position specific. Please, no phone calls or emails.

Job Title: Regional Medical Associate Director-Central About the Job Join the team transforming care for people with immune challenges, rare diseases, cancers, and neurological conditions. In Specialty Care, you'll help deliver breakthrough treatments that bring hope to patients with some of the highest unmet needs. The US Rare Disease, Regional Medical Associate Director (RMAD)-Central, will be responsible for cross-portfolio support including proactive engagement of select HCPs across multiple specialties. The RMAD will support pipeline initiatives, with a focus on enhancing awareness of disease states associated with late-stage pipeline assets (including alpha-1 antitrypsin deficiency-AATD) among HCPs across a breadth of accounts. About Sanofi: We're an R&D-driven, AI-powered biopharma company committed to improving people's lives and delivering compelling growth. Our deep understanding of the immune system - and innovative pipeline - enables us to invent medicines and vaccines that treat and protect millions of people around the world. Together, we chase the miracles of science to improve people's lives. Main Responsibilities: * Across the Rare Disease Nation and our 'one team, common goals, single mission' approach, this role will be expected to use their scientific expertise to provide disease education and deliver the medical strategy and ultimately improve patient pathways and outcomes. * Lead medical education programs, including disease state and product training sessions. * Facilitate disease education, including late-stage pipeline disease awareness and clinical trial support. * Continuously stay current with the latest medical and scientific advancements relevant to the therapeutic area through self-directed learning and training programs * Serve as a subject matter expert for internal projects and lead assignments as needed. * Collaborate with the Medical Divisional General Manager to develop account plans for emerging KOLs outside of key accounts * Gain deep insights into the needs and priorities of community accounts * Provide targeted education on outcomes data, scientific advances, and other scientific exchange. * Respond to HCP Medical Information Requests (MIRs) About You * Minimum 3-5 years of experience in medical affairs preferred * Advanced medical/science degree * An in-depth knowledge of cross-portfolio therapeutic areas and pipeline. * Strong communication and presentation skills to simplify complex topics. * Familiarity with omnichannel tools and digital communication in a remote environment. * Understanding of clinical development and clinical research. * Ability to critically evaluate clinical study protocols, reports and publications. * Knowledge of pharmacovigilance and local regulatory process. * Strong business acumen and ability to implement medical initiatives. * Experience working in respiratory space (specifically AATD or rare pulmonology) desired. Why Choose Us? * Bring the miracles of science to life alongside a supportive, future-focused team. * Discover endless opportunities to grow your talent and drive your career, whether it's through a promotion or a lateral move, at home or internationally. * Enjoy a thoughtful, well-crafted rewards package that recognizes your contribution and amplifies your impact. * Take good care of yourself and your family, with a wide range of health and wellbeing benefits including high-quality healthcare, prevention and wellness programs, and at least 14 weeks' gender-neutral parental leave. This position is eligible for a company car through the Company's FLEET program. Candidates must complete all fleet safety training and must maintain an acceptable driving record regarding accidents and incidents. Sanofi Inc. and its U.S. affiliates are Equal Opportunity and Affirmative Action employers committed to a culturally diverse workforce. All qualified applicants will receive consideration for employment without regard to race; color; creed; religion; national origin; age; ancestry; nationality; marital, domestic partnership or civil union status; sex, gender, gender identity or expression; affectional or sexual orientation; disability; veteran or military status or liability for military status; domestic violence victim status; atypical cellular or blood trait; genetic information (including the refusal to submit to genetic testing) or any other characteristic protected by law. #GD-SG #LI-GZ #LI-Remote #vhd Pursue progress, discover extraordinary Better is out there. Better medications, better outcomes, better science. But progress doesn't happen without people - people from different backgrounds, in different locations, doing different roles, all united by one thing: a desire to make miracles happen. So, let's be those people. At Sanofi, we provide equal opportunities to all regardless of race, colour, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, ability or gender identity. Watch our ALL IN video and check out our Diversity Equity and Inclusion actions at sanofi.com! US and Puerto Rico Residents Only Sanofi Inc. and its U.S. affiliates are Equal Opportunity and Affirmative Action employers committed to a culturally inclusive and diverse workforce. All qualified applicants will receive consideration for employment without regard to race; color; creed; religion; national origin; age; ancestry; nationality; natural or protective hairstyles; marital, domestic partnership or civil union status; sex, gender, gender identity or expression; affectional or sexual orientation; disability; veteran or military status or liability for military status; domestic violence victim status; atypical cellular or blood trait; genetic information (including the refusal to submit to genetic testing) or any other characteristic protected by law. North America Applicants Only The salary range for this position is: $172,500.00 - $249,166.66 All compensation will be determined commensurate with demonstrated experience. Employees may be eligible to participate in Company employee benefit programs. Additional benefits information can be found through the LINK.

When you join the team at Unum, you become part of an organization committed to helping you thrive. Here, we work to provide the employee benefits and service solutions that enable employees at our client companies to thrive throughout life's moments. And this starts with ensuring that every one of our team members enjoys opportunities to succeed both professionally and personally. To enable this, we provide: + Award-winning culture + Inclusion and diversity as a priority + Performance Based Incentive Plans + Competitive benefits package that includes: Health, Vision, Dental, Short & Long-Term Disability + Generous PTO (including paid time to volunteer!) + Up to 9.5% 401(k) employer contribution + Mental health support + Career advancement opportunities + Student loan repayment options + Tuition reimbursement + Flexible work environments **_*All the benefits listed above are subject to the terms of their individual Plans_** **.** And that's just the beginning... With 10,000 employees helping more than 39 million people worldwide, every role at Unum is meaningful and impacts the lives of our customers. Whether you're directly supporting a growing family, or developing online tools to help navigate a difficult loss, customers are counting on the combined talents of our entire team. Help us help others, and join Team Unum today! **General Summary:** Unum is expanding our team of expert physicians to serve as Medical Consultants! Step into a role that lets you leverage your clinical expertise without the demands of face‑to‑face patient care. If you're board-certified in Psychiatry, as a Medical Consultant at Unum you'll enjoy a full but well-balanced schedule with the freedom to focus on thoughtful, analytical work. This position offers the rare opportunity to apply your medical knowledge in a new way- you'll review and evaluate medical documentation for disability claims in a collaborative, team-oriented environment. Enjoy competitive benefits, generous PTO, and more. If you're seeking intellectually stimulating work with meaningful impact, this role offers a refreshing next chapter in your career." This position is responsible for providing expert medical analysis of claims files (or underwriting applications) across Unum US product lines. The incumbent provides high quality, timely, and efficient medical consultative services to the Benefits Center. The Medical Consultant adheres to current regulatory, claim process, and internal workflow standards as set forth in the Benefits Center Claims Manual, underwriting manual, and associated documentation. The incumbent adheres to accepted norms of medical practices and Code of Conduct guidelines. Physicians and psychologists conduct their reviews and analyses within appropriate ethical standards and maintain their professional licenses and Board certifications. This role is expected to provide excellent customer service and to interact on a regular basis with business partners, health care providers, and other specialized resources. **Principal Duties and Responsibilities** + Provide timely, clear medical direction and opinions to team partners, with reasoned forensic analysis to support the medical opinions + Partner/consult with fellow medical consultants when appropriate to ensure the completion of a whole person analysis + Apply medical knowledge to determine functional capacity through assessment of medical and other data related to impairment, regarding accuracy of diagnoses, treatment plans, duration guidelines, and prognosis + Provide relevant medical education and knowledge to others in terms appropriate and understandable to the intended audience + Perform telephone contacts with the insured's healthcare providers to gather medical information and to facilitate a better understanding of the claimant's functional abilities + Make timely and appropriate referrals for second opinion reviews when appropriate or required according to current guidelines and best practices + Demonstrate ability to manage and complete high volumes of assigned work, maintain consistently good turnaround times, and operate with a sense of urgency + Focus not only on individual workload, but on the team/group work volumes to ensure organizational success + Receive feedback and follow through with appropriate behaviors/actions + Perform other duties as assigned **Job Specifications** + Professional Degree (MD, DO, PhD, PsyD) + Active, unrestricted US medical license + Board certification required for physicians in their area of specialty + Minimum of five years of clinical experience in medical specialty + Strong team and collaborative skills. Ability to work in a fast paced, team based, corporate environment + Ability to mentor others and to give and receive constructive, behaviorally based feedback with peers and partners ~IN1 \#LI-RA1 Unum and Colonial Life are part of Unum Group, a Fortune 500 company and leading provider of employee benefits to companies worldwide. Headquartered in Chattanooga, TN, with international offices in Ireland, Poland and the UK, Unum also has significant operations in Portland, ME, and Baton Rouge, LA - plus over 35 US field offices. Colonial Life is headquartered in Columbia, SC, with over 40 field offices nationwide. Unum is an equal opportunity employer, considering all qualified applicants and employees for hiring, placement, and advancement, without regard to a person's race, color, religion, national origin, age, genetic information, military status, gender, sexual orientation, gender identity or expression, disability, or protected veteran status. The base salary range for applicants for this position is listed below. Unless actual salary is indicated above in the job description, actual pay will be based on skill, geographical location and experience. $133,500.00-$274,100.00 Additionally, Unum offers a portfolio of benefits and rewards that are competitive and comprehensive including healthcare benefits (health, vision, dental), insurance benefits (short & long-term disability), performance-based incentive plans, paid time off, and a 401(k) retirement plan with an employer match up to 5% and an additional 4.5% contribution whether you contribute to the plan or not. All benefits are subject to the terms and conditions of individual Plans. Company: Unum

**_What Finance Operations contributes to Cardinal Health_** Finance oversees the accounting, tax, financial plans and policies of the organization, establishes and maintains fiscal controls, prepares and interprets financial reports, oversees financial systems and safeguards the organization's assets. Finance Operations is responsible for core financial operation processes. This can include customer and vendor contract administration; customer and vendor pricing, rebates, billing vendor chargeback research and reconciliation; processing vendor invoices and employee expense reports for payment; fixed asset accounting for book and tax records; cash application; and journal entries. + Demonstrates knowledge of financial processes, accounting policies, systems, controls, and work streams + Demonstrates experience working in a transnational finance environment coupled with strong internal controls + Possesses understanding of service level goals and objectives when providing customer support + Works collaboratively to respond to non-standard requests + Possesses strong organizational skills and prioritizes getting the right things done **_Responsibilities_** + Manage a team of Cardinal Health and Genpact individuals who oversee the entirety of the GPO Admin Fees and Rebates set up and report creation functions, including P&L accruals, rebate setups within SAP Vistex and ad hoc reporting for key internal and external stakeholders. Responsible for the month end accounting close process. + Ensure GPO Admin Fees and Rebates are properly accounted for based on core accounting principles + Own first level review/approval responsibilities for non-standard rebate structures to ensure proper audit documentation is maintained and proper approvals are received + Oversee key rebate accuracy and timeliness CSLs and KPIs + Partner with cross-functional teams to research and resolve root cause issues impacting rebate accuracy or ability to set up Rebates and GPO Admin Fees timely; apply big picture knowledge to assess and interpret financial impact of process changes and resulting driver outcomes of GPO Admin Fee/Rebate set up changes + Foster a strong SOX internal control structure and seek opportunities for improvements, including build out of SOP processes and project development + Transform current payout and reporting process into Vistex implementation and go-forward build/upkeep + Develop plans for future systematic enhancements + Assist team with more complicated customer and transaction activities; oversee escalations to ensure closure in a timely manner + Partner with and be a thought-provoking leader to business partners across the organization to properly account for transactions, including but not limited to Sales, Legal, Finance, Pricing, Accounting and Contracting + Actively collaborate and support cross-functional team initiatives to improve customer experience, both internally and externally + Establish team and individual-oriented goals for growth and development **_Qualifications_** + Bachelor's Degree in Accounting, Finance or Business Management, preferred + CPA preferred + 8+ years of professional experience in related field, preferred, including Accounting, Finance, or Audit, preferred + Accounting and Finance acumen + Ability to lead a new team and influence others + Knowledge with SAP and legal contracts (revenue recognition standards is a plus) + Data mining experience (relevant application tool experience is a plus) + Strong written and verbal communication skills + Process improvement oriented + Strong SOX/internal control understanding **Anticipated salary range:** $105,100 - $135,090 **Bonus eligible:** Yes **Benefits:** Cardinal Health offers a wide variety of benefits and programs to support health and well-being. + Medical, dental and vision coverage + Paid time off plan + Health savings account (HSA) + 401k savings plan + Access to wages before pay day with my FlexPay + Flexible spending accounts (FSAs) + Short- and long-term disability coverage + Work-Life resources + Paid parental leave + Healthy lifestyle programs **Application window anticipated to close:** 1/16/2026 *if interested in opportunity, please submit application as soon as possible. The salary range listed is an estimate. Pay at Cardinal Health is determined by multiple factors including, but not limited to, a candidate's geographical location, relevant education, experience and skills and an evaluation of internal pay equity. _Candidates who are back-to-work, people with disabilities, without a college degree, and Veterans are encouraged to apply._ _Cardinal Health supports an inclusive workplace that values diversity of thought, experience and background. We celebrate the power of our differences to create better solutions for our customers by ensuring employees can be their authentic selves each day. Cardinal Health is an Equal_ _Opportunity/Affirmative_ _Action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, ancestry, age, physical or mental disability, sex, sexual orientation, gender identity/expression, pregnancy, veteran status, marital status, creed, status with regard to public assistance, genetic status or any other status protected by federal, state or local law._ _To read and review this privacy notice click_ here (***************************************************************************************************************************

**Become a part of our caring community and help us put health first** The Director Denials Management provides leadership for the audit, appeal and review process to preserve and recover revenue while maintaining the highest level of clinical and regulatory integrity and compliance. Manages the Denials Management data analytics, denial and appeal process. The Director, Home Health Grievances & Appeals assists members, via phone or face to face, further/support quality related goals. Investigates and resolves member and practitioner issues. Decisions are typically related to the implementation of new/updated programs or large-scale projects for the function and supporting technical/operational procedures and processes, and implements strategic plans, drives goals and objectives, and improves performance. Provides input into functions strategy. **Responsibilities:** + Oversee the process for direction and support to clinical and operational leadership regarding Medicare and governmental audit trends, denials, and any CMS initiative and/or demonstration projects. + Collaborates with leadership team in the development of an education plan to improve processes to preserve and recover revenue. + Analyzes region-wide outcome indicators to measure achievement of quantitative and qualitative standards. Assists in the development, implementation and analysis of internal and external benchmarking programs to measure the region's effectiveness in improving performance + Maintains region-wide Performance Improvement program which includes Customer Satisfaction, complaints, infection monitoring, Incident Reporting, and quarterly branch PI activity + Provides feedback and recommendations for changes to policies and processes, procedures and systems to enhance measures taken to improve performance + Communicate with Corporate leadership, Regional and Divisional leaders as appropriate to resolve issues that may place patients or the company at risk + Oversee educational in-services based on analysis of PI data and activities Acts as a resource for the Operations Support team and communicates Performance Improvement results + Participate in special projects and performs other duties as assigned. **Use your skills to make an impact** **Required Qualifications** + Bachelor's degree in Nursing or related field + 10-15 years progressively responsible experience in home health or hospice industry that includes performance improvement and outcomes measurement + 5 years' experience in a supervisory or teaching role + Thorough knowledge of health care policy, industry and related clinical practice + Knowledge in the interpretation and application of regulations and performance improvement standards + Strong Project management principles and clinical policy development/implementation required + Expert knowledge of all Medicare regulations and appeals processes + Excellent analytical skills with ability to interpret and apply regulatory requirements + Excellent verbal/written communication and presentation skills + Advanced knowledge with Payer requirements, ADR requests, Denials, Appeals, RAC/ZPIC and CERT responses + Must be able to work well independently and in a team environment + Excellent communication and organization skills + Strong attention to detail + Healthcare industry experience preferred + Must read, write and speak fluent English + Must have good and regular attendance + Approximate percent of time required to travel: 30% + Performs other related duties as assigned **Preferred Qualifications** + Master's Degree preferred + Licenses/Certification: RN, PT or OT preferred + More than 3 years of grievance and appeals experience + Strong knowledge in Microsoft Access or experience with SQL Server databases + Previous experience processing medical claims + Bilingual (English and Spanish); with the ability to read, write, and speak English and Spanish **Additional Information** **SSN Alert Statement** Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from ******************** with instructions on how to add the information into your official application on Humana's secure website. **Interview Format** As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. **WAH Internet Statement** To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. Satellite, cellular and microwave connection can be used only if approved by leadership. Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $126,300 - $173,700 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 01-30-2026 **About us** About CenterWell Home Health: CenterWell Home Health specializes in personalized, comprehensive home care for patients managing a chronic condition or recovering from injury, illness, surgery or hospitalization. Our care teams include nurses, physical therapists, occupational therapists, speech-language pathologists, home health aides, and medical social workers - all working together to help patients rehabilitate, recover and regain their independence so they can live healthier and happier lives. About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Centerwell, a wholly owned subsidiary of Humana, complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our full accessibility rights information and language options *************************************************************

Supervises and coordinates patient care services of one or more nursing units on a 24-hour basis. The Dir, Nursing ensures that physicians' orders are followed; ensures that patient conditions and progress are accurately reported; ensures that patient care is administered by all professional and nonprofessional personnel in the unit according to organization and regulatory policies and guidelines; and has staffing and budget control responsibilities for the unit. 1. Leadership a. Utilizes advanced clinical knowledge to develop and maintain a delivery system for individualized, appropriate, and compassionate patient care. Supports and encourages staff, patients, and significant others in the determination of treatment and rehabilitation goals for desired outcomes. Provides leadership and participates in emergency measures for sudden adverse patient developments. b. Provides leadership and demonstrates critical thinking ability in all areas of responsibility, treats all co-workers with respect, strives to enhance co-worker performance through cooperation and effective communication, and demonstrates hospitality and courtesy in all interactions. 2. Unit Management and Daily Operations a. Estimates future departmental personnel, equipment, and supply needs in order to ensure the attainment of operating goals. Develops, recommends, and implements the annual capital equipment, personnel, and operating budget for the department. Conducts periodic reviews of departmental performance, analyzes budget variances, and implements responsive action. b. Demonstrates clinical expertise in facilitating the timely availability, access, and utilization of multidisciplinary health care services, alternative levels of care, and community resources in a manner that ensures optimal continuity and expediency in the health care delivery process. c. Implements strategies that use current scientific knowledge to prevent and reduce the risk of infection transmission. Promptly and appropriately reports infections between and among staff, patients, and visitors in order to improve patient outcomes. d. Consults with nursing management, nursing staff, and Clinical Nurse Specialists in the development of instructional materials for patients and family members which will provide the specific knowledge and skill required to increase their understanding of the patient's illness, meet the patient's ongoing health care needs, and improve patient health outcomes. e. Develops and maintains documentation required for successful employee development and administrative and divisional communication. Supervises and participates in the efficient recording of pertinent patient care data utilizing the computerized medical record and manual documentation in order to promote timely and efficient access to required information throughout the organization. Preserves the confidentiality of data and information identified as sensitive in order to ensure the protection of patient dignity and privacy. f. Monitors and coordinates the effective use, maintenance, and repair of equipment, supplies, facilities, and resources that support patient care in order to maintain a functional and safe environment for patients, staff, and visitors. g. Maintains own clinical expertise and ensures the demonstrated clinical competency of staff members to deliver patient care services in accordance with the specific identified needs of adult and geriatric patients. Utilizes appropriate resources as needed for assistance in the planning and delivery of care to infant, pediatric, and adolescent patients. 3. Performance Improvement and Quality a. Provides ongoing assessments of the patient care delivery system in order to identify existing and potential health care needs within the scope of care for the unit. Evaluates and makes recommendations for current and potential unit staffing needs, assesses and introduces technological and procedural changes that enhance the efficiency and quality of patient care services and outcomes, and supervises the ongoing assessment of patients for physical, psychological, and social status needs and discharge planning. b. Coordinates and manages high quality health care services that recognize individual patient rights while acting as a role model for the nursing personnel. Educates staff and monitors care delivery in order to ensure that patients exercise their rights to be informed and to participate and make decisions in all aspects of their medical care. Ensures that patient care demonstrates respect for personal values and beliefs and is focused on the unique needs of each individual and their family. c. Utilizes continued analysis and evaluation of patient care outcomes to enhance the quality and efficiency of services and optimize the utilization of hospital resources. Participates actively in unit-specific and multidisciplinary continuous quality improvement and quality assurance studies in a manner that promotes compliance with hospital and divisional regulations and standards. d. Ensures that all staff members are oriented and continuously educated regarding their roles in sustaining and improving the overall environment. Assesses the learning and development needs of staff members and is responsible for the provision of appropriate educational services. e. Establishes departmental standards for the evaluation of personnel performance and monitors the performance of reporting personnel. Promotes and encourages the growth and development of staff members by encouraging their participation in approved continuing education activities such as professional conferences, seminars, and workshops. Advocates continuing education as a means of promoting the high quality services provided by all departmental personnel. f. Observes and adheres to all departmental and hospital policies and procedures, and follows all safety, quality assurance, and infection control standards. 4. Other Duties As Assigned a. Performs other duties as assigned or requested. Education - Bachelors of Science in Nursing from an accredited school of nursing Licensure: Current licensure in good standing in the state of Mississippi; Current BLS required. ACLS preferred.

**Parexel** is in the business of improving the world's health. We do this by providing a suite of biopharmaceutical services that help clients across the globe transform scientific discoveries into new treatments. From clinical trials to regulatory, consulting, and market access, our therapeutic, technical, and functional ability is underpinned by a deep conviction in what we do. We believe in our values, Patients First, Quality, Respect, Empowerment & Accountability. **Parexel is looking for a Medical Director with a very strong background in Ophthalmology to join our Global Medical Sciences team.** **The role is remotely based in the US.** The Medical Director is a medical expert with specialized therapeutic expertise and some experience across indications, clients and drug development. They initiate and maintain medical and consultative relationships with clients, consult on early engagement and pre-award efforts and serve as a medical monitor for contracted projects. The Medical Director may take on leadership roles by participating in initiatives, mentoring junior MDs and/or, where appropriate, managing a team of physicians. Primary activities will focus on **Medical Monitoring Delivery & PV Support** . The medical monitor will independently deliver all medical support required for successful delivery of the projects according to contracted agreement with the sponsor (i.e., tasks and time per task contracted) and according to the assigned role (Global Lead Physician or Regional Lead Physician). **Medical Expertise** and experience in **Ophthalmology** is essential to the medical monitor role and will be manifested in high quality consultation on protocol development or drug development programs, medical review of various documents, collaboration on internal therapeutic area meetings, training module development, white papers, slide sets, publications etc. **Client Relationship Building & Engagement,** including soliciting and addressing client feedback and suggestions regarding medical study-related activities, are core skills required of the medical monitor. **Business Development:** the medical monitor will provide medical expertise / leadership in Proposal Development Teams (PDTs) for client bid pursuit meetings. **Skills** + Excellent interpersonal skills including the ability to interact well with sponsor/client counterparts + Client-focused approach to work + Excellent time management skills + Excellent verbal and written medical communication skills + Excellent standard of written and spoken English + A flexible attitude with respect to work assignments and new learning + Ability to manage multiple and varied tasks with enthusiasm and prioritize workload with attention to detail + Willingness to work in a matrix environment and to value the importance of teamwork. **Knowledge And Experience** + Experience in clinical medicine (general or specialist qualifications) with Fellowship or specialty training in **Ophthalmology** , which is expected to be kept up to date. + A background in clinical aspects of drug development, including all aspects of Medical Monitoring and study design/execution, preferred + Clinical practice experience + Good knowledge of the drug development process including drug safety, preferred + Experience in Pharmaceutical Medicine, preferred + Experience leading, mentoring and managing individuals/ a team, preferred **Education** + US Board certified in **Ophthalmology** + Experience as a Physician in Industry or as a clinical trial investigator is required + Previous CRO experience is strongly preferred + Medically qualified in an acknowledged medical school with completion of at least basic training in clinical medicine (residency, internship) The ability to travel 15% domestically or internationally is required. \#LI-REMOTE EEO Disclaimer Parexel is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to legally protected status, which in the US includes race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.

**Your Future Evolves Here** Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones. Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business. Join Evolent for the mission. Stay for the culture. **What You'll Be Doing:** As a Physician Clinical Reviewer, Interventional Pain Management, you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in patients' lives, in a non-clinical environment. You can enjoy better work- life balance on a team that values collaboration and continuous learning while providing better health outcomes. **Collaboration Opportunities:** + Routinely interacts with leadership and management staff, other Physicians, and staff whenever a physician`s input is needed or required. Aids and acts as a resource to Initial Clinical Reviewers. **What You Will Be Doing:** + Serve as the Physician Clinical Reviewer for Interventional Pain Management, reviewing cases that do not initially meet the applicable medical necessity guidelines, as well as other imaging requests when providers, clients, or state laws require specialty reviews to be completed by the subject matter expert. + Discusses determinations (peer to peer phone calls) with requesting physicians or ordering providers, when available, within the regulatory timeframe of the request. + Utilizes medical/clinical review guidelines and parameters to assure consistency in the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality Assurance (NCQA) guidelines. + Provides clinical rationale for standard and expedited appeals. + Ensures documentation of all communications with medical office staff and/or MD provider is recorded in a timely and accurate manner. + Participates in on-going training per inter-rater reliability process. + On a requested basis, may function as Medical Director for selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with the Senior Medical Director. May assist the Senior Medical Director in research activities/questions. **Qualifications - Required and Preferred:** + MD/DO/MBBS- **Required** + Minimum of five (5) years' experience in the practice of Pain Medicine, post-residency- **Preferred** + Current, unrestricted clinical license in medicine or required specialty- **Required** + Obtaining and maintaining medical licenses in the state you reside and any required per business needs- **Required** + Active Board Certification in Pain Management or Active Board Certification in another specialty and clinical experience in Interventional Pain Management- **Required** + Strong clinical, management, communication, and organizational skills- **Required** + Energetic and curious with a passion for quality and value in health care- **Required** + Computer Proficiency- **Required** To ensure a secure hiring process we have implemented several identity verification steps, including submission of a government issued photo ID. We conduct identity verification during interviews, and final interviews may require onsite attendance. All candidates must complete a comprehensive background check, in-person I-9 verification, and may be subject to drug screening prior to employment. The use of artificial intelligence tools during interviews is prohibited and monitored. Misrepresentation will result in immediate disqualification from consideration. **Technical Requirements:** We require that all employees have the following technical capability at their home: High speed internet over 10 Mbps and, specifically for all call center employees, the ability to plug in directly to the home internet router. These at-home technical requirements are subject to change with any scheduled re-opening of our office locations. **Evolent is an equal opportunity employer and considers all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or disability status.** **If you need reasonable accommodation to access the information provided on this website, please contact** ************************** **for further assistance.** The expected base salary/wage range for this position is $105-110/hr. This position is also eligible for a bonus component that would be dependent on pre-defined performance factors. As part of our total compensation package, Evolent is proud to offer comprehensive benefits (including health insurance benefits) to qualifying employees. All compensation determinations are based on the skills and experience required for the position and commensurate with experience of selected individuals, which may vary above and below the stated amounts. Don't see the dream job you are looking for? Drop off your contact information and resume and we will reach out to you if we find the perfect fit!

The Director, CNS Publications Lead is responsible for leading the planning, development, and execution of the global medical publication strategy and publication deliverables for the CNS therapeutic area. This role ensures the timely, accurate, and compliant communication of scientific and clinical data through congress abstracts, posters, manuscripts, and other peer-reviewed outputs. Serving as the functional lead for publication operations within the CNS Medical Communications team, the Director partners closely with cross-functional stakeholders, including Clinical Development, Global Integrated Evidence & Innovation (GIE&I), Medical Strategy, Core Content, and external vendors, ensuring excellence and consistency in scientific communication across the portfolio. The position reports to the Senior Director, CNS Medical Communications Lead and plays a key leadership role in advancing Otsuka's mission to deliver impactful, evidence-based science that improves patient outcomes. **** **Key Responsibilities Include:** **Publications Strategy and Execution** + Lead execution of the publication plans for CNS assets, ensuring strategic alignment with global medical and communication objectives, data dissemination priorities, and the product lifecycle + Partner with Medical Communications and cross-functional teams to define publication timelines, data priorities, and congress/journal strategies in collaboration with study teams and medical leaders + Oversee the end-to-end development of publication deliverables, including abstracts, posters, and manuscripts to ensure scientific accuracy, quality, and adherence to Good Publication Practices (GPP), ICMJE, and company SOPs + Support the integration of publication insights into broader scientific communication platforms (SCPs), ensuring consistency across core content, field materials, and other medical channels + Future potential to manage other direct reports or a team **Vendor & Budget Management** + Manage publication vendors and medical writing partners to ensure timely delivery, cost-effectiveness + Oversee operational management of external publication agencies, providing clear direction, review, and feedback to ensure alignment with scientific and compliance standards + Manage assigned publication budgets, including forecasting, tracking, and reconciliation + Ensure efficient resource utilization and drive continuous process improvement across publication workflows, including considering managing in-house development of some publication content **Cross-functional Leadership** + Collaborate closely with Clinical Development, Global Integrated Evidence & Innovation, Medical Strategy, and Core Content teams to ensure data readiness, accurate interpretation, and timely publication of key clinical results + Serve as a publications subject matter expert within the CNS Medical Communications function, providing strategic and operational guidance and support to internal stakeholders and vendors + Partner with Field Medical and Medical Core content leads to ensure consistency of published data messaging across medical channels and external communications + Contribute to integrated medical communication planning, ensuring that publications effectively support data dissemination goals and launch readiness activities + Consider technology and AI to support workflow improvement **Compliance & Quality Oversight** + Ensure all publication activities are conducted in accordance with internal SOPs, GPP, ICMJE, and regional/global regulatory requirements + Partner with Legal, Regulatory, and Compliance teams to uphold publication governance, authorship transparency, and ethical data sharing standards + Contribute to audit readiness and documentation best practices for publication records and approvals **Qualifications** **Education and Experience:** + Advanced scientific or medical degree (PharmD, PhD, MD, or equivalent) required + 10+ years of experience in Medical Affairs, Medical Communications, or Publications within the pharmaceutical or biotechnology industry + Minimum 3-5 years of experience leading publication planning and execution for global or regional programs, preferably in CNS or related therapeutic areas + Proven experience managing vendors and external medical writers, including budget oversight and performance evaluation + Strong understanding of Good Publication Practices (GPP), ICMJE guidelines, and industry standards for scientific and medical communication **Skills and Competencies:** + Strong leadership presence and ability to present to executive leadership team + Demonstrated ability to lead publication strategy execution across global and regional teams + Exceptional project management and organizational skills, with the ability to manage multiple concurrent publication deliverables + Excellent written and verbal communication skills, with meticulous attention to scientific accuracy and compliance + Strong cross-functional collaboration skills, with the ability to influence and align internal and external partners + Proven leadership in vendor management, process optimization, and publication operations + Financial acumen and experience managing publication budgets + Strategic thinker with operational excellence mindset and the ability to translate complex data into clear, evidence-based scientific narratives + Proven experience leading a team a plus **Competencies** **Accountability for Results -** Stay focused on key strategic objectives, be accountable for high standards of performance, and take an active role in leading change. **Strategic Thinking & Problem Solving -** Make decisions considering the long-term impact to customers, patients, employees, and the business. **Patient & Customer Centricity -** Maintain an ongoing focus on the needs of our customers and/or key stakeholders. **Impactful Communication -** Communicate with logic, clarity, and respect. Influence at all levels to achieve the best results for Otsuka. **Respectful Collaboration -** Seek and value others' perspectives and strive for diverse partnerships to enhance work toward common goals. **Empowered Development -** Play an active role in professional development as a business imperative. Minimum $186,489.00 - Maximum $278,875.00, plus incentive opportunity: The range shown represents a typical pay range or starting pay for individuals who are hired in the role to perform in the United States. Other elements may be used to determine actual pay such as the candidate's job experience, specific skills, and comparison to internal incumbents currently in role. Typically, actual pay will be positioned within the established range, rather than at its minimum or maximum. This information is provided to applicants in accordance with states and local laws. **Application Deadline** : This will be posted for a minimum of 5 business days. **Company benefits:** Comprehensive medical, dental, vision, prescription drug coverage, company provided basic life, accidental death & dismemberment, short-term and long-term disability insurance, tuition reimbursement, student loan assistance, a generous 401(k) match, flexible time off, paid holidays, and paid leave programs as well as other company provided benefits. Come discover more about Otsuka and our benefit offerings; ********************************************* . **Disclaimer:** This job description is intended to describe the general nature and level of the work being performed by the people assigned to this position. It is not intended to include every job duty and responsibility specific to the position. Otsuka reserves the right to amend and change responsibilities to meet business and organizational needs as necessary. Otsuka is an equal opportunity employer. All qualified applicants are encouraged to apply and will be given consideration for employment without regard to race, color, sex, gender identity or gender expression, sexual orientation, age, disability, religion, national origin, veteran status, marital status, or any other legally protected characteristic. If you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation, if you are unable or limited in your ability to apply to this job opening as a result of your disability. You can request reasonable accommodations by contacting Accommodation Request (EEAccommodations@otsuka-us.com) . **Statement Regarding Job Recruiting Fraud Scams** At Otsuka we take security and protection of your personal information very seriously. Please be aware individuals may approach you and falsely present themselves as our employees or representatives. They may use this false pretense to try to gain access to your personal information or acquire money from you by offering fictitious employment opportunities purportedly on our behalf. Please understand, Otsuka will **never** ask for financial information of any kind or for payment of money during the job application process. We do not require any financial, credit card or bank account information and/or any payment of any kind to be considered for employment. We will also not offer you money to buy equipment, software, or for any other purpose during the job application process. If you are being asked to pay or offered money for equipment fees or some other application processing fee, even if claimed you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to exercise caution when you receive such an offer of employment. Otsuka will also never ask you to download a third-party application in order to communicate about a legitimate job opportunity. Scammers may also send offers or claims from a fake email address or from Yahoo, Gmail, Hotmail, etc, and not from an official Otsuka email address. Please take extra caution while examining such an email address, as the scammers may misspell an official Otsuka email address and use a slightly modified version duplicating letters. To ensure that you are communicating about a legitimate job opportunity at Otsuka, please only deal directly with Otsuka through its official Otsuka Career website ******************************************************* . Otsuka will not be held liable or responsible for any claims, losses, damages or expenses resulting from job recruiting scams. If you suspect a position is fraudulent, please contact Otsuka's call center at: ************. If you believe you are the victim of fraud resulting from a job recruiting scam, please contact the FBI through the Internet Crime Complaint Center at: ******************* , or your local authorities. Otsuka America Pharmaceutical Inc., Otsuka Pharmaceutical Development & Commercialization, Inc., and Otsuka Precision Health, Inc. ("Otsuka") does not accept unsolicited assistance from search firms for employment opportunities. All CVs/resumes submitted by search firms to any Otsuka employee directly or through Otsuka's application portal without a valid written search agreement in place for the position will be considered Otsuka's sole property. No fee will be paid if a candidate is hired by Otsuka as a result of an agency referral where no pre-existing agreement is in place. Where agency agreements are in place, introductions are position specific. Please, no phone calls or emails.

When you join the team at Unum, you become part of an organization committed to helping you thrive. Here, we work to provide the employee benefits and service solutions that enable employees at our client companies to thrive throughout life's moments. And this starts with ensuring that every one of our team members enjoys opportunities to succeed both professionally and personally. To enable this, we provide: + Award-winning culture + Inclusion and diversity as a priority + Performance Based Incentive Plans + Competitive benefits package that includes: Health, Vision, Dental, Short & Long-Term Disability + Generous PTO (including paid time to volunteer!) + Up to 9.5% 401(k) employer contribution + Mental health support + Career advancement opportunities + Student loan repayment options + Tuition reimbursement + Flexible work environments **_*All the benefits listed above are subject to the terms of their individual Plans_** **.** And that's just the beginning... With 10,000 employees helping more than 39 million people worldwide, every role at Unum is meaningful and impacts the lives of our customers. Whether you're directly supporting a growing family, or developing online tools to help navigate a difficult loss, customers are counting on the combined talents of our entire team. Help us help others, and join Team Unum today! **General Summary:** This position is responsible for providing expert medical analysis of claims files (or underwriting applications) across Unum US product lines. The incumbent provides high quality, timely, and efficient medical consultative services to the Benefits Center. The Medical Consultant adheres to current regulatory, claim process, and internal workflow standards as set forth in the Benefits Center Claims Manual, underwriting manual, and associated documentation. The incumbent adheres to accepted norms of medical practices and Code of Conduct guidelines. Physicians and psychologists conduct their reviews and analyses within appropriate ethical standards and maintain their professional licenses and Board certifications. This role is expected to provide excellent customer service and to interact on a regular basis with business partners, health care providers, and other specialized resources. **Principal Duties and Responsibilities** + Provide timely, clear medical direction and opinions to team partners, with reasoned forensic analysis to support the medical opinions + Partner/consult with fellow medical consultants when appropriate to ensure the completion of a whole person analysis + Apply medical knowledge to determine functional capacity through assessment of medical and other data related to impairment, regarding accuracy of diagnoses, treatment plans, duration guidelines, and prognosis + Provide relevant medical education and knowledge to others in terms appropriate and understandable to the intended audience + Perform telephone contacts with the insured's healthcare providers to gather medical information and to facilitate a better understanding of the claimant's functional abilities + Make timely and appropriate referrals for second opinion reviews when appropriate or required according to current guidelines and best practices + Demonstrate ability to manage and complete high volumes of assigned work, maintain consistently good turnaround times, and operate with a sense of urgency + Focus not only on individual workload, but on the team/group work volumes to ensure organizational success + Receive feedback and follow through with appropriate behaviors/actions + Perform other duties as assigned **Job Specifications** + Professional Degree (MD, DO, PhD, PsyD) + Active, unrestricted US medical license + Board certification required for physicians in their area of specialty + Minimum of five years of clinical experience in medical specialty + Strong team and collaborative skills. Ability to work in a fast paced, team based, corporate environment + Ability to mentor others and to give and receive constructive, behaviorally based feedback with peers and partners Unum and Colonial Life are part of Unum Group, a Fortune 500 company and leading provider of employee benefits to companies worldwide. Headquartered in Chattanooga, TN, with international offices in Ireland, Poland and the UK, Unum also has significant operations in Portland, ME, and Baton Rouge, LA - plus over 35 US field offices. Colonial Life is headquartered in Columbia, SC, with over 40 field offices nationwide. Unum is an equal opportunity employer, considering all qualified applicants and employees for hiring, placement, and advancement, without regard to a person's race, color, religion, national origin, age, genetic information, military status, gender, sexual orientation, gender identity or expression, disability, or protected veteran status. The base salary range for applicants for this position is listed below. Unless actual salary is indicated above in the job description, actual pay will be based on skill, geographical location and experience. $133,500.00-$274,100.00 Additionally, Unum offers a portfolio of benefits and rewards that are competitive and comprehensive including healthcare benefits (health, vision, dental), insurance benefits (short & long-term disability), performance-based incentive plans, paid time off, and a 401(k) retirement plan with an employer match up to 5% and an additional 4.5% contribution whether you contribute to the plan or not. All benefits are subject to the terms and conditions of individual Plans. Company: Unum

Supervises and coordinates patient care services of one or more nursing units on a 24-hour basis. The Dir, Nursing ensures that physicians' orders are followed; ensures that patient conditions and progress are accurately reported; ensures that patient care is administered by all professional and nonprofessional personnel in the unit according to organization and regulatory policies and guidelines; and has staffing and budget control responsibilities for the unit. Education - Bachelors of Science in Nursing from an accredited school of nursing Licensure: Current licensure in good standing in the state of Mississippi; Current BLS required. ACLS preferred. 1. Leadership a. Utilizes advanced clinical knowledge to develop and maintain a delivery system for individualized, appropriate, and compassionate patient care. Supports and encourages staff, patients, and significant others in the determination of treatment and rehabilitation goals for desired outcomes. Provides leadership and participates in emergency measures for sudden adverse patient developments. b. Provides leadership and demonstrates critical thinking ability in all areas of responsibility, treats all co-workers with respect, strives to enhance co-worker performance through cooperation and effective communication, and demonstrates hospitality and courtesy in all interactions. 2. Unit Management and Daily Operations a. Estimates future departmental personnel, equipment, and supply needs in order to ensure the attainment of operating goals. Develops, recommends, and implements the annual capital equipment, personnel, and operating budget for the department. Conducts periodic reviews of departmental performance, analyzes budget variances, and implements responsive action. b. Demonstrates clinical expertise in facilitating the timely availability, access, and utilization of multidisciplinary health care services, alternative levels of care, and community resources in a manner that ensures optimal continuity and expediency in the health care delivery process. c. Implements strategies that use current scientific knowledge to prevent and reduce the risk of infection transmission. Promptly and appropriately reports infections between and among staff, patients, and visitors in order to improve patient outcomes. d. Consults with nursing management, nursing staff, and Clinical Nurse Specialists in the development of instructional materials for patients and family members which will provide the specific knowledge and skill required to increase their understanding of the patient's illness, meet the patient's ongoing health care needs, and improve patient health outcomes. e. Develops and maintains documentation required for successful employee development and administrative and divisional communication. Supervises and participates in the efficient recording of pertinent patient care data utilizing the computerized medical record and manual documentation in order to promote timely and efficient access to required information throughout the organization. Preserves the confidentiality of data and information identified as sensitive in order to ensure the protection of patient dignity and privacy. f. Monitors and coordinates the effective use, maintenance, and repair of equipment, supplies, facilities, and resources that support patient care in order to maintain a functional and safe environment for patients, staff, and visitors. g. Maintains own clinical expertise and ensures the demonstrated clinical competency of staff members to deliver patient care services in accordance with the specific identified needs of adult and geriatric patients. Utilizes appropriate resources as needed for assistance in the planning and delivery of care to infant, pediatric, and adolescent patients. 3. Performance Improvement and Quality a. Provides ongoing assessments of the patient care delivery system in order to identify existing and potential health care needs within the scope of care for the unit. Evaluates and makes recommendations for current and potential unit staffing needs, assesses and introduces technological and procedural changes that enhance the efficiency and quality of patient care services and outcomes, and supervises the ongoing assessment of patients for physical, psychological, and social status needs and discharge planning. b. Coordinates and manages high quality health care services that recognize individual patient rights while acting as a role model for the nursing personnel. Educates staff and monitors care delivery in order to ensure that patients exercise their rights to be informed and to participate and make decisions in all aspects of their medical care. Ensures that patient care demonstrates respect for personal values and beliefs and is focused on the unique needs of each individual and their family. c. Utilizes continued analysis and evaluation of patient care outcomes to enhance the quality and efficiency of services and optimize the utilization of hospital resources. Participates actively in unit-specific and multidisciplinary continuous quality improvement and quality assurance studies in a manner that promotes compliance with hospital and divisional regulations and standards. d. Ensures that all staff members are oriented and continuously educated regarding their roles in sustaining and improving the overall environment. Assesses the learning and development needs of staff members and is responsible for the provision of appropriate educational services. e. Establishes departmental standards for the evaluation of personnel performance and monitors the performance of reporting personnel. Promotes and encourages the growth and development of staff members by encouraging their participation in approved continuing education activities such as professional conferences, seminars, and workshops. Advocates continuing education as a means of promoting the high quality services provided by all departmental personnel. f. Observes and adheres to all departmental and hospital policies and procedures, and follows all safety, quality assurance, and infection control standards. 4. Other Duties As Assigned a. Performs other duties as assigned or requested.

Supervises and coordinates patient care services of one or more nursing units on a 24-hour basis. The Dir, Nursing ensures that physicians' orders are followed; ensures that patient conditions and progress are accurately reported; ensures that patient care is administered by all professional and nonprofessional personnel in the unit according to organization and regulatory policies and guidelines; and has staffing and budget control responsibilities for the unit. Education - Bachelors of Science in Nursing from an accredited school of nursing Licensure: Current licensure in good standing in the state of Mississippi; Current BLS required. ACLS preferred. 1. Leadership a. Utilizes advanced clinical knowledge to develop and maintain a delivery system for individualized, appropriate, and compassionate patient care. Supports and encourages staff, patients, and significant others in the determination of treatment and rehabilitation goals for desired outcomes. Provides leadership and participates in emergency measures for sudden adverse patient developments. b. Provides leadership and demonstrates critical thinking ability in all areas of responsibility, treats all co-workers with respect, strives to enhance co-worker performance through cooperation and effective communication, and demonstrates hospitality and courtesy in all interactions. 2. Unit Management and Daily Operations a. Estimates future departmental personnel, equipment, and supply needs in order to ensure the attainment of operating goals. Develops, recommends, and implements the annual capital equipment, personnel, and operating budget for the department. Conducts periodic reviews of departmental performance, analyzes budget variances, and implements responsive action. b. Demonstrates clinical expertise in facilitating the timely availability, access, and utilization of multidisciplinary health care services, alternative levels of care, and community resources in a manner that ensures optimal continuity and expediency in the health care delivery process. c. Implements strategies that use current scientific knowledge to prevent and reduce the risk of infection transmission. Promptly and appropriately reports infections between and among staff, patients, and visitors in order to improve patient outcomes. d. Consults with nursing management, nursing staff, and Clinical Nurse Specialists in the development of instructional materials for patients and family members which will provide the specific knowledge and skill required to increase their understanding of the patient's illness, meet the patient's ongoing health care needs, and improve patient health outcomes. e. Develops and maintains documentation required for successful employee development and administrative and divisional communication. Supervises and participates in the efficient recording of pertinent patient care data utilizing the computerized medical record and manual documentation in order to promote timely and efficient access to required information throughout the organization. Preserves the confidentiality of data and information identified as sensitive in order to ensure the protection of patient dignity and privacy. f. Monitors and coordinates the effective use, maintenance, and repair of equipment, supplies, facilities, and resources that support patient care in order to maintain a functional and safe environment for patients, staff, and visitors. g. Maintains own clinical expertise and ensures the demonstrated clinical competency of staff members to deliver patient care services in accordance with the specific identified needs of adult and geriatric patients. Utilizes appropriate resources as needed for assistance in the planning and delivery of care to infant, pediatric, and adolescent patients. 3. Performance Improvement and Quality a. Provides ongoing assessments of the patient care delivery system in order to identify existing and potential health care needs within the scope of care for the unit. Evaluates and makes recommendations for current and potential unit staffing needs, assesses and introduces technological and procedural changes that enhance the efficiency and quality of patient care services and outcomes, and supervises the ongoing assessment of patients for physical, psychological, and social status needs and discharge planning. b. Coordinates and manages high quality health care services that recognize individual patient rights while acting as a role model for the nursing personnel. Educates staff and monitors care delivery in order to ensure that patients exercise their rights to be informed and to participate and make decisions in all aspects of their medical care. Ensures that patient care demonstrates respect for personal values and beliefs and is focused on the unique needs of each individual and their family. c. Utilizes continued analysis and evaluation of patient care outcomes to enhance the quality and efficiency of services and optimize the utilization of hospital resources. Participates actively in unit-specific and multidisciplinary continuous quality improvement and quality assurance studies in a manner that promotes compliance with hospital and divisional regulations and standards. d. Ensures that all staff members are oriented and continuously educated regarding their roles in sustaining and improving the overall environment. Assesses the learning and development needs of staff members and is responsible for the provision of appropriate educational services. e. Establishes departmental standards for the evaluation of personnel performance and monitors the performance of reporting personnel. Promotes and encourages the growth and development of staff members by encouraging their participation in approved continuing education activities such as professional conferences, seminars, and workshops. Advocates continuing education as a means of promoting the high quality services provided by all departmental personnel. f. Observes and adheres to all departmental and hospital policies and procedures, and follows all safety, quality assurance, and infection control standards. 4. Other Duties As Assigned a. Performs other duties as assigned or requested.

Supervises and coordinates patient care services of one or more nursing units on a 24-hour basis. The Dir, Nursing ensures that physicians' orders are followed; ensures that patient conditions and progress are accurately reported; ensures that patient care is administered by all professional and nonprofessional personnel in the unit according to organization and regulatory policies and guidelines; and has staffing and budget control responsibilities for the unit. Responsibilities 1. Leadership a. Utilizes advanced clinical knowledge to develop and maintain a delivery system for individualized, appropriate, and compassionate patient care. Supports and encourages staff, patients, and significant others in the determination of treatment and rehabilitation goals for desired outcomes. Provides leadership and participates in emergency measures for sudden adverse patient developments. b. Provides leadership and demonstrates critical thinking ability in all areas of responsibility, treats all co-workers with respect, strives to enhance co-worker performance through cooperation and effective communication, and demonstrates hospitality and courtesy in all interactions. 2. Unit Management and Daily Operations a. Estimates future departmental personnel, equipment, and supply needs in order to ensure the attainment of operating goals. Develops, recommends, and implements the annual capital equipment, personnel, and operating budget for the department. Conducts periodic reviews of departmental performance, analyzes budget variances, and implements responsive action. b. Demonstrates clinical expertise in facilitating the timely availability, access, and utilization of multidisciplinary health care services, alternative levels of care, and community resources in a manner that ensures optimal continuity and expediency in the health care delivery process. c. Implements strategies that use current scientific knowledge to prevent and reduce the risk of infection transmission. Promptly and appropriately reports infections between and among staff, patients, and visitors in order to improve patient outcomes. d. Consults with nursing management, nursing staff, and Clinical Nurse Specialists in the development of instructional materials for patients and family members which will provide the specific knowledge and skill required to increase their understanding of the patient's illness, meet the patient's ongoing health care needs, and improve patient health outcomes. e. Develops and maintains documentation required for successful employee development and administrative and divisional communication. Supervises and participates in the efficient recording of pertinent patient care data utilizing the computerized medical record and manual documentation in order to promote timely and efficient access to required information throughout the organization. Preserves the confidentiality of data and information identified as sensitive in order to ensure the protection of patient dignity and privacy. f. Monitors and coordinates the effective use, maintenance, and repair of equipment, supplies, facilities, and resources that support patient care in order to maintain a functional and safe environment for patients, staff, and visitors. g. Maintains own clinical expertise and ensures the demonstrated clinical competency of staff members to deliver patient care services in accordance with the specific identified needs of adult and geriatric patients. Utilizes appropriate resources as needed for assistance in the planning and delivery of care to infant, pediatric, and adolescent patients. 3. Performance Improvement and Quality a. Provides ongoing assessments of the patient care delivery system in order to identify existing and potential health care needs within the scope of care for the unit. Evaluates and makes recommendations for current and potential unit staffing needs, assesses and introduces technological and procedural changes that enhance the efficiency and quality of patient care services and outcomes, and supervises the ongoing assessment of patients for physical, psychological, and social status needs and discharge planning. b. Coordinates and manages high quality health care services that recognize individual patient rights while acting as a role model for the nursing personnel. Educates staff and monitors care delivery in order to ensure that patients exercise their rights to be informed and to participate and make decisions in all aspects of their medical care. Ensures that patient care demonstrates respect for personal values and beliefs and is focused on the unique needs of each individual and their family. c. Utilizes continued analysis and evaluation of patient care outcomes to enhance the quality and efficiency of services and optimize the utilization of hospital resources. Participates actively in unit-specific and multidisciplinary continuous quality improvement and quality assurance studies in a manner that promotes compliance with hospital and divisional regulations and standards. d. Ensures that all staff members are oriented and continuously educated regarding their roles in sustaining and improving the overall environment. Assesses the learning and development needs of staff members and is responsible for the provision of appropriate educational services. e. Establishes departmental standards for the evaluation of personnel performance and monitors the performance of reporting personnel. Promotes and encourages the growth and development of staff members by encouraging their participation in approved continuing education activities such as professional conferences, seminars, and workshops. Advocates continuing education as a means of promoting the high quality services provided by all departmental personnel. f. Observes and adheres to all departmental and hospital policies and procedures, and follows all safety, quality assurance, and infection control standards. 4. Other Duties As Assigned a. Performs other duties as assigned or requested. Qualifications Education - Bachelors of Science in Nursing from an accredited school of nursing Licensure: Current licensure in good standing in the state of Mississippi; Current BLS required. ACLS preferred.