84 Medical Assistants jobs in Grand Ronde

Description
We are seeking a dedicated and organized Medical Scheduler to join our team in a dynamic healthcare setting. This role plays a critical part in ensuring smooth operations by efficiently coordinating and scheduling appointments and procedures for patients. If you excel in organization, communication, and enjoy assisting others, we'd love to hear from you!
Key Responsibilities
+ Coordinate and schedule medical appointments, follow-ups, and procedures to support patient care.
+ Communicate effectively with patients, healthcare providers, and team members to confirm or adjust appointment details.
+ Update and maintain accurate patient records using scheduling or electronic medical record systems.
+ Resolve scheduling conflicts and address patient inquiries with professionalism and a customer-focused mindset.
Requirements
Qualifications
+ Previous experience in medical scheduling or healthcare administration preferred.
+ Familiarity with medical terminology and scheduling software (experience with EMR systems is a plus).
+ Strong organizational skills with the ability to handle multiple tasks in a fast-paced environment.
+ Excellent written and verbal communication skills.
+ Attention to detail and the ability to maintain confidentiality.
TalentMatch®
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All applicants applying for U.S. job openings must be legally authorized to work in the United States. Benefits are available to contract/temporary professionals, including medical, vision, dental, and life and disability insurance. Hired contract/temporary professionals are also eligible to enroll in our company 401(k) plan. Visit roberthalf.gobenefits.net for more information.
© 2025 Robert Half. An Equal Opportunity Employer. M/F/Disability/Veterans. By clicking "Apply Now," you're agreeing to Robert Half's Terms of Use ( .

**Company :**
Highmark Inc.
**Job Description :**
**JOB SUMMARY**
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: J266916

Join Our Team as an RN in the Medical Surgical Unit!

Location: Providence Newberg Medical Center

Position: .9 FTE Night Shift (7 PM - 7:30 AM, 3 shifts per week with rotating weekends)

Why Choose Providence?

At Providence, we believe that our nurses are not just valued—they're invaluable. Join us in a culture that prioritizes patient-focused, whole-person care, built on understanding, commitment, and mutual respect. Your voice matters here, and we empower our nurses to inspire and retain the best talent.

Exciting Incentives Await You!

• Night Shift Differential: Earn an additional $10 per hour!
• Hiring Bonus: Eligible external hires can receive a $,000 bonus!
• Relocation Assistance: Available for eligible external hires.

Comprehensive Benefits Package

We offer a fantastic benefits package designed to support your well-being and professional growth:

• Free Parking: Convenient and ample parking for all staff.
• TriMet Annual Pass: For eligible staff working within the Portland Service Area.
• Medical Plan Assistance: Free or reduced-cost coverage for caregivers and eligible dependents.
• Tuition Reimbursement: Up to 5,250 per year for select degrees, with 100% coverage for required books and fees.
• Generous Paid Time Off: Enjoy ample PTO accrual allowances.
• Retirement Savings: Employer matching and discretionary contributions to help you save for your future.
• Lyra Caregiver Assistance: Access to up to 25 counseling or coaching sessions per year.

Your Role and Responsibilities

As an RN in our Medical Surgical Unit, you will:

• Deliver exceptional patient care with compassion and expertise.
• Collaborate with a dedicated team of healthcare professionals.
• Utilize your specialized training to make a meaningful impact on patients' lives.

Required Qualifications

• Graduation from an accredited nursing program.
• Oregon Registered Nurse License upon hire.
• National Provider BLS certification from the American Heart Association upon hire.
• At least 1 year of nursing experience.

Working Conditions

This position is full-time, on-site, and requires night shifts. You will be part of a supportive team that values your contributions and encourages your growth.

About Providence

With a legacy dating back to 1856, Providence is the largest healthcare system and private employer in Oregon. We are committed to serving our communities with compassion and excellence, providing a full spectrum of care across various specialties.

Join Us!

Become part of a team that is dedicated to caring for everyone, especially the most vulnerable. At Providence, we support you in your career journey, ensuring you can focus on delivering exceptional care.

Pay Range: 54.58 - 75.37 (Base pay; additional compensation may be available)

Providence is proud to be an Equal Opportunity Employer, committed to creating an inclusive workforce where diversity is valued and everyone is respected.

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 its team of skilled Physicians focusing on Internal Medicine, Family Practice, Occupational Medicine, and Physical Medicine and Rehabilitation.
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

Description
Join Amazon's mission to become Earth's safest place to work! At Amazon, we've set the ambitious goal to become the benchmark of safety excellence across all industries in which we operate. The Amazon Workplace Health & Safety (WHS) team sets the strategic direction to provide resources, best practices, and safe environments to proactively manage the health and wellbeing of our workforce. To support these goals, Amazon is seeking an experienced and dynamic Onsite Medical Representative (OMR) to join our team. In this position, you will work closely with the WHS Site Manager, WHS Specialist, and occasionally the Injury Prevention Specialist (IPS). This includes attending weekly associate safety committee meetings, greeting all new hires for the site or through daily one-on-one interaction. Additionally, the OMR will participate in weekly case management review meetings as necessary. As an OMR, you will independently assess and administer first aid as well as offer guidance to Amazon Associates (AAs) on both occupational and non-occupational injuries or illnesses. You should be passionate about learning and advocating health and wellness principles to consistently support AAs on a daily basis. You will refer care to outside medical providers as needed, and learn about OSHA regulations, risk, and analysis. The OMR will function as a part of the larger team onsite, assisting with all first aid needs and support safety operations as needed.
Responsibilities include but are not limited to:
- Provide first aid support and make referrals to outside medical providers as necessary.
- Minimize the AA risk of injury through awareness, education, and proactive engagement.
- Maintain all records of care provided to AAs.
- Coordinate and maintain the workers' compensation and return to work programs for AAs with work-related injuries.
- Provide daily activity logs and end of shift reports.
- Engage with AAs and leadership on operations floor to provide coaching regarding observed at-risk work habits.
- Maintain a clean working environment and ensure appropriate medical supply inventory is maintained.
- Participate in training and certification to facilitate first aid, CPR and AED certifications classes.
- Maintain all first aid, CPR, AED credentials.
- Work flexible shifts which could include days, nights, holidays, and/or weekends.
- Assist with random saliva drug testing protocols.
- Maintain effective care delivery in emergencies and assist emergency response at the site.
Additional Job Elements include:
- Lift up to 49 pounds and frequently push, pull, squat, bend, and reach
- Stand/walk for up to 12 hours during shifts
- Work in an environment where the noise level varies
- Work in an environment that is subject to variable temperatures and weather (delivery stations include outside loading departments)
- Continuously climb and descend stairs (applies to sites with stairs)
For those that do not have an adult First Aid, CPR, AED certification from the American Heart Association or American Red Cross, must obtain within 3 weeks of start date.
Basic Qualifications
- High school or equivalent diploma
- Current valid Basic Life Support (BLS) certification by an approved emergency cardiac care (ECC) provider; AND must have one of the following:
- Current valid Emergency Medical Technician (EMT) OR Paramedic Certification from the Department of Health OR the National Registry of Emergency Medical Technicians (NREMT); OR
- In the last year, six months job experience in the Military as a Combat Medic (U.S. Army), Field Medic (U.S. Army), Healthcare Specialist (U.S. Army), Hospital Corpsman (U.S. Navy), or Aerospace Medical Service Technician (U.S. Air Force); OR
- Current active Athletic Trainer Certification, by either the Board of Certification (BOC) or equivalent State Certification.
Preferred Qualifications
- Certified to teach first aid, CPR, and AED training from American Heart Association or American Red Cross
- Proficient in Microsoft Office
- Experience with an industrial wellness program
- Experience managing musculoskeletal disorders, ergonomics, and coaching on body mechanics
- Demonstrated work experience with OSHA regulations and Workers Compensation
- Proficient in digital recordkeeping
Amazon is an equal opportunity employer and does not discriminate on the basis of protected veteran status, disability, or other legally protected status.
Our inclusive culture empowers Amazonians to deliver the best results for our customers. If you have a disability and need a workplace accommodation or adjustment during the application and hiring process, including support for the interview or onboarding process, please visit for more information. If the country/region you're applying in isn't listed, please contact your Recruiting Partner.
Our compensation reflects the cost of labor across several US geographic markets. The base pay for this position ranges from $46,900/year in our lowest geographic market up to $71,000/year in our highest geographic market. Pay is based on a number of factors including market location and may vary depending on job-related knowledge, skills, and experience. Amazon is a total compensation company. Dependent on the position offered, equity, sign-on payments, and other forms of compensation may be provided as part of a total compensation package, in addition to a full range of medical, financial, and/or other benefits. For more information, please visit . This position will remain posted until filled. Applicants should apply via our internal or external career site.

Sr. Medical Analyst
Company: MMIT
Location: Remote, United States
Date Posted: Jul 30, 2025
Employment Type: Full Time
Job ID: R-1370
**Description**
**Why Norstella?**
At Norstella, we are on a mission to help our clients bring life-saving therapies to market faster and support patients in need. We are seeking a Senior Medical Analyst to join our team and drive data-driven healthcare initiatives.
In this role, you will leverage your expertise in healthcare data analytics to extract meaningful insights from real-world data (RWD) sources, including claims, laboratory results, billing codes, and electronic health records (EHRs). You will be responsible for translating clinical and medical data requests into structured queries, ensuring that extracted data aligns with research, regulatory, and business objectives.
This role is critical in ensuring our clients receive accurate, clinically relevant, and actionable insights to drive data-informed decisions in drug development, market access, and patient care strategies.
**Responsibilities:**
+ Analyze healthcare datasets to identify trends, patient cohorts, and treatment pathways that support Life Sciences clients across therapeutic areas such as oncology, rare diseases, and immunology.
+ Collaborate with data science and engineering teams to develop and refine database queries, data pipelines, and processing workflows, incorporating AI/ML methodologies for advanced analytics.
+ Partner with engagement managers and directors to ensure the accurate representation of clinical concepts within the data and align insights with client needs.
+ Monitor and troubleshoot data quality issues, ensuring the integrity and reliability of insights provided to clients while adhering to regulatory requirements such as HIPAA, GDPR, and FDA RWE guidance.
+ Support client engagements by participating in scoping discussions and helping design custom RWD solutions that address key clinical, regulatory, and business questions.
+ And other duties as assigned.
**Qualifications:**
+ Advanced degree (Master's or Doctorate) in Biostatistics, Epidemiology, Public Health, Pharmacy (PharmD), Medicine (MD/DO), or a related field.
+ Experience working with and querying large healthcare databases, including claims, EMR/EHR, and laboratory data, in an academic or industry setting.
+ Strong understanding of the life sciences industry and the drug development lifecycle, with experience supporting research in clinical development, market access, or health economics and outcomes research (HEOR).
+ Familiarity with epidemiological study design and real-world evidence (RWE) methodologies.
+ Ability to work collaboratively with cross-functional teams, including AI and data science teams, as well as independently with minimal supervision.
+ Strong problem-solving and analytical skills, with attention to detail and the ability to interpret complex healthcare data.
**Our Guiding Principles for success at Norstella:**
01: Bold, Passionate, and Mission-First
02: Integrity, Truth, and Reality
03: Kindness, Empathy, and Grace
04: Resilience, Mettle, and Perseverance
05: Humility, Gratitude, and Learning
_Please Note: All candidates must be authorized to work in the United States. We do not provide visa sponsorship or transfers. We are not currently accepting candidates who are on an OPT visa_
**Benefits:**
+ Medical and Prescription Drug Benefits
+ Health Savings Accounts (HSA) or Flexible Spending Accounts (FSA)
+ Dental & Vision Benefits
+ Basic Life and AD&D Benefits
+ 401k Retirement Plan with Company Match
+ Company Paid Short & Long-Term Disability
+ Paid Parental Leave
+ Open Vacation Policy & Company Holidays
_The expected base salary for this position ranges from $100,000 to $110,000. It is not typical for offers to be made at or near the top of the range. Salary offers are based on a wide range of factors including relevant skills, training, experience, education, and, where applicable, licensure or certifications obtained. Market and organizational factors are also considered. In addition to base salary and a competitive benefits package, successful candidates are eligible to receive a discretionary bonus._
_Norstella is an equal opportunity employer. All job applicants will receive equal treatment regardless of race, creed, color, religion, alienage or national origin, ancestry, citizenship status, age, physical or mental disability or handicap, medical condition, sex (including pregnancy and pregnancy-related conditions), marital or domestic partner status, military or veteran status, gender, gender identity or expression, sexual orientation, genetic information, reproductive health decision making, or any other protected characteristic as established by federal, state, or local law._
_Sometimes the best opportunities are hidden by self-doubt. We disqualify ourselves before we have the opportunity to be considered. Regardless of where you came from, how you identify, or the path that led you here- you are welcome. If you read this job description and feel passion and excitement, we're just as excited about you._
_All legitimate roles with Norstella will be posted on Norstella's job board which is located at norstella.com/careers. If a role is not posted on this job board, a candidate should assume the role is not a legitimate role with Norstella. Norstella is not responsible for an application that may be submitted by or through a third-party and candidates should proceed with extreme caution if a third-party approaches them about an open role with Norstella. Norstella will never ask for anything of value or any type of payment during or as part of any recruitment, interview, or pre-hire onboarding process. If you are aware of or have reason to believe a job posting purportedly for a role with Norstella is fraudulent or otherwise not authorized by Norstella, please contact the Company using the following email address:_ _(email protected)_ _._
Norstella is an equal opportunity employer. All job applicants will receive equal treatment regardless of race, creed, color, religion, alienage or national origin, ancestry, citizenship status, age, physical or mental disability or handicap, medical condition, sex (including pregnancy and pregnancy-related conditions), marital or domestic partner status, military or veteran status, gender, gender identity or expression, sexual orientation, genetic information, reproductive health decision making, or any other protected characteristic as established by federal, state, or local law.

Sr. Medical Analyst
Company: MMIT
Location: Remote, United States
Date Posted: Jul 29, 2025
Employment Type: Full Time
Job ID: R-1344
**Description**
**Why MMIT?**
At MMIT, we simplify the complexities of healthcare to smooth access to life saving therapies. Our collective teams achieve this through prioritizing cultivating industry leading data coupled with cutting edge technology to solve some of healthcare's most complex challenges.
MMIT is regarded as a trusted go-to-market partner that identifies barriers to patient access and helps coordinate major stakeholders to move therapies from pipeline to prescription-answering the "what" of how payers cover therapies and the "why" behind those decisions. MMIT's product portfolio has been built by listening to our clients, and with expert teams of pharmacists, clinicians, data specialists and market researchers who provide foresight, clarity and confidence.
In 2022, MMIT joined forces with other market-leading pharmaceutical-solutions providers-Evaluate, Citeline, Panalgo and The Dedham Group-to launch Norstella, which aims to deliver must-have answers for critical strategic and commercial decision-making along the entire drug development journey.
**The Role:**
At Norstella, we are on a mission to help our clients bring life-saving therapies to market faster and support patients in need. We are seeking a Senior Medical Analyst to join our team and drive data-driven healthcare initiatives.
In this role, you will leverage your expertise in healthcare data analytics to extract meaningful insights from real-world data (RWD) sources, including claims, laboratory results, billing codes, and electronic health records (EHRs). You will be responsible for translating clinical and medical data requests into structured queries, ensuring that extracted data aligns with research, regulatory, and business objectives.
This role is critical in ensuring our clients receive accurate, clinically relevant, and actionable insights to drive data-informed decisions in drug development, market access, and patient care strategies.
**Responsibilities:**
+ Analyze healthcare datasets to identify trends, patient cohorts, and treatment pathways that support Life Sciences clients across therapeutic areas such as oncology, rare diseases, and immunology.
+ Collaborate with data science and engineering teams to develop and refine database queries, data pipelines, and processing workflows, incorporating AI/ML methodologies for advanced analytics.
+ Partner with engagement managers and directors to ensure the accurate representation of clinical concepts within the data and align insights with client needs.
+ Monitor and troubleshoot data quality issues, ensuring the integrity and reliability of insights provided to clients while adhering to regulatory requirements such as HIPAA, GDPR, and FDA RWE guidance.
+ Support client engagements by participating in scoping discussions and helping design custom RWD solutions that address key clinical, regulatory, and business questions.
+ And other duties as assigned.
**Qualifications:**
+ Advanced degree (Master's or Doctorate) in Biostatistics, Epidemiology, Public Health, Pharmacy (PharmD), Medicine (MD/DO), or a related field.
+ Experience working with and querying large healthcare databases, including claims, EMR/EHR, and laboratory data, in an academic or industry setting.
+ Strong understanding of the life sciences industry and the drug development lifecycle, with experience supporting research in clinical development, market access, or health economics and outcomes research (HEOR).
+ Familiarity with epidemiological study design and real-world evidence (RWE) methodologies.
+ Ability to work collaboratively with cross-functional teams, including AI and data science teams, as well as independently with minimal supervision.
+ Strong problem-solving and analytical skills, with attention to detail and the ability to interpret complex healthcare data.
**Our Guiding Principles for success at Norstella:**
01: Bold, Passionate, and Mission-First
02: Integrity, Truth, and Reality
03: Kindness, Empathy, and Grace
04: Resilience, Mettle, and Perseverance
05: Humility, Gratitude, and Learning
**Please Note:** All candidates must be authorized to work in the United States. We do not provide visa sponsorship or transfers. We are not currently accepting candidates who are on an OPT visa.
**Benefits:**
+ Medical and Prescription Drug Benefits
+ Health Savings Accounts (HSA) or Flexible Spending Accounts (FSA)
+ Dental & Vision Benefits
+ Basic Life and AD&D Benefits
+ 401k Retirement Plan with Company Match
+ Company Paid Short & Long-Term Disability
+ Paid Parental Leave
+ Paid Time Off & Company Holidays
_The expected base salary for this position ranges from $100,000 to $110,000. It is not typical for offers to be made at or near the top of the range. Salary offers are based on a wide range of factors including relevant skills, training, experience, education, and, where applicable, licensure or certifications obtained. Market and organizational factors are also considered. In addition to base salary and a competitive benefits package, successful candidates are eligible to receive a discretionary bonus._
_Norstella is an equal opportunity employer. All job applicants will receive equal treatment regardless of race, creed, color, religion, alienage or national origin, ancestry, citizenship status, age, physical or mental disability or handicap, medical condition, sex (including pregnancy and pregnancy-related conditions), marital or domestic partner status, military or veteran status, gender, gender identity or expression, sexual orientation, genetic information, reproductive health decision making, or any other protected characteristic as established by federal, state, or local law._
_Sometimes the best opportunities are hidden by self-doubt. We disqualify ourselves before we have the opportunity to be considered. Regardless of where you came from, how you identify, or the path that led you here- you are welcome. If you read this job description and feel passion and excitement, we're just as excited about you._
_All legitimate roles with Norstella will be posted on Norstella's job board which is located at norstella.com/careers. If a role is not posted on this job board, a candidate should assume the role is not a legitimate role with Norstella. Norstella is not responsible for an application that may be submitted by or through a third-party and candidates should proceed with extreme caution if a third-party approaches them about an open role with Norstella. Norstella will never ask for anything of value or any type of payment during or as part of any recruitment, interview, or pre-hire onboarding process. If you are aware of or have reason to believe a job posting purportedly for a role with Norstella is fraudulent or otherwise not authorized by Norstella, please contact the Company using the following email address:_ _(email protected)_ _._
Norstella is an equal opportunity employer. All job applicants will receive equal treatment regardless of race, creed, color, religion, alienage or national origin, ancestry, citizenship status, age, physical or mental disability or handicap, medical condition, sex (including pregnancy and pregnancy-related conditions), marital or domestic partner status, military or veteran status, gender, gender identity or expression, sexual orientation, genetic information, reproductive health decision making, or any other protected characteristic as established by federal, state, or local law.

**Become a part of our caring community and help us put health first**
The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.
The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized. All work occurs with a context of regulatory compliance, and work is assisted by diverse resources which may include national clinical guidelines, CMS policies and determinations, clinical reference materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements, and will understand how to operationalize this knowledge in their daily work.
The Medical Director's work includes computer based review of moderately complex to complex clinical scenarios, review of all submitted clinical records, prioritization of daily work, communication of decisions to internal associates, and possible participation in care management. The clinical scenarios predominantly arise from inpatient or post-acute care environments. Has discussions with external physicians by phone to gather additional clinical information or discuss determinations regularly, and in some instances these may require conflict resolution skills. Some roles include an overview of coding practices and clinical documentation, grievance and appeals processes, and outpatient services and equipment, within their scope.
The Medical Director may speak with contracted external physicians, physician groups, facilities, or community groups to support regional market priorities, which may include an understanding of Humana processes, as well as a focus on collaborative business relationships, value based care, population health, or disease or care management. Medical Directors support Humana values, and Humana's Bold Goal mission, throughout all activites.
**Use your skills to make an impact**
**Responsibilities**
The Medical Director provides medical interpretation and determinations whether services provided by other healthcare professionals are in agreement with national guidelines, CMS requirements, Humana policies, clinical standards, and (in some cases) contracts. The ideal candidate supports and collaborates with other team members, other departments, Humana colleagues and the Regional VP Health Services. After completion of mentored training, daily work is performed with minimal direction. Enjoys working in a structured environment with expectations for consistency in thinking and authorship. Exercises independence in meeting departmental expectations, and meets compliance timelines. Supports the assigned work with respect to market-wide objectives (e.g. Bold Goal) and community relations as directed.
**Required Qualifications**
+ MD or DO degree
+ 5+ years of direct clinical patient care experience post residency or fellowship, which preferably includes some experience in an inpatient environment and/or related to care of a Medicare type population (disabled or >65 years of age).
+ Current and ongoing Board Certification an approved ABMS Medical Specialty
+ A current and unrestricted license in at least one jurisdiction and willing to obtain additional license, if required.
+ No current sanction from Federal or State Governmental organizations, and able to pass credentialing requirements.
+ Excellent verbal and written communication skills.
+ Evidence of analytic and interpretation skills, with prior experience participating in teams focusing on quality management, utilization management, case management, discharge planning and/or home health or post-acute services such as inpatient rehabilitation.
**Preferred Qualifications**
+ Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management.
+ Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance.
+ Experience with national guidelines such as MCG® or InterQual
+ Internal Medicine, Family Practice, Geriatrics, Hospitalist, Emergency Medicine clinical specialists
+ Advanced degree such as an MBA, MHA, MPH
+ Exposure to Public Health, Population Health, analytics, and use of business metrics.
+ Experience working with Case managers or Care managers on complex case management, including familiarity with social determinants of health.
+ The curiosity to learn, the flexibility to adapt and the courage to innovate
**Additional Information**
Typically reports to a Regional Vice President of Health Services, Lead, or Corporate Medical Director, depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an assigned market, member population, or condition type. May also engage in grievance and appeals reviews. May participate on project teams or organizational committees.
#physiciancareers
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.
$223,800 - $313,100 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: 08-10-2025
**About us**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
**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.
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

**Who Are We?**
Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 160 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it.
**Job Category**
Claim
**Compensation Overview**
The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards.
**Salary Range**
$255,800.00 - $393,400.00
**Target Openings**
1
**What Is the Opportunity?**
Lead the strategy and operations of Travelers Claim Medical initiatives focusing on how developments in the broader medical environment impact Property & Casualty product lines. This role will serve as a thought leader and help develop the following critical areas for Travelers: Develop strategies and direction to advance Travelers medical capabilities to keep Travelers at the leading edge of the P&C industry. Develop medical management strategies that help injured employees return to work as soon as medically appropriate. Ensure Travelers is prepared to incorporate new and emerging medical technology and practices into its strategies, practices and workflow where appropriate. Conduct research and analysis related to medical and healthcare trends. This includes the physical and psychological influences which can impact claim outcomes. Organize and coordinate Travelers' medical review functions. This includes interpreting Federal and State regulations and medical guidelines to establish medical review policies. Works in close collaboration with the Claim leaders and in partnership with other Medical and Pharmacy professionals.
**What Will You Do?**
+ Provide overall program leadership as the organization's lead physician. Serve as the key enabler and facilitator for the Travelers medical strategies and represent the Travelers brand both internally and externally.
+ This position will oversee the following key areas:
+ Medical Claim Product Research, Strategy and Innovation:
+ Design and direct innovative, outcome focused strategies and business plans for medical related product development and enhancements. Strategies may influence design, marketing, best practices, system development, vendor management, policies and procedures and response to legislative and regulatory issues.
+ Conduct industry research and analysis related to medical, healthcare and group health trends and practices to keep Travelers at the leading edge of the P&C industry.
+ Partner with stakeholders to develop and design projects and proofs of concept to improve business results.
+ Stay connected to industry and relevant external bodies/associations to assess trends and coordinate Travelers medical position as appropriate.
+ Inform Product and Underwriting insights as appropriate to anticipate, respond to and manage trends.
+ Attend external forums representing Travelers. Function as a liaison and professional relations contact on a local and national level.
+ May provide input and support medical vendor strategies including vendor selection, negotiation and contracting.
+ Medical Direction and Oversight:
+ Participate in the design and development of organizational design and workflows that ensure effective implementation of medical strategies.
+ Oversee engagement of Regional Medical Directors, Medical Consortiums and other medical resources as appropriate. Train and evaluate physician and non-physician medical review personnel and activities.
+ Stay apprised of changes in medical technology and adjust review organizational design and workflows functions accordingly.
+ Interpret regulations, statutes and guidelines to establish medical policies as necessary.
+ Provide input into the investigation of new technology and the application for improving business process and increasing productivity.
+ Claim Practices & Support:
+ Provide Medical guidance, support and direction as needed to the Claim Field organization.
+ Provide input into to claim practices, marketing strategy and customer services as appropriate to anticipate, respond to and manage medical trends.
+ Partner with key stakeholders to assist in the review and monitoring of financial and qualitative operating results related to medical. Share accountability with business partners to achieve and sustain quality results.
+ Partner with other medical and pharmacy experts on the development and design of training strategies, programs and curriculum.
+ Perform other duties as assigned.
**What Will Our Ideal Candidate Have?**
+ Understanding of healthcare systems including Hospital Services, Pharmacy and Group Health insurance
+ Strong background in Occupational Medicine
+ Background in pain management or orthopedics a plus
+ Understanding of the psychological factors in achieving optimal medical outcomes a plus
+ Experience leading major projects or transformational initiatives from inception through implementation
+ Management experience preferred
+ Proven ability to work in a team environment and collaborate on innovative projects
+ Demonstrated thought leadership
+ Strong research and project management skills
+ Ability to analyze business problems thoughtfully and draw conclusions in uncertain situations
+ Ability to communicate complex issues and connect with all levels of the organization
+ Direct and/or indirect leadership skills
+ Financial management and analysis skills
**What is a Must Have?**
+ Licensed MD
+ 5 years clinical and utilization management experience
+ Certified by the American Board of Medical Specialties
**What Is in It for You?**
+ **Health Insurance** : Employees and their eligible family members - including spouses, domestic partners, and children - are eligible for coverage from the first day of employment.
+ **Retirement:** Travelers matches your 401(k) contributions dollar-for-dollar up to your first 5% of eligible pay, subject to an annual maximum. If you have student loan debt, you can enroll in the Paying it Forward Savings Program. When you make a payment toward your student loan, Travelers will make an annual contribution into your 401(k) account. You are also eligible for a Pension Plan that is 100% funded by Travelers.
+ **Paid Time Off:** Start your career at Travelers with a minimum of 20 days Paid Time Off annually, plus nine paid company Holidays.
+ **Wellness Program:** The Travelers wellness program is comprised of tools, discounts and resources that empower you to achieve your wellness goals and caregiving needs. In addition, our mental health program provides access to free professional counseling services, health coaching and other resources to support your daily life needs.
+ **Volunteer Encouragement:** We have a deep commitment to the communities we serve and encourage our employees to get involved. Travelers has a Matching Gift and Volunteer Rewards program that enables you to give back to the charity of your choice.
**Employment Practices**
Travelers is an equal opportunity employer. We value the unique abilities and talents each individual brings to our organization and recognize that we benefit in numerous ways from our differences.
In accordance with local law, candidates seeking employment in Colorado are not required to disclose dates of attendance at or graduation from educational institutions.
If you are a candidate and have specific questions regarding the physical requirements of this role, please send us an email ( ) so we may assist you.
Travelers reserves the right to fill this position at a level above or below the level included in this posting.
To learn more about our comprehensive benefit programs please visit .