19 general medicine jobs found

Reference #: 431221 Site Name: UK - London - New Oxford Street, UK - Hertfordshire - Stevenage, USA - Pennsylvania - Upper Providence Posted Date: Dec 12 2025 Director, R&D DT Priority Program Management Business Introduction GSK remains committed to achieving bold commercial ambitions for the future. By 2031, we aim to deliver 40 billion in annual sales, leveraging our existing strong performance momentum to significantly increase our positive impact on the health of billions of patients globally. Our Ahead Together strategy is centred on early intervention to prevent and alter the course of disease, thereby protecting people and supporting healthcare systems. Our diverse portfolio consists of vaccines, specialty medicines, and general medicines. Through continuous innovation and a dedicated focus on scientific and technical excellence, we strive to develop and launch new, groundbreaking treatments that address critical health challenges. Position Summary You...

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...

Become a part of our caring community and help us put health first Encounter Data Management Professional is responsible for ensuring accurate submission and reconciliation of encounter data to Medicaid and Medicare through effective business processes. Ensures claims submissions meet or exceed all compliance standards via analysis of data and develops tools to enhance the encounter acceptance rate by Medicaid/Medicare. Looks for long-term improvements of claims submission processes. Takes ownership by applying professional standards, regulations, and strategies within their work area. Independently sets priorities and makes decisions on work approach while following established direction. Work is managed and often guided by precedent and/or documented procedures/regulations/professional standards with some interpretation. Humana's Encounter Data Management (EDM) team is seeking an Encounter Data Management Professional that has experience with business processing and data...

Reference #: 432550 Site Name: UK - Hertfordshire - Stevenage, GSK HQ, Mississauga, USA - Pennsylvania - Upper Providence, Wavre Posted Date: Dec 17 2025 GSK's success absolutely depends on our people. While getting ahead of disease together is about our ambition for patients and shareholders, it's also about making GSK a place where people can thrive. We want GSK to be a place where people feel inspired, encouraged and challenged to be the best they can be. A place where they can be themselves - feeling welcome, valued and included. Where they can keep growing and look after their wellbeing. So, if you share our ambition, join us at this exciting moment in our journey to get Ahead Together. Job Purpose: The Director Process Management will be accountable for overseeing and optimizing Risk-based Quality Management processes within Global Clinical Operations (GCO). The Director of Process Management will be a senior leader with expertise in process design, leading complex...

At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us. Job Posting Title Compliance Analyst (Regulatory Change Management) - Remote Job Description The Compliance Analyst assists in the implementation of Prime's compliance programs within their designated areas and partners with key internal stakeholders to monitor aspects of compliance and validate policies, procedures, licensure, and program manuals are effectively followed and maintained. Responsibilities Executes compliance procedures and enforces policy governance across the organization to validate requirements are met and that business operations are aligned with expectations of applicable regulatory guidance Develop solutions to moderately complex compliance problems by referring to precedence, policies and standard...

At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us. Job Posting Title Senior Compliance Analyst (Regulatory Change Management) - Remote Job Description The Senior Compliance Analyst assists in the implementation of Prime's compliance programs and leads initiatives within their designated areas. This role partners with key internal stakeholders to monitor aspects of compliance and validate policies, procedures, licensure, and program manuals are effectively followed and maintained. Responsibilities Executes compliance procedures and enforces policy governance across the organization to validate regulatory reporting requirements are met and that business operations are aligned with expectations of applicable regulatory guidance Lead project management efforts for highly sensitive...

Site Name: USA - Pennsylvania - Upper Providence, Home Worker - USA Posted Date: Dec 18 2025 Pipeline Project Management drives decisions and enables teams to choose the best path and deliver medicines to patients faster than ever. In GSK, the Pipeline Project Manager (PPM) will act as the ‘COO’ of the asset and will partner with project leads to help teams plot the best course, then accelerate through complexity and uncertainty with no compromise to quality or safety. Pipeline Project Managers compose a community of drug/vaccine development and commercialization experts applying industry-leading project management practices to plan and deliver pipeline projects with industry-leading performance: Apply a holistic perspective and broad knowledge of drug/vaccine development to help Research and Development teams test ideas and optimize the strategy. Empower teams to challenge convention, manage uncertainty, and accelerate delivery of critical milestones. Continuously...

Pipeline Project Management drives decisions and enables teams to choose the best path and deliver medicines to patients faster than ever. In GSK, the Pipeline Project Manager (PPM) will act as the ‘COO’ of the asset and will partner with project leads to help teams plot the best course, then accelerate through complexity and uncertainty with no compromise to quality or safety. Pipeline Project Managers compose a community of drug/vaccine development and commercialization experts applying industry-leading project management practices to plan and deliver pipeline projects with industry-leading performance: Apply a holistic perspective and broad knowledge of drug/vaccine development to help Research and Development teams test ideas and optimize the strategy. Empower teams to challenge convention, manage uncertainty, and accelerate delivery of critical milestones. Continuously assess progress and clear the way for uninterrupted focus on the critical path. Build...

Site Name: USA - Pennsylvania - Upper Providence, Home Worker - USA Posted Date: Dec 18 2025 Pipeline Project Management drives decisions and enables teams to choose the best path and deliver medicines to patients faster than ever. In GSK, the Pipeline Project Manager (PPM) will act as the ‘COO’ of the asset and will partner with project leads to help teams plot the best course, then accelerate through complexity and uncertainty with no compromise to quality or safety. Pipeline Project Managers compose a community of drug/vaccine development and commercialization experts applying industry-leading project management practices to plan and deliver pipeline projects with industry-leading performance: Apply a holistic perspective and broad knowledge of drug/vaccine development to help Research and Development teams test ideas and optimize the strategy. Empower teams to challenge convention, manage uncertainty, and accelerate delivery of critical milestones....

Become a part of our caring community and help us put health first Care Manager Support Assistants assist in ensuring TRICARE beneficiaries receive the highest quality health care for Autism Spectrum Disorder (ASD) related services in accordance with the Autism Care Demonstration (ACD). This role supports the Autism Service Navigator (ASN) by verifying eligibility for the ACD and monitoring and supporting the family for 180 to assist with any barriers to accessing services; education and initial registration into ECHO registration portal for active duty family members; assistance with regional transfers and ensuring the receiving Managed Care Support Contractor receives the appropriate paperwork; processes faxes for ECHO eligibility or other paperwork pertaining to ACD requirements such as eligibility, referrals, etc.; and identification of ABA providers and researching necessary resources to support the beneficiary. KEY ACCOUNTABILITIES Assist beneficiaries with...

Reference #: 431939 Site Name: UK - Hertfordshire - Stevenage, Belgium-Wavre, Canada - Ontario - Mississauga, GSK HQ, USA - Pennsylvania - Upper Providence Posted Date: Dec 9 2025 GSK's success absolutely depends on our people. While getting ahead of disease together is about our ambition for patients and shareholders, it's also about making GSK a place where people can thrive. We want GSK to be a place where people feel inspired, encouraged and challenged to be the best they can be. A place where they can be themselves - feeling welcome, valued and included. Where they can keep growing and look after their wellbeing. So, if you share our ambition, join us at this exciting moment in our journey to get Ahead Together. Job Purpose: The Director Process Management will be accountable for overseeing and optimizing clinical trial supply management and protocol deviation management processes within Global Clinical Operations (GCO). The Director of Process Management will be a...

Become a part of our caring community and help us put health first Humana is evolving its marketing operations to enable smarter planning, faster execution, and greater transparency-and we're looking for a product manager to lead that effort. As Senior Associate/Product Manager - Marketing Resource Management (MRM) Capabilities, you'll own the roadmap for tools and workflows that support campaign intake, planning, approvals, and performance tracking. This role is central to enabling scalable, compliant, and insight-driven marketing operations. You'll help guide the transition to a modern resource management platform and evaluate opportunities to integrate with enterprise workflow systems to support intelligent orchestration. This role supports the day-to-day configuration and optimization of marketing resource management tools and workflows. You'll work closely with cross-functional teams-including Marketing, Creative, Legal, and IT-to ensure campaign planning and...

Become a part of our caring community and help us put health first With over 10 million sales interactions annually, Humana understands that while great products are important, it's the quality of our service that truly defines us. We know that when our members and prospects have delightful and memorable experiences, it strengthens their connection with us and enables us to put their Health First. After all, a health services company that has multiple ways to improve the lives of its customers is uniquely positioned to put those customers at the center of everything it does. The Lead Product Owner is responsible for conveying product vision and roadmap to an Agile delivery team by defining user stories and prioritizing product backlog. The Lead Product Owner works on problems of diverse scope and complexity ranging from moderate to substantial. This role will be aligned to Humana sales technology platforms, helping further advance capabilities that provide a seamless...

Become a part of our caring community and help us put health first The Associate Director, Finance Data Management supports all aspects of configuration control, data management, and deficiency reporting. The Associate Director, Finance Data Management requires a solid understanding of how Finance organization data capabilities interrelate across department(s). The Associate Director, Finance Data Management supports implementation of government and industry policies for requirements management, document management, change management, production and delivery, and configuration management of the performance, functional, and physical baselines. Acquires, validates, stores, protects, and processes required data to ensure the accessibility, reliability, and timeliness of the data for its users. Develops and executes architecture, policies, practices and procedures that properly manage the full data lifecycle needs of an enterprise. Decisions are typically related to identifying...

Reference #: JR25-16846 Welcome! We're excited you're considering an opportunity with us! To apply to this position and be considered, click the Apply button located above this message and complete the application in full. Below, you'll find other important information about this position. The West Virginia University Health System, the state's largest health system and largest private employer, comprises 18 hospitals throughout the state and bordering states. In addition, it includes five institutes, as well as providing management services for other local hospitals through affiliate agreements. Whether you are caring for our patients at one of the critical access hospitals, community sites, regional or academic medical centers, we are all one WVU Health System. Work Here. Thrive Here. Additional Job Description: WVUHS Medical Group seeks a Pain Management Physician. The successful candidate will be expected to practice in the primary location of Uniontown, PA. Duties:...

Reference #: 430885 Site Name: UK - Hertfordshire - Stevenage, Belgium-Wavre, GSK HQ, India - Karnataka - Bengaluru, Mississauga, USA - Pennsylvania - Upper Providence, Warsaw Rzymowskiego 53 Posted Date: Dec 3 2025 Company Overview At GSK, we have bold ambitions for patients, aiming to positively impact the health of 2.5 billion people by the end of the decade. Our R&D focuses on discovering and delivering vaccines and medicines, combining our understanding of the immune system with cutting-edge technology to transform people's lives. GSK fosters a culture ambitious for patients, accountable for impact, and committed to doing the right thing, making sure that we focus our efforts on accelerating significant assets that meet patients' needs and have the highest probability of success. GSK enters 2026 with strong momentum, building on 2025 growth and advancing a robust pipeline. We expect key regulatory milestones, including new approvals and expanded indications, supported...

Site Name: UK - Hertfordshire - Stevenage, Belgium-Wavre, Canada - Ontario - Mississauga, GSK HQ, USA - Pennsylvania - Upper Providence Posted Date: Dec 9 2025 GSK’s success absolutely depends on our people. While getting ahead of disease together is about our ambition for patients and shareholders, it’s also about making GSK a place where people can thrive. We want GSK to be a place where people feel inspired, encouraged and challenged to be the best they can be. A place where they can be themselves – feeling welcome, valued and included. Where they can keep growing and look after their wellbeing. So, if you share our ambition, join us at this exciting moment in our journey to get Ahead Together. Job Purpose: The Director Process Management will be accountable for overseeing and optimizing clinical trial supply management and protocol deviation management processes within Global Clinical Operations (GCO). The Director of Process Management will be a senior leader...

Become a part of our caring community and help us put health first We are looking for a dynamic Lead Product Manager to develop clinical solutions for our members and providers, with full accountability from strategy to execution. The Lead Product & Strategy Manager - Provider Practice Management role is a critical member of the multidisciplinary clinical initiatives team within Clinical Strategy and Analytics. This role is not a traditional software product manager role. Instead, it requires demonstrated expertise in healthcare delivery, provider performance improvement, operational redesign, and translating insights into actionable workflows for clinical practices. The Lead Product & Strategy Manager will work across clinical initiatives focused on reducing 30-day Plan All-Cause Readmissions (PCR). They will partner closely with high-performing and low-performing provider groups to identify clinical best practices, understand operational gaps, and design and...

Become a part of our caring community and help us put health first The Staff Utilization Management Pharmacist is a clinical expert responsible for conducting medical necessity and comprehensive medication reviews for prescriptions requiring prior authorization. This role involves evaluating complex clinical scenarios and applying evidence-based criteria to ensure appropriate medication use. The pharmacist addresses moderately complex to complex issues that require critical thinking and in-depth analysis of variable factors. Earn a $5,000 hiring bonus! Bonus is paid after 180 days of employment; you must be employed until that date to be eligible to receive the payment." Location: Remote - United States Schedule: 8-hour shifts, Monday through Friday, between 10:30 AM and 11:00 PM EST OR 10-hour shifts, Tuesday through Friday, between 10:30 AM and 11:00 PM EST Required to work every 5th Saturday Required to work 1 company holiday...