- UPMC (Pittsburgh, PA)
- The Medical Director , Utilization Management is responsible for assuring physician commitment and delivery of comprehensive high-quality health care to ... Changing Medicine happen. **Responsibilities:** + Actively participates in the daily utilization management and quality improvement review processes, including… more
- AnMed Health (Anderson, SC)
- The Utilization Review Medical Director ...Utilization Management programs at AnMed. The Medical Director ensures the program and associated ... the leadership and staff who perform the functions of Utilization Management (UM), Case Management ...practice preferred. + Minimum of five years post residency medical practice experience with hospital, managed care or long-… more
- Intermountain Health (Las Vegas, NV)
- …, care management , claims, network management , and finance. As the Medical Director for Utilization Management , you are responsible, in ... quality improvement efforts. Serves as the chair of Quality Medical Management Committee (QMMC) and other designated...timely documentation and reporting. + Demonstrated knowledge of case management , utilization management , quality … more
- Wellpath (Lemoyne, PA)
- …and point of care support. **How you make a difference** The Medical Director of Utilization Management leads and oversees utilization review, ... appropriate utilization of medical services. The Medical Director of Utilization Management serves as a key liaison with external partners and… more
- Humana (Boston, MA)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an ... caring community and help us put health first** The Medical Director actively uses their medical...healthcare providers, clinical group practice management . + Utilization management experience in a medical… more
- Humana (Nashville, TN)
- … Medical Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of the care received by members in the ... caring community and help us put health first** The Medical Director relies on medical ...healthcare providers, clinical group practice management . + Utilization management experience in a medical… more
- CVS Health (Springfield, IL)
- …Management in support of Key Clients as assigned. The Medical Director transacts Utilization Management UM activities (prior authorization and ... Fortune 6 company, has an outstanding opportunity for a Medical Director ( Medical Affairs). This...commercial client program support. Will share in reviews of utilization management (PA) criteria and clinical policy… more
- Humana (Harrisburg, PA)
- …Information** Reports to a Lead Medical Director . The Medical Director conducts Utilization Management of the care received by members in an ... caring community and help us put health first** The Medical Director relies on medical ...Medical Hematology/Oncology specialties + Prefer Medicaid experience + Utilization management experience in a medical… more
- Humana (Juneau, AK)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an ... caring community and help us put health first** The Medical Director relies on medical ...healthcare providers, clinical group practice management . + Utilization management experience in a medical… more
- Martin's Point Health Care (Portland, ME)
- …managed care experience with progressively increasing responsibilities in medical director capacities, including utilization management and medical ... to Work" since 2015. Position Summary The Health Plan Medical Director provides leadership for the clinical...and executes on all aspects of the health plan's medical policy, clinical utilization management … more