- AmeriHealth Caritas (Newtown Square, PA)
- …administrative services. Discover more about us at www.amerihealthcaritas.com. **Responsibilities:** The Medical Director , Utilization Management ... and related policy and practice initiatives in collaboration with the Corporate Medical Director (s), Utilization Management and the Vice President, … more
- 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
- Rady Children's Hospital San Diego (San Diego, CA)
- …of Experience Previous knowledge of health plan operations, clinical issues, trends and medical management , utilization management , quality management ... JOB SUMMARY: The Medical Director , UM is a clinical subject-matter expert for the Utilization Management Team and shall assist in the oversight of all UM… 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)
- …training, education, and point of care support. **About this role** The Medical Director of Utilization Management leads and oversees utilization ... appropriate utilization of medical services. The Medical Director of Utilization Management serves as a key liaison with external partners and… 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
- Humana (Jefferson City, MO)
- … 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
- 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
- CVS Health (Springfield, IL)
- …a regional role that primarily supports the Aetna Better Health Plan of Illinois. This UM ( Utilization Management ) Medical Director will be a "Work from ... convenient and affordable. **Position Summary:** Ready to take your Medical Director skills to the next level...and appeal request. This position is primarily responsible for Utilization Management , including prior authorization as well… more