- 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
- Humana (Little Rock, AR)
- … 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 (Carson City, NV)
- … 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)
- …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 (Columbia, SC)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an ... healthcare providers, clinical group practice management + Utilization management experience in a medical... management operational improvements, including those within the medical director area + Participate in call… 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
- LA Care Health Plan (Los Angeles, CA)
- …vs. observation) admission in the acute setting. Works with UM leadership, including the Utilization Management Medical Director , on requests where ... Utilization Management Admissions Liaison RN II...clinical data presented and established criteria/guidelines, escalating to the medical director if needed. Triages and assesses… more
- CVS Health (Baton Rouge, LA)
- …a regional role that primarily supports the Aetna Better Health Plan of Louisiana. 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
- Trinity Health (Boise, ID)
- …**Job Description:** Saint Alphonsus is seeking a physician leader to become our Medical Director of Documentation and Utilization Excellence. This position ... appointed and evaluated annually by the Saint Alphonsus Chief Clinical Officer. The Medical Director of Documentation and Utilization Excellence (MDDUE) is… more
- Ascension Health (Nashville, TN)
- …the TN market. Must be located within TN market. We're looking for an experienced Director of Utilization Management to join our team! In this pivotal ... **Details** + **Department:** Utilization Management + **Schedule:** Monday -...optimize patient care, and partner with the National Senior Director of UM to align on organizational goals. Ready… more