- AmeriHealth Caritas (Philadelphia, PA)
- ; **Responsibilities:** The Medical Director , Utilization Management provides organizational leadership in the operational areas of care 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 UPMC ... happen. **Responsibilities:** + Actively participates in the daily utilization management and quality improvement review processes, including concurrent, prospective… more
- UPMC (Pittsburgh, PA)
- The Regional Medical Director , CC/DP and Utilization Review, provides clinical and management leadership across multiple hospitals within the region. This ... utilization, and length of stay (LOS) strategic oversight. The Medical Director will report to the Vice...hospital in their region. Key Responsibilities + Leadership & Management **: + Oversee Utilization Management (UM) across… more
- Humana (Harrisburg, PA)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members ... **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 … more
- Philips (New Kensington, PA)
- As the ** Director of Program Management ** , you will lead a team of project managers in driving the successful execution of complex, cross-functional programs ... within a regulated medical device environment. This role is responsible for developing...project managers; build operational discipline in portfolio and resource management + Oversee execution of cross-functional programs from concept… more
- Humana (Harrisburg, PA)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members ... **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 … more
- Humana (Harrisburg, PA)
- …reports to the Lead Medical Director .** **Other duties:** + Identify medical management operational improvements, including those within the medical ... part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home… more
- Wellpath (Lemoyne, PA)
- …training, education, and point of care support. **How you make a difference** The Medical Director of Utilization Management leads and oversees utilization ... patient care and the appropriate utilization of medical services. The Medical Director of Utilization Management serves as a key liaison with external… more
- Sumitomo Pharma (Harrisburg, PA)
- …seeking a dynamic, highly motivated, and experienced individual for the position of **Associate Medical Director .** The Associate Medical Director will ... support for SMPA investigational and commercial products. The incumbent will provide medical safety support for safety signal management throughout product… more
- Centene Corporation (Harrisburg, PA)
- …the Chief Medical Director to direct and coordinate the medical management , quality improvement and credentialing functions for the business unit. + ... 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a...performance improvement initiatives for capitated providers. + Assists Chief Medical Director in planning and establishing goals… more