• Medical Director - Florida

    Humana (Salt Lake City, UT)
    …analytic and interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , ... a focus on collaborative business relationships, value based care, population health, or disease or care management ....size of region or line of business. The Medical Director conducts Utilization Management of the care… more
    Humana (07/29/25)
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  • Medical Director - South Carolina SE Region

    Humana (Salt Lake City, UT)
    …value based care, population health, or disease or care management . **Responsibilities** The Medical Director provides medical interpretation and ... skills, with prior experience participating in teams focusing on quality management , utilization management , case...size of region or line of business. The Medical Director conducts Utilization Management of the care… more
    Humana (07/22/25)
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  • Medical Director - Mid West Region

    Humana (Salt Lake City, UT)
    …analytic and interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , ... a focus on collaborative business relationships, value based care, population health, or disease or care management ....size of region or line of business. The Medical Director conducts Utilization Management of the care… more
    Humana (05/14/25)
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  • Medical Director - NorthEast Region

    Humana (Salt Lake City, UT)
    …analytic and interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , ... environment and/or related to care of a Medicare type population (disabled or >65 years of age). + Current...size of region or line of business. The Medical Director conducts Utilization Management of the care… more
    Humana (07/25/25)
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  • Medical Director - OneHome

    Humana (Salt Lake City, UT)
    …of the Medicare population and reports to the Lead Medical Director . **Other duties:** + Identify medical management operational improvements, including ... community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on...environment and/or related to care of a Medicare type population (disabled or >65 years of age) + Internal… more
    Humana (07/15/25)
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  • Associate Director , Provider Engagement…

    Evolent (Salt Lake City, UT)
    …(ie, RN, NP) + Must demonstrate knowledge of healthcare delivery operations, population health management best practices with proven success leading initiatives ... NORTHEAST REGION We are seeking a strategic and collaborative Associate Director , Provider Engagement to lead our oncology-focused provider engagement and practice… more
    Evolent (07/25/25)
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  • Sr Director Clinical Strategy and Oncology…

    Prime Therapeutics (Salt Lake City, UT)
    …and drives every decision we make. **Job Posting Title** Sr Director Clinical Strategy and Oncology Specialty Solutions/PharmD required- REMOTE **Job Description** ... The Senior Director Clinical Strategy and Oncology Specialty Solutions is responsible...years of work experience within medical and pharmacy drug management within a PBM or managed care organization, or… more
    Prime Therapeutics (07/01/25)
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  • Director Reimbursement Design & Market…

    Highmark Health (Salt Lake City, UT)
    …Highmark Health Solutions, Health Plan Operations. **ESSENTIAL RESPONSIBILITIES** + Perform management responsibilities to include, but are not limited to: involved ... termination decisions, coaching and development, rewards and recognition, performance management and staff productivity. Plan, organize, staff, direct and control… more
    Highmark Health (07/30/25)
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  • Program Director , Value-Based Care…

    Molina Healthcare (Salt Lake City, UT)
    …across Medicaid, Medicare, and Marketplace populations, ensuring alignment with clinical, quality and financial goals. **Job Duties** + Leads the end-to-end design ... stakeholders to ensure program alignment with clinical models of care, quality strategies, and organizational goals. + Establishes metrics and monitoring plans… more
    Molina Healthcare (07/23/25)
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  • Director , Operational Oversight - Medicare…

    Molina Healthcare (Layton, UT)
    …the implementation of techniques to ensure the maintenance of performance and quality levels in the Business' products and processes. Reviews operation process ... * 7 years of managed care experience (Regulatory and Compliance) * Previous management experience of 5 years or more **Preferred Education** Master's Degree in… more
    Molina Healthcare (07/19/25)
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