• Director , Physician Leadership…

    Humana (Harrisburg, PA)
    …most vulnerable members. The Director , Physician leadership will lead Medical Directors performing utilization management for inpatient authorizations ... a key enterprise leader, with responsibility for evolving Humana's Utilization Management of medical review...rate with denials and overturns. Deliver the upmost consistent medical director decision making. + _Internal Operations… more
    Humana (08/21/25)
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  • Field Medical Director , Cardiology

    Evolent (Harrisburg, PA)
    …per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management ... you will be a key member of the utilization management team. We can offer you...management while working in conjunction with the Senior Medical Director . **Qualifications - Required and Preferred:**… more
    Evolent (08/15/25)
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  • Field Medical Director , MSK (Spine…

    Evolent (Harrisburg, PA)
    …per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management ... cases. you will be a key member of the utilization management team. We can offer you...management while working in conjunction with the Senior Medical Director . **Qualifications - Required and Preferred:**… more
    Evolent (08/19/25)
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  • Behavioral Health Medical Director

    Humana (Harrisburg, PA)
    …relationships, value-based care, quality metrics, population health, and disease or care management . The Behavioral Health Medical Director may develop ... and help us put health first** The Behavioral Health Medical Director is responsible for behavioral health...healthcare providers, clinical group practice management + Utilization management experience in a medical more
    Humana (08/09/25)
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  • Medical Director , Grievances

    UPMC (Pittsburgh, PA)
    …Family Practice, Internal Medicine, or Emergency Medicine Physician with a Pennsylvania Medical License for a Medical Director , Grievances role ... to choose their weekly availability within the aforementioned time frame. The Medical Director , Grievances is responsible for assuring physician commitment and… more
    UPMC (08/16/25)
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  • Field Medical Director , Oncology

    Evolent (Harrisburg, PA)
    …in a timely and accurate manner. . May assist the Senior Medical Director in research activities/questions related to the Utilization Management process, ... the culture. **What You'll Be Doing:** As a Field Medical Director , Oncology, you will be a...Oncology, you will be a key member of the utilization management team. We can offer you… more
    Evolent (08/19/25)
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  • Medical Director -Pharmacy Appeals

    Humana (Harrisburg, PA)
    …Integrated Delivery Systems, health insurance, or clinical group practice management + Utilization management experience in a medical management ... caring community and help us put health first** The Medical Director relies on broad clinical expertise...with prior experience participating in teams focusing on quality management , utilization management , or similar… more
    Humana (08/22/25)
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  • Field Medical Director , Physical…

    Evolent (Harrisburg, PA)
    …in a timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management process, ... the culture. **What You'll Be Doing:** As a Field Medical Director , Physical Medicine and Rehab you...Rehab you will be a key member of the utilization management team. We can offer you… more
    Evolent (07/24/25)
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  • Field Medical Director , Radiology…

    Evolent (Harrisburg, PA)
    …in a timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management process, ... Radiology you will be a key member of the utilization management team. We can offer you...Imaging cases, that do not initially meet the applicable medical necessity guidelines, as well as other imaging requests… more
    Evolent (08/02/25)
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  • Medical Director - Medicare Appeals

    CVS Health (Harrisburg, PA)
    … will provide clinical, coding, and reimbursement expertise as well as directing case management when necessary. The Medical Director will act as a ... / Pediatrics (Med / Peds) Board Certification. In the Medical Director role, you will provide oversight...and Health Care Industry. *Prior UM ( Utilization Management ) experience *Active and current state medical more
    CVS Health (08/08/25)
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