- UPMC (Pittsburgh, PA)
- The Medical Director , Utilization Management is responsible for assuring physician commitment and delivery of comprehensive high-quality health care to ... Health Plan members. This fully remote role will be responsible for assuring physician commitment and delivery of comprehensive high quality health care to UPMC… 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 ... role focuses on improving patient flow, resource utilization , and length of stay (LOS) strategic oversight....hospital VPMAs and presidents. The Regional Medical Director will have direct reports, including Physician … more
- Humana (Harrisburg, PA)
- …members. The Director , Physician leadership will lead Medical Directors performing utilization management for inpatient authorizations training ... responsibility for evolving Humana's Utilization Management of medical review by physician or nurse, with...medical director team to assist and facilitate new hires and… more
- Guthrie (Troy, PA)
- …the revenue cycle process, coordinates as necessary with the hospital Business Office, physician offices, Care Coordination, Medical Director and other ... coding, medical record or chart auditing, and experience in utilization management processes preferred. Knowledge of computer applications (such as Microsoft… more
- UPMC (Media, PA)
- …Behavioral Health (CCBH) is seeking a qualified individual to fulfill the role of Regional Medical Director in Delaware County, PA. The Regional Medical ... for the clinical needs of Community Care members. The Medical Director also participates in regional leadership...appropriate committees of the PH MCOs. + Reviews the medical aspects of cost and utilization reports… more
- UPMC (Pittsburgh, PA)
- …Family Practice, Internal Medicine, or Emergency Medicine Physician with a Pennsylvania Medical License for a Medical Director , Grievances role with UPMC ... weekly availability within the aforementioned time frame. The Medical Director , Grievances is responsible for assuring physician commitment and delivery… more
- Humana (Harrisburg, PA)
- …and outpatient services and equipment, within their scope. The Medical Director may speak with contracted external physicians, physician groups, facilities, ... Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an… more
- Evolent (Harrisburg, PA)
- …per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management process, ... culture. **What You'll Be Doing:** As a Cardiology, Field Medical Director you will be a key... you will be a key member of the utilization management team. We can offer you a meaningful… more
- Evolent (Harrisburg, PA)
- …per inter-rater reliability process. + On a requested basis, may function as Medical Director for selecting health plans or regions, assuming overall ... for the culture. **What You'll Be Doing:** As a Physician Clinical Reviewer, Interventional Pain Management, you will be... management while working in conjunction with the Senior Medical Director . May assist the Senior … more
- Evolent (Harrisburg, PA)
- …per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management process, ... **What You'll Be Doing:** As a Vascular Surgery, Field Medical Director you will be a key... you will be a key member of the utilization management team. We can offer you a meaningful… more