• PCO Medical Director - UM

    CenterWell (Phoenix, AZ)
    **Become a part of our caring community and help us put health first** The Medical Director , Primary Care relies on medical background and reviews health ... claims. The Medical Director , Primary Care work assignments involve moderately complex to...internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements… more
    CenterWell (11/06/25)
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  • Medical Director - Nat'l UM

    Humana (Phoenix, AZ)
    **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 ... Medical Director work assignments involve moderately complex to complex issues...internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements,… more
    Humana (11/07/25)
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  • Medical Director - Nat'l IP…

    Humana (Phoenix, AZ)
    …Become a part of our caring community and help us put health first The Medical Director actively uses their medical background, experience, and judgement to ... and will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all submitted medical more
    Humana (11/15/25)
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  • Medical Director (NV)

    Molina Healthcare (Tucson, AZ)
    JOB DESCRIPTION Job Summary Provides medical oversight and expertise in appropriateness and medical necessity of services provided to members, targeting ... and cost-effective member care. Essential Job Duties * Determines appropriateness and medical necessity of health care services provided to plan members. * Supports… more
    Molina Healthcare (11/21/25)
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  • Senior Clinical Pharmacist, Medical Affairs…

    CVS Health (Scottsdale, AZ)
    …and best practices in the development and maintenance of programs supported by Medical Affairs, drives the regulatory strategy of UM programs and supports ... efficiencies. + Manage the maintenance and external requests of Medical Affairs UM Policies and Procedures. +...across organization by supporting all Heartbeat page maintenance throughout Medical Affairs. + Work with the Lead Director more
    CVS Health (11/14/25)
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  • Nurse Utilization Review

    Dignity Health (Gilbert, AZ)
    **Job Summary and Responsibilities** Under the general direction of the Director of Care Management, performs criteria-based concurrent and retrospective utilization ... ensure progression of care. + Engages the second level physician reviewer, internal or external, as indicated to support the appropriate status. **Job Requirements**… more
    Dignity Health (11/21/25)
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  • Nurse Utilization Review

    Dignity Health (Chandler, AZ)
    **Job Summary and Responsibilities** Under the general direction of the Director of Care Management, performs criteria-based concurrent and retrospective utilization ... ensure progression of care. + Engages the second level physician reviewer, internal or external, as indicated to support the appropriate status. **Job Requirements**… more
    Dignity Health (11/21/25)
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