• Medical Director - Northeast Region

    Humana (Raleigh, NC)
    …Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a medical ... decisions about the appropriateness of services provided by other healthcare professionals in compliance with review policies, procedures, and...size of region or line of business. The Medical Director conducts Utilization Management of… more
    Humana (07/25/25)
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  • Director Post Acute Partnerships (External…

    Genesis Healthcare (NM)
    Overview At Genesis Healthcare , we are dedicated to improving the lives we touch through the delivery of high-quality care and exceptional service. As a leading ... In an assigned geographic area, you will build an awareness of Genesis HealthCare and increase Genesis nursing centers' census. A monthly financial incentive for… more
    Genesis Healthcare (06/25/25)
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  • Lead Medical Director

    Blue KC (MO)
    …clinical initiatives by providing direction to physicians and other providers, Provides utilization management for medical, surgical and pharmacy activity. + ... medical policy updates. + Serves as expert/resource on appeals related to utilization management issues. + Provides medical leadership and physician advice… more
    Blue KC (08/26/25)
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  • Behavioral Health Medical Director

    Humana (Concord, NH)
    …Delivery Systems, health insurance, other healthcare providers, clinical group practice management + Utilization management experience in a medical ... behavioral health topics to the clinical operations team and healthcare organization. The Medical Director 's work includes...with prior experience participating in teams focusing on quality management , utilization management , case … more
    Humana (08/09/25)
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  • Medical Director -Pain Management

    Elevance Health (Durham, NC)
    **Medical Director -Pain Management /Anesthesia Appeals** **Location:** This role enables associates to work virtually full-time, with the exception of required ... accommodation is granted as required by law. The **Medical Director Pain Management /Anesthesia Appeals** is responsible for...state or territory of the United States when conducting utilization review or an appeals consideration and cannot be… more
    Elevance Health (08/21/25)
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  • Director , Highly Integrated Dual Eligible…

    Corewell Health (Grand Rapids, MI)
    …in coordination with external partners and reports directly to the Senior Director of Utilization Management . Essential Functions Strategic Leadership ... Job Summary The Director , Highly Integrated Dual Eligible Special Needs (HIDE-SNP)...leaders across the enterprise (eg, Medical Directors, Quality Improvement, Utilization Management , Care Management , Medicare… more
    Corewell Health (09/10/25)
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  • Medical Director - Mid West Region

    Humana (San Juan, PR)
    …Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a medical ... Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in… more
    Humana (09/16/25)
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  • Director , Clinical Logistics

    WMCHealth (Valhalla, NY)
    Director , Clinical Logistics Company: WMC Advanced Physician Services PC City/State: Valhalla, NY Category: Executive/ Management Department: TeleMedicine Union: ... (https://pm.healthcaresource.com/cs/wmc1/#/preApply/30239) Internal Applicant link Job Details: Job Summary: The Director of Clinical Logistics is responsible for overseeing and… more
    WMCHealth (09/12/25)
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  • Director , Quality Safety & Risk Prevention…

    Vanderbilt University Medical Center (Lebanon, TN)
    …or written) to explain/clarify problems, issues or requests. * Participate in periodic management meetings to keep top management informed of department problems ... and justify a proposed budget (operating and capital expenditure) to a management review committee * Evaluate organizational functions and structures to best… more
    Vanderbilt University Medical Center (09/16/25)
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  • PV Risk Management Scientist/Associate…

    Takeda Pharmaceuticals (Boston, MA)
    …inspire you and empower you to shine? Join us as a PV Risk Management Scientist/Associate Director . At Takeda, we are transforming the pharmaceutical industry ... for excellence in everything we do. As an Associate Director / PV Risk Management Scientist, being part...strategy + Develop and provide recommendations for appropriate risk management interventions such as direct healthcare professional… more
    Takeda Pharmaceuticals (08/21/25)
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