• Medical Director - Medicaid (Oklahoma)

    CVS Health (MO)
    …regional role that primarily supports the Aetna Better Health Plan of Oklahoma. This UM (Utilization Management) Medical Director will be a "Work from Home" ... Oklahoma. Support for other regions may occasionally be required. The UM Medical Director will ensure timely and consistent responses to members and providers… more
    CVS Health (01/16/26)
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  • Utilization Management Coordinator

    Integra Partners (Troy, MI)
    …call center and other internal & external sources + Other duties as assigned by UM Director + Strong organizational skills, ability to adapt quickly to change ... The UM Coordinator assists and supports the clinical team ( UM Nurses/Medical Director ) with administrative and non-clinical tasks related to processing… more
    Integra Partners (11/28/25)
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  • Chair of Critical Care - UM Capital Region

    University of Maryland, Baltimore (Baltimore, MD)
    The University of Maryland School of Medicine is seeking a Chair and Medical Director of Critical Care for the UM Capital Region Health Medical Center (UMCRH), ... PA They will work closely and in collaboration with the Trauma Medical Director , Chief of Cardiac Surgery, Surgery, Medicine, Neurocritical Care. The Chair will be… more
    University of Maryland, Baltimore (11/11/25)
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  • Senior Business Consultant (Remote)

    CareFirst (Baltimore, MD)
    …initiatives forward in alignment with direction established through thought partnership with the Director of UM and the VP/CMO of Medical Management.Ability to ... utilization management, the Senor Business Consultant acts as a liaison between the UM clinical teams, the technical support teams, and the claims operations teams.… more
    CareFirst (01/08/26)
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  • Senior Business Process Analyst (Remote)

    CareFirst (Baltimore, MD)
    …critical initiatives in alignment with direction established through thought partnership with the Director of UM and the VP/CMO of Medical Management.Ability to ... platforms and workflows that results in automation and driving efficiencies for the UM teams. + Interfaces with all areas affected by the project including clinical… more
    CareFirst (01/08/26)
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  • Clinical Reviewer, Nurse Practitioner/Physician…

    Evolent (Topeka, KS)
    …participate in meetings as assigned with practices and/or payers. + Will work with the Director of UM to ensure client satisfaction. + Perform all peer clinical ... one of the Vascular Surgeons or Cardiologists. + Responsible for coordinating with UM staff to ensure timely and accurate communication of clinical decisions. +… more
    Evolent (01/15/26)
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  • Utilization Management Nurse Specialist RN II

    LA Care Health Plan (Los Angeles, CA)
    …cost cases and reports are maintained and referred to the Physician Advisor/ UM Director . Document in platform/system of record. Utilize designated software ... and implement a successful discharge plan. Works with the UM Manager and Physician Advisor on case reviews for...or HMO setting . Preferred: Managed Care experience performing UM and CM at a medical group or management… more
    LA Care Health Plan (12/20/25)
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  • Director of Basic and Translational…

    University of Maryland, Baltimore (Baltimore, MD)
    …Fischell Department of Bioengineering, and Maryland Institute for Neuroscience Discovery ( UM -MIND). The Director is expected to contribute 10-15% effort ... * Director of Basic and Translational Research* (Ph.D. and/or...and elevate the visibility of the department's research portfolio. UM -Neurosurgery seeks to solve complex neurological problems to improve… more
    University of Maryland, Baltimore (10/28/25)
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  • LVN Care Coordinator - Utilization Management…

    Sharp HealthCare (San Diego, CA)
    …or services, readmissions to acute or visit to the Emergency Department.Informs Director , QI/ UM of any quality issues.Attends hospitalists rounds, as required, ... for medical necessity are issued under the direction of the Medical Director or designee.Assists with transfers, when necessary. + Demonstrates knowledge of… more
    Sharp HealthCare (12/14/25)
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  • Ihp Research Fellow

    University of Michigan (Dearborn, MI)
    …Islander (AAPI) communities on campus. Working under the guidance of the IHP Director of Research for UM -Dearborn, the Research Fellow will be responsible ... The IHP Research Fellow will report to the IHP Director of Research for the Dearborn campus, Camron Amin....UM -Dearborn campus history, working in collaboration with the Director of Research and the IHP Program Coordinator for… more
    University of Michigan (01/10/26)
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