• Medical Director , Post-Acute Care

    MVP Health Care (Tarrytown, NY)
    …continuous improvement. To achieve this, we're looking for a **Medical Director , Post-Acute Care Utilization Management ** to join #TeamMVP. If you have a ... At MVP Health Care , we're on a mission to create a...stay requests, and handling first-level appeals. + Collaborate with Utilization Management , Case Management , Quality… more
    MVP Health Care (08/10/25)
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  • Utilization Review Care

    Intermountain Health (Las Vegas, NV)
    **Job Description:** The Utilization Review Care Management Director is responsible for providing leadership and administrative direction for ... and attainment of financial goals. Reporting to the Sr. Director /AVP/VP Utilization Management , the role...team in delivering and collaborating on all aspects of utilization management and care coordination… more
    Intermountain Health (07/02/25)
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  • Regional Medical Director , Care

    UPMC (Pittsburgh, PA)
    …collaborate effectively with hospital administration and clinical teams. + Experience in utilization management and care coordination. + In-depth ... The Regional Medical Director , CC/DP and Utilization Review, provides clinical and management ...documentation of all physician advisory activities in the UPMC Care Management information system. + Conduct or… more
    UPMC (07/11/25)
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  • Medical Director - Care Plus…

    Humana (Montpelier, VT)
    …depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an assigned ... of decisions to internal associates, and possible participation in care management . The clinical scenarios predominantly arise...with prior experience participating in teams focusing on quality management , utilization management , case … more
    Humana (06/28/25)
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  • Medical Director - South Central

    Humana (Harrisburg, PA)
    …depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an assigned ... of decisions to internal associates, and possible participation in care management . The clinical scenarios predominantly arise...with prior experience participating in teams focusing on quality management , utilization management , case … more
    Humana (07/11/25)
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  • Medical Director - NorthEast Region

    Humana (Bismarck, ND)
    …depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an assigned ... with prior experience participating in teams focusing on quality management , utilization management , case ...business metrics. + Experience working with Case managers or Care managers on complex case management , including… more
    Humana (07/25/25)
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  • Executive System Director

    UNC Health Care (Morrisville, NC)
    …and well-being of the unique communities we serve. **Summary** : The **Executive System Director of Utilization Management (UM)** is a strategic and ... value-based care across the healthcare system. **Responsibilities** : 1. ** Utilization Management ** - Develop and lead a system-wide utilization more
    UNC Health Care (07/27/25)
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  • Utilization Review Medical Director

    Commonwealth Care Alliance (Boston, MA)
    … will be responsible for providing leadership and subject matter expertise to our utilization management (UM) group. This role is a key role in helping ... management team members. + Support the development of utilization management policy initiatives. + Support the... care environment is strongly preferred. + Primary care discipline, prior experience as Associate Medical Director more
    Commonwealth Care Alliance (06/27/25)
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  • Director , Utilization

    Alameda Health System (Oakland, CA)
    Director , Utilization Management + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day + Nursing + Req ... plans **Role Overview:** Alameda Health System is hiring! The Director of Utilization Management holds...needed. In essence, they orchestrate efficient utilization management to deliver high-quality patient care . **DUTIES… more
    Alameda Health System (08/08/25)
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  • Director Utilization

    Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
    About The Role The Director , Utilization Management (UM) will manage the Utilization Management team consisting of Clinicians and Non-Clinical ... onboardings with time sensitive requirements. + Support and grow the utilization management team through strong professional relationships, mentorship, modelling… more
    Brighton Health Plan Solutions, LLC (07/18/25)
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