• Physician Advisor - Allegheny Health…

    Highmark Health (Pittsburgh, PA)
    …reports to the Senior Vice President of Care Continuum and Transitions and the Medical Director of Physician Advisors. **Duties:** + The Physician ... Physician Advisor is an integral part of the Utilization Management Committee and participates in hospital and enterprise-level...When requested, discuss the case with the insurance company medical director to obtain payer authorization or… more
    Highmark Health (06/19/25)
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  • Assistant Professor, Medicine, General Internal…

    University of Miami (Miami, FL)
    …Medicine, Cancer Survivorship has an exciting opportunity for an Assistant Professor of Clinical ( Medical Director ). The Medical Director is appointed by ... Miami Hospital and Clinics/ Sylvester Comprehensive Cancer Center for the respective discipline. The Medical Director shall be a member of the active Medical more
    University of Miami (05/24/25)
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  • Medical Director - Behavioral…

    CVS Health (Oklahoma City, OK)
    …resources. **This is a remote-based (work from home) role.** In this role as Medical Director (Behavioral Health), you will: * Provide leadership and day-to-day ... physician oversight for utilization management team, including...care concerns * Provide psychiatric leadership to an interdisciplinary utilization management team, including medical /clinical oversight, consultation… more
    CVS Health (07/13/25)
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  • Field Medical Director , MSK Surgery

    Evolent (Lincoln, NE)
    …timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management process, ... the culture. **What You'll Be Doing:** As a Field Medical Director , MSK Surgery you will be...Surgery you will be a key member of the utilization management team. We can offer you a meaningful… more
    Evolent (07/04/25)
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  • Director , System Payer Contracting…

    Albany Medical Center (Albany, NY)
    …candidate will be required to attend and host in person meetings. The Director is responsible for overseeing as well as implementing, developing, maintaining, and ... stakeholders to optimize contracts or mediate issues requires the Director to possess exceptional leadership, organizational, analytic, and communication… more
    Albany Medical Center (07/16/25)
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  • Physician Advisor

    AdventHealth (Orlando, FL)
    …relationships and share observations and provider improvement opportunities. Collaborates with Medical Director (s) to review and provide insight regarding ... CDI and Quality teams. Provides education and serves as a resource to Medical Staff colleagues regarding best practices, Utilization Management and Care… more
    AdventHealth (08/07/25)
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  • Medical Director - New England…

    CVS Health (Hartford, CT)
    Medical Directors will be a part of the rotation. The Medical Director will be responsible for overseeing the utilization review for health systems and ... utilization reviews and other quality activities. The Medical Director will be required to have...Health Plan / Payor. *Previous UM experience as a Physician Advisor in a Health / Hospital system. *Board… more
    CVS Health (08/02/25)
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  • Associate Market Medical Director

    ChenMed (Richmond, VA)
    …3 years preferred. + Strongly prefer one (1) years' previous experience as Medical Director or equivalent with a Medicare or Medicaid patient population ... activities preferred. + Preferred to be an existing high performing PCP partner and/or Medical Director within the ChenMed core model, with a proven ability to… more
    ChenMed (07/22/25)
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  • Senior Child Behavioral Medical

    Centene Corporation (New York, NY)
    … directors. Assume VPMA responsibility in absence of VPMA. + Provide medical leadership for all utilization management, pharmacy, case management, disease ... and medical quality improvement activities. + Perform medical review activities pertaining to utilization review,...structure, processes, and membership. + Oversee the activities of physician advisors and other medical directors. +… more
    Centene Corporation (08/08/25)
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  • Medical Director Surgical…

    Intermountain Health (Billings, MT)
    **Job Description:** Medical Group Medical Director of Surgical and Procedural Care in Montana Market, Billings is a leadership position reporting to and ... market operations directors sustain healthy relationships among providers and Intermountain Health. The Medical Director must be a patient centric leader who is… more
    Intermountain Health (05/13/25)
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