- Rady Children's Hospital San Diego (San Diego, CA)
- …This position is part time with full benefits with a remote work option. The Medical Director , UM is a clinical subject-matter expert for the Utilization ... with the Rady Children's Health Network. The Utilization Management Medical Director will collaborate closely with the...Team and shall assist in the oversight of all UM activities. This position serves as a resource to… more
- University of Miami (Miami, FL)
- …abdominal organs in approximately 50% of cases. + In conjunction with the Medical Director assumes ultimate responsibility for donor management and the process ... the LAORA electronic medical record. + Shares on-call responsibility with Medical Director to oversee clinical evaluation and management of potential organ… more
- Evolent (Augusta, ME)
- …Appropriately identifies and refers quality issues to the Senior Director of Medical Management or Medical Director . + Appropriately identifies potential ... opportunity to make a meaningful impact by providing exceptional support to internal and external customers through positive interactions, and timely delivery of… more
- CVS Health (Springfield, IL)
- …will participate in inter-rater review activities and other quality oversight processes for internal Director UM decisions. If specifically assigned to one ... Management in support of Key Clients as assigned. The Medical Director transacts Utilization Management UM...Medical Affairs). **Required Qualifications** * Family Medicine or Internal Medicine Board Certification. * Minimum of 5 years… more
- Excellus BlueCross BlueShield (Buffalo, NY)
- …the Quality Management/Utilization Management (QM/ UM ) Plan, including having the BH Medical Director for Children's Services and participate on the BH ... of the Children's Behavioral Health (BH) Carve-In program. The Medical Director for BH Children's Services has...clinical setting). + A minimum of ten (10) years medical experience and strong working knowledge of QM/ UM… more
- Sharp HealthCare (San Diego, CA)
- …the position, and employer business practices. **What You Will Do** This Senior Medical Director position provides critical management and oversight for Sharp ... Officer. **Required Qualifications** + Doctor of Medicine (MD) - Internal Medicine or Family Practice + **OR** Doctor of...+ 5 years' experience as an HMO Health Plan Medical Director . + California Physicians and Surgeons… more
- UPMC (Pittsburgh, PA)
- The Regional Medical Director , CC/DP and Utilization Review, provides clinical and management leadership across multiple hospitals within the region. This role ... utilization, and length of stay (LOS) strategic oversight. The Medical Director will report to the Vice...Collaboration + Serve as a liaison and consultant for internal UM functions, promoting effective communication and… more
- CVS Health (Springfield, IL)
- …Michigan, Kansas and Oklahoma. Support for other regions may occasionally be required. The UM Medical Director will ensure timely and consistent responses to ... supports the Aetna Better Health Plan of Illinois. This UM (Utilization Management) Medical Director ...care experience - Board certification in Family Medicine or Internal Medicine / Pediatrics - Prior UM … more
- Excellus BlueCross BlueShield (Rochester, NY)
- …you see is right for you, we encourage you to apply! Job Description: The Medical Director participates in the broad array of activities of the Medical ... reviews and may require peer-to-peer discussions with providers regarding UM case review determinations. + Provides clinical expertise on...and medical criteria. + Assists with training medical director colleagues and nursing staff ,… more
- Wellpath (Lemoyne, PA)
- …education, and point of care support. **How you make a difference** The Medical Director of Utilization Management leads and oversees utilization review, case ... in their efforts to ensure quality patient care and the appropriate utilization of medical services. The Medical Director of Utilization Management serves as… more