• Medical Director - Medicaid…

    CVS Health (Trenton, NJ)
    …primarily supporting the Aetna Northeast Medicaid plan and the UM team. The UM Medical Director will ensure timely and consistent responses to members ... Medicaid plans in Aetna's Northeast region but may support other plans when needed. This UM (Utilization Management) Medical Director will be a "Work from… more
    CVS Health (08/31/25)
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  • Director Utilization Mgmt (Do Or MD…

    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
    Wellpath (08/08/25)
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  • Chief Psychiatrist - Behavioral Health…

    Humana (Springfield, IL)
    …and build collaborative care models in their practices + Coordinates with the Medical Director to integrate the administration and management of behavioral and ... in this role collaborates closely with Clinical Services and the Chief Medical Officer(CMO) to integrate the day-to-day administration and strategic management of… more
    Humana (08/29/25)
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  • RN System Director Utilization Management…

    Tufts Medicine (Burlington, MA)
    …functions. The position establishes the department's strategy and vision and oversees daily UM operations. The position functions as the internal resource on ... remote. May require occasional travel to local facilities including Tufts Medical Center, Melrose Wakefield Hospital, Lowell General Hospital, and our Corporate… more
    Tufts Medicine (09/11/25)
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  • Utilization Review Medical Director

    Commonwealth Care Alliance (Boston, MA)
    023520 Clin Alli-Physicians Group **Position Summary:** Reporting to the Senior Medical Director of Medical Policy and Utilization Review, the Utilization ... Review Medical Director will be responsible for providing leadership and subject...leadership and subject matter expertise to our utilization management ( UM ) group. This role is a key role in… more
    Commonwealth Care Alliance (09/05/25)
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  • Medical Director - Dsnp/MMP

    CVS Health (Tallahassee, FL)
    …resistant illnesses through peer review and educational interventions. * Work with medical director teams focusing on inpatient care management, clinical ... * Outward facing position to interact and collaborate with medical / physical professional associates, the local provider community,...State Fair Hearings as needed and state calls. Understand UM and participate in UM front line… more
    CVS Health (09/04/25)
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  • Medical Director - Assistant…

    University of Maryland, Baltimore (Baltimore, MD)
    …Professor*level (non-tenure track) to join our dynamic team and serve as* Medical Director *of our vibrant community-based academic radiation oncology practice ... **Faculty* **Organization:** **School of Medicine - Clinical Departments* **Title:** * Medical Director - Assistant or Associate Professor Community-Based… more
    University of Maryland, Baltimore (06/27/25)
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  • Director of the University of Maryland St.…

    University of Maryland, Baltimore (Baltimore, MD)
    …Comprehensive Cancer Center (UMGCCC), located in Baltimore, MD are recruiting for a*full-time Medical Director of the University of Maryland St. Joseph Cancer ... in Towson, MD.**_ Administrative duties and responsibilities of the Medical Director role will include, but not...be board certified or board-eligible by the ABIM in Internal Medicine and Hematology and/or Medical Oncology… more
    University of Maryland, Baltimore (06/27/25)
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  • Medical Policy Director

    Commonwealth Care Alliance (Boston, MA)
    011200 CCA-Central Clin Ops Leadership **Position Summary:** Reporting to the Sr. Medical Director of Utilization Management ( UM ) and Policy, the Medical ... services specific to the population serviced by CCA. The Medical Policy Director is an independent contributor...medical policies as needed + Collaborate effectively with internal business areas such as payment policies and claims… more
    Commonwealth Care Alliance (08/31/25)
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  • Medical Director -PSCCR

    Elevance Health (Denver, CO)
    ** Medical Director -PSCCR** Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, ... for employment, unless an accommodation is granted as required by law. The ** Medical Director -PSCCR** is responsible for the administration of physical and/or… more
    Elevance Health (09/10/25)
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