- AmeriHealth Caritas (Philadelphia, PA)
- ; **Responsibilities:** The Medical Director , Utilization Management provides organizational leadership in the operational areas of care management , ... and related policy and practice initiatives in collaboration with the Corporate Medical Director (s), Utilization Management and the Vice President,… more
- OhioHealth (Columbus, OH)
- …the patient grievance process at GMC and RMH. **Responsibilities And Duties:** 60% The Medical Director , Risk Management ("MDRM) will provide expertise and ... The MDRM's general function is to be the primary medical expert/resource/advisor to the Risk Management department and the Office of the General Counsel ("OGC).… more
- UPMC (Pittsburgh, PA)
- The Medical Director , Utilization Management is responsible for assuring physician commitment and delivery of comprehensive high-quality health care to UPMC ... happen. **Responsibilities:** + Actively participates in the daily utilization management and quality improvement review processes, including concurrent, prospective… more
- Henry Ford Health System (Clinton Township, MI)
- GENERAL SUMMARY: The Medical Director of Utilization Management shall have responsibility for the medical oversight of activities related to Henry Ford ... MD or DO. Two (2) years of physician advisor and/or utilization management experience. Medical Staff membership in good standing at Henry Ford Macomb Hospital… more
- Elevance Health (Durham, NC)
- **Utilization Management Medical Director - NC Medicaid** Location: This role enables associates to work virtually full-time, with the exception of required ... candidate will live in North Carolina. Alternate locations may be considered. The ** Medical Director ** will be responsible for utilization review case … more
- Sharp HealthCare (San Diego, CA)
- …for the position, and employer business practices. **What You Will Do** This Senior Medical Director position provides critical management and oversight for ... Management Program and Quality Improvement Program, in conjunction with the Director of PHM/ Medical Management and Quality Improvement Director . +… 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 ... utilization, and length of stay (LOS) strategic oversight. The Medical Director will report to the Vice...hospital in their region. Key Responsibilities + Leadership & Management **: + Oversee Utilization Management (UM) across… more
- Elevance Health (Cincinnati, OH)
- **Clinical Operations Associate Medical Director ** **Carelon Medical Benefits Management ** **Post Acute Care Benefit Utilization Management ** ... for the people we serve._ The **Clinical Operations Associate Medical Director ** is responsible for supporting the... Director ** is responsible for supporting the medical management staff ensuring timely and consistent… more
- CVS Health (Hartford, CT)
- …full continuum of our members' health care and social determinant needs. The Case Management (CM) Medical Director will participate in executing and ... Duties and Responsibilities:** * Provides clinical oversight of the case management teams and the Interdisciplinary Care Team (ICT) processes by participating… more
- WestCare Foundation (Fresno, CA)
- …oversight and assistance to all treatment programs in the region; + To assist the Medical Director and management staff with the design of treatment ... Degree Salary Range $115000.00 - $135000.00 Salary/year Job Category Management Description Position Summary: Person in this position will...to identify clinical trends and provides analysis to the Medical Director ; + Assists in grant planning… more
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