• Director , Utilization Management

    Alameda Health System (Oakland, CA)
    Director , Utilization Management + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day + Nursing + Req #:40826-30155 + ... plans **Role Overview:** Alameda Health System is hiring! The Director of Utilization Management holds a critical...Health System is hiring! The Director of Utilization Management holds a critical role encompassing operational oversight,… more
    Alameda Health System (08/08/25)
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  • Director Utilization Management

    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 support staff ... onboardings with time sensitive requirements. + Support and grow the utilization management team through strong professional relationships, mentorship, modelling of… more
    Brighton Health Plan Solutions, LLC (07/18/25)
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  • Medical Director - Utilization

    UPMC (Pittsburgh, PA)
    The Medical Director , Utilization Management is responsible for assuring physician commitment and delivery of comprehensive high-quality health care to UPMC ... care to UPMC Health Plan members. Oversees adherence to quality and utilization standards through committee delegations, and further establishes an effective working… more
    UPMC (06/12/25)
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  • Medical Director Utilization

    AmeriHealth Caritas (Philadelphia, PA)
    ; **Responsibilities:** The Medical Director , Utilization Management provides organizational leadership in the operational areas of care management, ... related policy and practice initiatives in collaboration with the Corporate Medical Director (s), Utilization Management and the Vice President, Medical Affairs.… more
    AmeriHealth Caritas (08/12/25)
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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, ... efforts to ensure quality patient care and the appropriate utilization of medical services. The Medical Director of Utilization Management serves as a key… more
    Wellpath (08/08/25)
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  • Executive System Director

    UNC Health Care (Morrisville, NC)
    …well-being of the unique communities we serve. **Summary** : The **Executive System Director of Utilization Management (UM)** is a strategic and operational ... leader responsible for designing, implementing, and standardizing utilization management functions across a large healthcare system, including a complex academic… more
    UNC Health Care (07/27/25)
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  • Regional Medical Director , Care Management…

    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 ... focuses on improving patient flow, resource utilization , and length of stay (LOS) strategic oversight. The...and length of stay (LOS) strategic oversight. The Medical Director will report to the Vice President of Care… more
    UPMC (07/11/25)
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  • Medical Director , Post-Acute Care…

    MVP Health Care (Rochester, NY)
    …thinking and continuous improvement. To achieve this, we're looking for a **Medical Director , Post-Acute Care Utilization Management** to join #TeamMVP. If you ... continued stay requests, and handling first-level appeals. + Collaborate with Utilization Management, Case Management, Quality Department and other areas of the… more
    MVP Health Care (08/11/25)
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  • Utilization Review Care Management…

    Intermountain Health (Las Vegas, NV)
    **Job Description:** The Utilization Review Care Management Director is responsible for providing leadership and administrative direction for Utilization ... level of care, and attainment of financial goals. Reporting to the Sr. Director /AVP/VP Utilization Management, the role of the Director for Utilization more
    Intermountain Health (07/02/25)
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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 ... for providing leadership and subject matter expertise to our utilization management (UM) group. This role is a key...+ Primary care discipline, prior experience as Associate Medical Director (or equivalent) or physician reviewer in a Managed… more
    Commonwealth Care Alliance (06/27/25)
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