• Senior Utilization Review Medical…

    Integra Partners (Troy, MI)
    …as operational needs require. The Senior MD provides clinical oversight to the Utilization Review Medical Director (s), ensures consistent application of ... representing Integra's clinical position to internal and external stakeholders. The Senior Utilization Review Medical Director 's responsibilities include but… more
    Integra Partners (12/03/25)
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  • Utilization Review Medical…

    Integra Partners (Troy, MI)
    The Utilization Review Medical Director is responsible for conducting clinical reviews of Durable Medical Equipment (DME) and related requests to support ... and are committed to consistency, compliance, and evidence-based decision making. The Utilization Review Medical Director 's responsibilities include but… more
    Integra Partners (12/02/25)
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  • Utilization Review Clinician (Santa…

    Sacramento Behavioral Healthcare Hospital (Santa Rosa, CA)
    …PAY RANGE: LVN/LPT $35.00-44.19 Per Hour RN/LCSW/LMFT/LPCC $54.00-68.18 Per Hour REPORTS TO: Director of Utilization Review DESCRIPTION OF POSITION: Work as ... monitor and optimize reimbursement for external reviewers/third party payers. The Utilization Review Clinician maintains knowledge of, participates in further… more
    Sacramento Behavioral Healthcare Hospital (12/11/25)
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  • PCO Medical Director - UM - Full Time

    CenterWell (Boston, MA)
    …to the Director of Physician Strategy at Utilization Management. The Medical Director conducts Utilization review of the care received by members in ... understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to complex… more
    CenterWell (11/06/25)
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  • Senior Director Case Management

    Houston Methodist (Houston, TX)
    …and strategic oversight for all hospital-based Case Management Directors and the Central Utilization Review Director across the system. This position is ... At Houston Methodist, the Sr Director Case Management position is responsible for providing...initiatives aimed at optimizing patient progression of care, aligning utilization review practices, enhancing discharge planning processes,… more
    Houston Methodist (10/16/25)
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  • Medical Director (Hybrid)

    CareFirst (Baltimore, MD)
    …& Qualifications** **PURPOSE:** The Medical Director oversees all activities of utilization review , care management and quality to determine the medical ... for peer-to-peer case discussion. + Provides clinical support for utilization review , care management and quality to determine the medical effectiveness… more
    CareFirst (11/20/25)
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  • Medical Director Managed Care Physician…

    Dignity Health (Bakersfield, CA)
    …CRM. - Provide backup support to the Medical Director of Utilization Management in medical review activities, peer-to-peer consultations, appeals and ... primarily in the Bakersfield/Central CA region.** **Position Summary:** The Medical Director of Physician Engagement is responsible for developing and driving… more
    Dignity Health (12/14/25)
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  • Director , Utilization Management…

    Fallon Health (Worcester, MA)
    Director to identify and prioritize the cost of care opportunities related to Utilization Management. + Works with VP/ Medical Director to set agenda related ... of purpose:** With the general direction from the VP Sr. Medical Director Clinical Management and SVP/Chief Medical Officer will provide strategic leadership and… more
    Fallon Health (12/14/25)
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  • Director , Organ Utilization

    LifeCenter Northwest (Bellevue, WA)
    …- $199,200.00 Salary Position Type Full Time Description and Qualifications The Director , Organ Utilization ( Director ), is responsible for overseeing ... of organ donation systems, allocation practices, and regulatory compliance. The Director develops and executes strategies to improve organ allocation strategy and… more
    LifeCenter Northwest (11/21/25)
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  • Director , Utilization Management

    Alameda Health System (Oakland, CA)
    …each individual in the classification. + Lead and manage a team of utilization review professionals providing guidance, training, and performance evaluations. + ... Director , Utilization Management + Oakland, CA...reviews and determine program improvements. + Develop and implement utilization review policies and procedures in accordance… more
    Alameda Health System (11/07/25)
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