• Medical Director Managed Care Physician…

    Dignity Health (Bakersfield, CA)
    …and 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 (10/17/25)
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  • 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 ... clinical position to internal and external stakeholders. The Senior Utilization Review Medical Director 's responsibilities...OIG sanctions + 5+ years of utilization management experience, including complex case review +… more
    Integra Partners (12/03/25)
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  • Director , Utilization

    Fallon Health (Worcester, MA)
    … to identify and prioritize the cost of care opportunities related to Utilization Management . + Works with VP/ Medical Director to set agenda related to UM ... strategic leadership and oversight responsibility for the clinical and operational utilization management activities for all inpatient and outpatient care,… more
    Fallon Health (12/14/25)
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  • Director , Utilization

    Alameda Health System (Oakland, CA)
    Director , Utilization Management + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day + Nursing + Req ... plans **Role Overview:** Alameda Health System is hiring! The Director of Utilization Management holds...the classification. + Lead and manage a team of utilization review professionals providing guidance, training, and… more
    Alameda Health System (11/07/25)
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  • Executive System Director

    UNC Health Care (Morrisville, NC)
    …and 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… more
    UNC Health Care (10/29/25)
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  • Utilization Review Medical…

    Integra Partners (Troy, MI)
    The Utilization Review Medical Director ...or past OIG or state sanctions + Experience performing utilization management or clinical review ... 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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  • Medical Director , Utilization

    UPMC (Pittsburgh, PA)
    …UMPC Health Plan is seeking a licensed MD or DO for a fully remote Medical Director , Utilization Management role. The Medical Director , Utilization ... and full remote role._ Responsibilities: + Actively participates in the daily utilization management and quality improvement review processes, including… more
    UPMC (12/11/25)
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  • Director of Case Management

    Prime Healthcare (Inglewood, CA)
    …provides leadership and supervision to case managers, social workers and case management coordinators/discharge planners, utilization review coordinators and ... Workers, and Clinical Coordinators. This leader will oversee all facets of utilization management , discharge planning, and care coordination to ensure patients… more
    Prime Healthcare (10/18/25)
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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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  • Utilization Management Medical…

    Elevance Health (Indianapolis, IN)
    ** Utilization Management Medical Director - Indiana Medicaid** **Location:** This role enables associates to work virtually full-time, with the exception of ... state or territory of the United States when conducting utilization review or an appeals consideration and...and Family Medicine specialties preferred. + 3-5 years of Utilization Management experience preferred. + Indiana license… more
    Elevance Health (12/05/25)
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