• Medical Director , Post-Acute…

    MVP Health Care (Rochester, NY)
    …and continuous improvement. To achieve this, we're looking for a ** Medical Director , Post-Acute Care Utilization Management ** to join #TeamMVP. If you ... our Talent team at ###@mvphealthcare.com . **Job Details** **Job Family** ** Medical Management /Clinical** **Pay Type** **Salary** **Hiring Min Rate** **240,067… more
    MVP Health Care (08/01/25)
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  • Regional Medical Director

    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...documentation of all physician advisory activities in the UPMC Care Management information system. + Conduct or… more
    UPMC (07/11/25)
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  • Enhanced Care Management Clinical…

    LA Care Health Plan (Los Angeles, CA)
    …Supervisor of ECM and receives clinical supervision as needed from the Medical Director of Care Management . The position is responsible for providing ... Enhanced Care Management Clinical Specialist II Job...or chronic conditions in collaboration with members and interdisciplinary care professionals in a hospital, medical group… more
    LA Care Health Plan (07/16/25)
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  • RN Care Coordinator

    Corewell Health (Royal Oak, MI)
    …status and level of care . Uses defined resources to guide decisions, including Medical Director Care Management , Physician Advisors, and ... evaluates appropriateness of admission or continued stay based on medical necessity. The overall goal of the position is...of all hospitalized patients. 1. Identifies patients that need care management services (ie utilization review; … more
    Corewell Health (06/27/25)
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  • Medical Director - Dsnp/MMP

    CVS Health (Tallahassee, FL)
    …* Work with medical director teams focusing on inpatient care management , clinical coverage review, member appeals clinical review, medical ... health populations to optimize risk adjustment, clinical quality, and care management . * Actively participate in meetings...as needed. * Develop and guide the implementation of Medical Management programs to ensure providers deliver… more
    CVS Health (07/18/25)
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  • Medical Director - Care Plus…

    Humana (Montpelier, VT)
    …region or line of business. The Medical Director conducts Utilization Management of the care received by members in an assigned market, member ... caring community and help us put health first** The Medical Director relies on medical ...based care , population health, or disease or care management . Medical Directors support… more
    Humana (06/28/25)
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  • Medical Director - South Carolina SE…

    Humana (Salem, OR)
    …value based care , population health, or disease or care management . **Responsibilities** The Medical Director provides medical interpretation ... , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an assigned… more
    Humana (07/22/25)
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  • Medical Director - Mid West Region

    Humana (Charleston, WV)
    …region or line of business. The Medical Director conducts Utilization Management of the care received by members in an assigned market, member ... caring community and help us put health first** The Medical Director actively uses their medical...based care , population health, or disease or care management . Medical Directors support… more
    Humana (05/14/25)
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  • Medical Director - NorthEast Region

    Humana (Bismarck, ND)
    …region or line of business. The Medical Director conducts Utilization Management of the care received by members in an assigned market, member ... caring community and help us put health first** The Medical Director relies on medical ...business metrics. + Experience working with Case managers or Care managers on complex case management , including… more
    Humana (07/25/25)
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  • Medical Director , Clinical Review…

    MVP Health Care (Schenectady, NY)
    …innovative thinking and continuous improvement. To achieve this, we're looking for a ** Medical Director , Clinical Review and Care Integrity** to join ... preferred. + Experience working in a matrixed healthcare environment + Previous medical director or clinical leadership experience within a health plan… more
    MVP Health Care (07/31/25)
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