- UPMC (Pittsburgh, PA)
- …The UMPC Health Plan is seeking a licensed MD or DO for a fully remote Medical Director , Utilization Management role. The Medical Director , ... role._ Responsibilities: + Actively participates in the daily utilization management and quality improvement review processes, including concurrent, prospective and… 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
- Humana (Raleigh, NC)
- …a Lead Medical Director , depending on the line of business. The Medical Director conducts Utilization Management or clinical validation of the care ... **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement… more
- Elevance Health (Indianapolis, IN)
- **Utilization Management Medical Director - Indiana Medicaid** **Location:** This role enables associates to work virtually full-time, with the exception of ... is granted as required by law. Alternate locations may be considered. The ** Medical Director ** is responsible for reviewing cases for IN Medicaid members.… more
- Evolent (Helena, MT)
- …accountability for utilization management while working in conjunction with the Senior Medical Director . May assist the Senior Medical Director ... Be Doing:** As a Physician Clinical Reviewer, Interventional Pain Management , you will be a key member of the...process. + On a requested basis, may function as Medical Director for selecting health plans or… more
- Fallon Health (Worcester, MA)
- …and LinkedIn. **Brief summary of purpose:** With the general direction from the VP Sr. Medical Director Clinical Management and SVP/Chief Medical Officer ... of care opportunities related to Utilization Management . + Works with VP/ Medical Director to set agenda related to UM and represent the plan at clinical… more
- Highmark Health (Harrisburg, PA)
- …URAC, CMS, DOH, and DOL regulations, etc.). Ensure that all aspects of the medical management process are consistent with community standards of care. + ... care (hospital, outpatient, or private practice) **Preferred** + 1 year in Medical Management in a Health Insurance Plan; strong knowledge of managed care… more
- Humana (Indianapolis, IN)
- …to the Lead Medical Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of the care received by members ... **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The … more
- Ascendis Pharma (Princeton, NJ)
- …Associate Medical Director supports the US Medical Director for deliverables and activities associated with management and implementation of phase ... Global Communications, and other functional group contributors to support the US Medical Director in successful management of Medical Affairs projects.… more
- University of Michigan (Ann Arbor, MI)
- …Chief Nursing Officer (ACNO) for Primary Care and Post Acute + Partners with the Medical Director for Care Management + Work closely with Finance and ... a senior leader, this individual partners with executive leadership, medical staff, and other healthcare teams to align departmental... Management and Social Work) **Job Title** Case Management Director **Work Location** Michigan Medicine -… more
Related Job Searches:
Director,
Director Management,
Management,
Medical,
Medical Director,
Medical Management