- UPMC (Pittsburgh, PA)
- The Medical Director , Utilization Management is responsible for assuring physician commitment and delivery of comprehensive high-quality health care to ... Changing Medicine happen. **Responsibilities:** + Actively participates in the daily utilization management and quality improvement review processes, including… more
- Wellpath (Lemoyne, PA)
- …and point of care support. **How you make a difference** The Medical Director of Utilization Management leads and oversees utilization review, ... appropriate utilization of medical services. The Medical Director of Utilization Management serves as a key liaison with external partners and… more
- Intermountain Health (Las Vegas, NV)
- …, care management , claims, network management , and finance. As the Medical Director for Utilization Management , you are responsible, in ... quality improvement efforts. Serves as the chair of Quality Medical Management Committee (QMMC) and other designated...timely documentation and reporting. + Demonstrated knowledge of case management , utilization management , quality … more
- HonorHealth (AZ)
- …agencies, other hospitals, health plans and vendors, as required. Works closely with the Medical Director , Utilization Management , Nursing, the Chief ... Learn more at HonorHealth.com. Responsibilities Job Summary The Case Management Director is accountable and responsible for...contacts to assure quality service is provided. Partners with medical staff to assure proper utilization of… more
- Integra Partners (Troy, MI)
- …Summary + Integra Partners is seeking a full-time Utilization Review Medical Director to support our Utilization Management team. This is a salaried, ... the local delivery system rendering the criteria inappropriate, the Utilization Management Nurse will route the case... Nurse will route the case to the UR Medical Director . The UR Medical … more
- Humana (Annapolis, MD)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an ... caring community and help us put health first** The Medical Director relies on medical ...healthcare providers, clinical group practice management . + Utilization management experience in a medical… more
- Humana (Dover, DE)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an ... caring community and help us put health first** The Medical Director relies on medical ...healthcare providers, clinical group practice management . + Utilization management experience in a medical… more
- CVS Health (Springfield, IL)
- …Management in support of Key Clients as assigned. The Medical Director transacts Utilization Management UM activities (prior authorization and ... Fortune 6 company, has an outstanding opportunity for a Medical Director ( Medical Affairs). This...commercial client program support. Will share in reviews of utilization management (PA) criteria and clinical policy… more
- Humana (Charleston, WV)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an ... caring community and help us put health first** The Medical Director actively uses their medical...healthcare providers, clinical group practice management . + Utilization management experience in a medical… more
- Humana (Concord, NH)
- … Director , depending on size of team or line of business. The Medical Director conducts Utilization Management of the care received by members in an ... caring community and help us put health first** The Medical Director relies on fundamentals of CMS...healthcare providers, clinical group practice management . + Utilization management experience in a medical… more
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