- 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 ... full remote role._ Responsibilities: + Actively participates in the daily utilization management and quality improvement review processes, including concurrent,… more
- Elevance Health (Indianapolis, IN)
- ** Utilization Management Medical Director - Indiana Medicaid** **Location:** This role enables associates to work virtually full-time, with the exception ... required by law. Alternate locations may be considered. The ** Medical Director ** is responsible for reviewing cases...and Family Medicine specialties preferred. + 3-5 years of Utilization Management experience preferred. + Indiana license… 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
- Humana (Raleigh, NC)
- … Director , depending on the line of business. The Medical Director conducts Utilization Management or clinical validation of the care received ... 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 (Indianapolis, IN)
- … Medical Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of the care received by members in the ... 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 (Baton Rouge, LA)
- … 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...commercial client program support. Will share in reviews of utilization management (PA) criteria and clinical policy… more
- Dignity Health (Bakersfield, CA)
- …remote patient monitoring, and CRM. - Provide backup support to the Medical Director of Utilization Management in medical review activities, ... offices, primarily in the Bakersfield/Central CA region.** **Position Summary:** The Medical Director of Physician Engagement is responsible for developing… more
- Dignity Health (Bakersfield, CA)
- …the managed care populations. This leader will have direct oversight of the Medical Director of Utilization Management (UM) and the Medical ... Relations, Customer Service, and Clinical Oversight functions. + Oversee and manage the medical director capacity to support Managed Care Services and approve… more
- LA Care Health Plan (Los Angeles, CA)
- …vs. observation) admission in the acute setting. Works with UM leadership, including the Utilization Management Medical Director , on requests where ... Utilization Management Admissions Liaison RN II...clinical data presented and established criteria/guidelines, escalating to the medical director if needed. Triages and assesses… more
Related Job Searches:
Director,
Director Utilization,
Director Utilization Management,
Management,
Medical,
Medical Director,
Utilization,
Utilization Management