• Medical Director Utilization

    AmeriHealth Caritas (Philadelphia, PA)
    ; **Responsibilities:** The Medical Director , Utilization Management provides organizational leadership in the operational areas of care management , ... and related policy and practice initiatives in collaboration with the Corporate Medical Director (s), Utilization Management and the Vice President, … more
    AmeriHealth Caritas (08/12/25)
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  • Medical Director

    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
    UPMC (06/12/25)
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  • Medical Director , Post-Acute Care…

    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 ... reviews, continued stay requests, and handling first-level appeals. + Collaborate with Utilization Management , Case Management , Quality Department and other… more
    MVP Health Care (08/11/25)
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  • Utilization Management

    Elevance Health (Durham, NC)
    ** Utilization Management Medical Director - NC Medicaid** Location: This role enables associates to work virtually full-time, with the exception of ... Alternate locations may be considered. The ** Medical Director ** will be responsible for utilization review case management for North Carolina Medicaid.… more
    Elevance Health (08/08/25)
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  • Director Utilization Mgmt (Do Or MD…

    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
    Wellpath (08/08/25)
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  • Regional Medical Director , Care…

    UPMC (Pittsburgh, PA)
    The Regional Medical Director , CC/DP and Utilization Review, provides clinical and management leadership across multiple hospitals within the region. ... , and length of stay (LOS) strategic oversight. The Medical Director will report to the Vice...hospital in their region. Key Responsibilities + Leadership & Management **: + Oversee Utilization Management more
    UPMC (07/11/25)
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  • Medical Director - Florida

    Humana (Providence, RI)
    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 (07/29/25)
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  • Medical Director ( Medical

    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
    CVS Health (08/09/25)
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  • Medical Director - South Central

    Humana (Harrisburg, PA)
    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 (07/11/25)
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  • Medical Director - NorthEast Region

    Humana (Bismarck, ND)
    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 (07/25/25)
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