• 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...care organizations, providers, and payers to address benefit coverage, utilization review , and quality assurance. + Promote… more
    UPMC (07/11/25)
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  • Utilization Review Medical

    Commonwealth Care Alliance (Boston, MA)
    Director of Medical Policy and Utilization Review , the Utilization Review Medical Director will be responsible for providing leadership ... Serve as the lead for CCA's Utilization Review functions working closely with other medical ...preferred. + Primary care discipline, prior experience as Associate Medical Director (or equivalent) or physician reviewer… more
    Commonwealth Care Alliance (06/27/25)
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  • Utilization Review Medical

    Integra Partners (Troy, MI)
    Position Summary + Integra Partners is seeking a full-time Utilization Review Medical Director to support our Utilization Management team. This is a ... the local delivery system rendering the criteria inappropriate, the Utilization Management Nurse will route the case to the...UR Medical Director . The UR Medical Director will review the… more
    Integra Partners (06/07/25)
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  • Utilization Review Care Management…

    Intermountain Health (Las Vegas, NV)
    **Job Description:** The Utilization Review Care Management Director is responsible for providing leadership and administrative direction for Utilization ... optimal patient level of care, and attainment of financial goals. Reporting to the Sr. Director /AVP/VP Utilization Management, the role of the Director for … more
    Intermountain Health (07/02/25)
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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 UPMC ... 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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  • Director , Utilization Management

    Alameda Health System (Oakland, CA)
    …each individual in the classification. + Lead and manage a team of utilization review professionals providing guidance, training, and performance evaluations. + ... Director , Utilization Management + Oakland, CA...reviews and determine program improvements. + Develop and implement utilization review policies and procedures in accordance… more
    Alameda Health System (05/06/25)
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  • Assistant Director of Case Management/…

    Mount Sinai Health System (New York, NY)
    …influence other services by focusing on patient processes. 9. Develops and implements Utilization Review (UR) based on internal data collection, data received ... from external agencies, Physician Advisors and the Medical Director . 10. Works collaboratively with Admitting, Transfer Services and Finance to ensure… more
    Mount Sinai Health System (07/04/25)
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  • Director Utilization Mgmt

    Wellpath (Lemoyne, PA)
    …training, education, and point of care support. **How you make a difference** The Medical Director of Utilization Management leads and oversees ... to ensure quality patient care and the appropriate utilization of medical services. The Medical Director of Utilization Management serves as a key… more
    Wellpath (06/23/25)
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  • Director of Case Management…

    Prime Healthcare (Inglewood, CA)
    …to case managers, social workers and case management coordinators/discharge planners, utilization review coordinators and utilization technicians. ... Overview AtCentinela Hospital Medical Center, our dedicated team of professionals are...part-time. Responsibilities We are seeking a strategic and compassionate Director of Case Management to lead our dynamic Case… more
    Prime Healthcare (05/30/25)
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  • Utilization Review Nurse

    Actalent (Sunrise, FL)
    …appropriateness, utilizing standardized Review Criteria. + Coordinate with the Medical Director /Physicians for requests outside standard Review Criteria. ... service utilization . Working under the general supervision of the Director and/or Manager/Supervisor of Medical Management, and in collaboration with… more
    Actalent (07/04/25)
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