• Senior Utilization Review

    Integra Partners (Troy, MI)
    …as operational needs require. The Senior MD provides clinical oversight to the Utilization Review Medical Director (s), ensures consistent application ... Integra's clinical position to internal and external stakeholders. The Senior Utilization Review Medical Director 's responsibilities include but are… more
    Integra Partners (12/03/25)
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  • Utilization Review Medical

    Integra Partners (Troy, MI)
    The Utilization Review Medical Director is responsible for conducting clinical reviews of Durable Medical Equipment (DME) and related requests to ... and are committed to consistency, compliance, and evidence-based decision making. The Utilization Review Medical Director 's responsibilities include but… more
    Integra Partners (12/02/25)
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  • PCO Medical Director - UM - Full…

    CenterWell (Boston, MA)
    Director of Physician Strategy at Utilization Management. The Medical Director conducts Utilization review of the care received by members in an ... understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to… more
    CenterWell (11/06/25)
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  • Medical Director

    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 , ... full remote role._ Responsibilities: + Actively participates in the daily utilization management and quality improvement review processes, including concurrent,… more
    UPMC (12/11/25)
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  • Director , Utilization Management…

    Fallon Health (Worcester, MA)
    …the cost of care opportunities related to Utilization Management. + Works with VP/ Medical Director to set agenda related to UM and represent the plan at ... purpose:** With the general direction from the VP Sr. Medical Director Clinical Management and SVP/Chief ...for hiring appropriate non-physician clinical and non-clinical personnel to review medical cases and determine if requests… more
    Fallon Health (12/14/25)
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  • Utilization Management Medical

    Elevance Health (Indianapolis, IN)
    ** Utilization Management Medical Director - Indiana Medicaid** **Location:** This role enables associates to work virtually full-time, with the exception of ... required by law. Alternate locations may be considered. The ** Medical Director ** is responsible for reviewing cases...state or territory of the United States when conducting utilization review or an appeals consideration and… more
    Elevance Health (12/05/25)
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  • Director , Organ Utilization

    LifeCenter Northwest (Bellevue, WA)
    …- $199,200.00 Salary Position Type Full Time Description and Qualifications The Director , Organ Utilization ( Director ), is responsible for overseeing ... of organ donation systems, allocation practices, and regulatory compliance. The Director develops and executes strategies to improve organ allocation strategy and… more
    LifeCenter Northwest (11/21/25)
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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 (11/07/25)
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  • Executive System Director

    UNC Health Care (Morrisville, NC)
    …People** - Operational oversight of centralized and site-specific UM teams, including utilization review nurses and support staff. Cultivate and empower ... well-being of the unique communities we serve. **Summary** : The **Executive System Director of Utilization Management (UM)** is a strategic and operational… more
    UNC Health Care (10/29/25)
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  • Director Utilization Mgmt (Do Or MD…

    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 (11/07/25)
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