- 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
- 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
- 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
- Ascension Health (Milwaukee, WI)
- …initiatives. + Develop systems and process for prospective, concurrent and retrospective utilization review for all self-funded and fully insured clients to ... **Details** + **Department:** Utilization Management + **Schedule:** Full Time, Partially Remote + **Hospital:** Multiple Ascension Hospitals in WI + **Location:**… more
- Elevance Health (Durham, NC)
- ** Utilization Management Medical Director -...Medical Director ** will be responsible for utilization review case management for North Carolina ... opportunities. May serve as a resource to staff including Medical Director Associates. **How you will make...state or territory of the United States when conducting utilization review or an appeals consideration and… more
- 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
- 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
- AmeriHealth Caritas (Philadelphia, PA)
- ; **Responsibilities:** The Medical Director , Utilization Management provides organizational leadership in the operational areas of care management, ... utilization review , appeals, quality improvement and related...policy and practice initiatives in collaboration with the Corporate Medical Director (s), Utilization Management and… more
- 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
- 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
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