• Utilization Management…

    Elevance Health (Wallingford, CT)
    ** 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 (09/26/25)
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  • Medical Director Aetna Duals Center…

    CVS Health (CT)
    …urgent cases can be done from your laptop. **Fundamental Components:** * Utilization management - The medical director will perform concurrent and prior ... services to its membership. Aetna is looking for a medical director to be part of a...state licensure a plus. **Preferred Qualifications:** Previous Experience in Utilization Management / Claims Determination with another… more
    CVS Health (08/31/25)
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  • Field Medical Director…

    Evolent (Hartford, CT)
    …setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional cardiology ... per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management … more
    Evolent (07/30/25)
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  • Medical Director - Gulf South

    Humana (Hartford, CT)
    … 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 (10/03/25)
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  • Medical Director - Mid West Region

    Humana (Hartford, CT)
    … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an ... healthcare providers, clinical group practice management . + Utilization management experience in a medical... management operational improvements, including those within the medical director area + Participate in call… more
    Humana (09/16/25)
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  • Medical Director - Northeast Region

    Humana (Hartford, CT)
    … 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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  • National Accounts Medical Director

    Elevance Health (Wallingford, CT)
    …responsibilities means that the medical director is directly involved in Utilization Management and Case Management . + Daily case reviews for both ... Director ** is responsible for serving as the Operational Medical Director for our care management...director provides clinical expertise in all aspects of utilization review and case management . Provides input… more
    Elevance Health (09/23/25)
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  • Field Medical Director , Pain…

    Evolent (Hartford, CT)
    …for utilization management while working in conjunction with the Senior Medical Director . May assist the Senior Medical Director in ... , you will be a key member of the utilization management team. We can offer you...process. + On a requested basis, may function as Medical Director for selecting health plans or… more
    Evolent (09/25/25)
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  • Field Medical Director , Cardiology

    Evolent (Hartford, CT)
    …per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management ... you will be a key member of the utilization management team. We can offer you...management while working in conjunction with the Senior Medical Director . **Qualifications - Required and Preferred:**… more
    Evolent (10/01/25)
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  • Field Medical Director - Vascular…

    Evolent (Hartford, CT)
    …per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management ... you will be a key member of the utilization management team. We can offer you...management while working in conjunction with the Senior Medical Director . **Qualifications - Required and Preferred:**… more
    Evolent (08/28/25)
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