• 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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  • Medical Director , MSK Surgery

    Evolent (Lansing, MI)
    …new hires to educate and train on Utilization management system and Field Medical Director process, standards and resources. + Acts as assigned mentor as ... Stay for the culture. **What You'll Be Doing:** The Medical Director for MSK Surgery is a...Provides medical direction to the support services review process. Responsible for the quality of utilization… more
    Evolent (05/20/25)
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  • Field Medical Director…

    Evolent (Lansing, MI)
    …non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional ... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National...process. + May assist the Senior Medical Director in research activities/questions related to the Utilization… more
    Evolent (04/30/25)
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  • Medical Director - Care Plus…

    Humana (Lansing, MI)
    …how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer based review of moderately complex to complex ... management. + Utilization management experience in a medical management review organization, such as Medicare...on size of region or line of business. The Medical Director conducts Utilization Management… more
    Humana (04/24/25)
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  • Field Medical Director , Cardiology

    Evolent (Lansing, MI)
    …per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management process, ... culture. **What You'll Be Doing:** As a Cardiology, Field Medical Director you will be a key... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National… more
    Evolent (05/16/25)
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  • Field Medical Director , Vascular…

    Evolent (Lansing, MI)
    …per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management process, ... **What You'll Be Doing:** As a Vascular Surgery, Field Medical Director you will be a key... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National… more
    Evolent (06/06/25)
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  • Medical Director (Marketplace)

    Molina Healthcare (Ann Arbor, MI)
    …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... + 3+ years relevant experience, including: + 2 years previous experience as a Medical Director in a clinical practice. + Current clinical knowledge. + Experience… more
    Molina Healthcare (06/06/25)
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  • Medical Director - Mid West Region

    Humana (Lansing, MI)
    …will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex ... management. + Utilization management experience in a medical management review organization, such as Medicare...on size of region or line of business. The Medical Director conducts Utilization Management… more
    Humana (05/14/25)
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  • Medical Director - OneHome

    Humana (Lansing, MI)
    …Medical Director , depending on size of team or line of business. The Medical Director conducts Utilization Management of the care received by members ... caring community and help us put health first** The Medical Director relies on fundamentals of CMS...management. + Utilization management experience in a medical management review organization, such as Medicare… more
    Humana (05/31/25)
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  • Medical Director -Payment Integrity

    Humana (Lansing, MI)
    …will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex ... caring community and help us put health first** The Medical Director actively uses their medical...management. + Utilization management experience in a medical management review organization, such as Medicare… more
    Humana (06/06/25)
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