• Medical Director - Utilization…

    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 (05/14/25)
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  • Director Utilization Mgmt

    Wellpath (Lemoyne, PA)
    …education, and point of care support. **How you make a difference** The Medical Director of Utilization Management leads and oversees utilization ... quality patient care and the appropriate utilization of medical services. The Medical Director of Utilization Management serves as a key liaison with… more
    Wellpath (03/25/25)
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  • Senior Director Utilization…

    The Cigna Group (Philadelphia, PA)
    **Overall** Responsible for leading clinical strategy development and product management for pharmacy utilization management and the coordination of rebate ... contracting efforts to ensure alignment across formulary, utilization management , SafeGuard, and other trend solutions. **Essential Functions:** + Ability to… more
    The Cigna Group (04/04/25)
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  • Medical Director - Medicaid N. Central

    Humana (Harrisburg, PA)
    …to the Lead Medical Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....with prior experience participating in teams focusing on quality management , utilization management , case … more
    Humana (05/14/25)
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  • Medical Director - Pacific SW Region

    Humana (Harrisburg, PA)
    … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....with prior experience participating in teams focusing on quality management , utilization management , case … more
    Humana (05/10/25)
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  • Medical Director - Care Plus - Florida

    Humana (Harrisburg, PA)
    … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....with prior experience participating in teams focusing on quality management , utilization management , case … more
    Humana (04/24/25)
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  • Associate Director , Admissions…

    University of Pennsylvania (Philadelphia, PA)
    …By triaging technical requests and advocating for best practices, the Associate Director fosters efficient system utilization and empowers staff to leverage ... wellness programs and resources, and much more. Posted Job Title Associate Director , Admissions Operations//Slate Manager Job Profile Title Associate Director C,… more
    University of Pennsylvania (05/15/25)
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  • Psychiatric Director

    YesCare Corp (Philadelphia, PA)
    …with the Regional Medical Director provide psychiatric leadership for the utilization management program in the region. Provide timely feedback in ... is a list of your responsibilities as a **Psychiatric Director ** with YesCare with the Philadelphia Contract. + Provide...Utilization Management matters including outpatient and inpatient… more
    YesCare Corp (04/11/25)
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  • Learning Experience Design Director

    Pfizer (Collegeville, PA)
    …the needs of various CFC learner types and roles. The Learning Experience Design Director will leverage and lead the utilization of the GCET's learning ... understanding of our patient-centric approach. The **Learning Experience Design Director ** is responsible for **curating comprehensive training content and designing… more
    Pfizer (05/17/25)
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  • Coordinator, Utilization Management

    Evolent (Harrisburg, PA)
    …LMSWs, LCSW, and LPCs, Clinical Reviewers. Opportunities to work collaboratively with other Utilization Management Leaders including our Director may also be ... Stay for the culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management ** at Evolent will serve as a point of contact for processing… more
    Evolent (05/03/25)
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