• 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 (09/11/25)
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  • Director Utilization Mgmt (Do…

    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 (08/08/25)
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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 (10/25/25)
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  • Medical Director - Medicaid Team - FL/SC

    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 (10/28/25)
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  • Medical Director - Claims Management

    Humana (Harrisburg, PA)
    …a Lead Medical Director , depending on the line of business. The Medical Director conducts Utilization Management or clinical validation of the care ... community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement...with prior experience participating in teams focusing on quality management , utilization management , case … more
    Humana (11/01/25)
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  • Medical Director - Mid West 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 ... with prior experience participating in teams focusing on quality management , utilization management , case ...management operational improvements, including those within the medical director area + Participate in call rotation + Develop… more
    Humana (09/16/25)
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  • Field Medical Director - ( MD /DO)

    Evolent (Harrisburg, PA)
    …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + ... Radiology you will be a key member of the utilization management team. We can offer you...review guidelines and parameters to assure consistency in the MD review process to reflect appropriate utilization … more
    Evolent (09/26/25)
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  • Field Medical Director , Pain…

    Evolent (Harrisburg, PA)
    …Clinical Reviewer, Interventional Pain Management , you will be a key member of the utilization management team. We can offer you a meaningful way to make a ... for selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with the Senior Medical… more
    Evolent (09/25/25)
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  • Field Medical Director , Interventional…

    Evolent (Harrisburg, PA)
    …impact on patient care in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your ... Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. +… more
    Evolent (10/29/25)
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  • Field Medical Director - Vascular Surgery

    Evolent (Harrisburg, PA)
    …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + ... you will be a key member of the utilization management team. We can offer you... while working in conjunction with the Senior Medical Director . **Qualifications - Required and Preferred:** + MD… more
    Evolent (10/10/25)
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