• Medical Director , Utilization

    UPMC (Pittsburgh, PA)
    …Health Plan is seeking a licensed MD or DO for a fully remote Medical Director , Utilization Management role. The Medical Director , Utilization ... full remote role._ Responsibilities: + Actively participates in the daily utilization management and quality improvement review processes, including concurrent,… more
    UPMC (12/11/25)
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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 (11/07/25)
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  • Medical Director - OP Claims Mgmt

    Humana (Harrisburg, PA)
    …reports to Lead 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 actively uses their medical background, experience, and judgement...with prior experience participating in teams focusing on quality management , utilization management , case … more
    Humana (11/24/25)
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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 - IP Claims…

    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 (12/11/25)
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  • PCO Medical Director - UM - Full Time

    CenterWell (Harrisburg, PA)
    …**Additional Information** Will report to the Director of Physician Strategy at Utilization Management . The Medical Director conducts Utilization ... a part of our caring community and help us put health first** The Medical Director , Primary Care relies on medical background and reviews health claims. The Medical … more
    CenterWell (11/06/25)
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  • Senior Managing Director , Human…

    Ankura (PA)
    …objectives, streamline processes, and foster sustainable growth. Role Overview: This Senior Managing Director will join the leadership team of Strategy & ... capabilities, and sets the overall strategy for the practice. Additionally, the Senior Managing Director will lead and oversee multiple client engagements within… more
    Ankura (12/03/25)
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  • Managing Director Corporate Tax…

    Grant Thornton (Pittsburgh, PA)
    As the Managing Director , Corporate Tax Solutions you'll deliver personalized relationship driven services to create demand in the Pittsburgh market while ... review and client management + Meet or exceed targeted billing hours ( utilization ), sales targets for new and follow-on work as well as managed revenue targets… more
    Grant Thornton (12/11/25)
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  • Senior Managing Director , Data…

    Ankura (PA)
    …any cyber incident. Role Overview:The Global Sales Cybersecurity and Data Privacy Senior Managing Director is an executive level position that leads global sales ... development and execution, key performance indicators/metrics, and strategic account management . + Initiates and converts business opportunities and collaborates… more
    Ankura (11/25/25)
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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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