- Alameda Health System (Oakland, CA)
- Director , Utilization Management + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day + Nursing + Req ... off plans **Role Overview:** Alameda Health System is hiring! The Director of Utilization Management holds a critical role encompassing operational… more
- UPMC (Pittsburgh, PA)
- …UPMC 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 (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
- AmeriHealth Caritas (Philadelphia, PA)
- **Role Overview:** The Medical Director , Utilization Management , provides organizational leadership in the operational areas of appeals, utilization ... policy and practice initiatives in collaboration with the Corporate Medical Directors, Utilization Management and the Vice President, Medical Affairs. ; **Work… more
- Texas Health Resources (Arlington, TX)
- Director Utilization Management -Clinical Review _Are you looking for a rewarding career with family-friendly hours and top-notch benefits? We're looking for ... leader for system services for wholly owned and Partner hospitals for utilization management . Job Duties OPERATIONS: Plans, organizes and delegates activities… more
- Henry Ford Health System (Clinton Township, MI)
- GENERAL SUMMARY: The Medical Director of Utilization Management shall have responsibility for the medical oversight of activities related to Henry Ford ... REQUIRED: MD or DO. Two (2) years of physician advisor and/or utilization management experience. Medical Staff membership in good standing at Henry Ford Macomb… more
- Commonwealth Care Alliance (Boston, MA)
- … Mgmt * Directs, coordinates and evaluates efficiency and productivity of utilization management functions for physical health services and long term ... a high quality team.collaboration with the broader clinical organization. * Ensures that utilization management processes are integrated with care management … more
- Wellpath (Lemoyne, PA)
- …education, and point of care support. **How you make a difference** The Medical Director of Utilization Management leads and oversees utilization ... care and the appropriate utilization of medical services. The Medical Director of Utilization Management serves as a key liaison with external partners… more
- Centene Corporation (Tallahassee, FL)
- …LMFT, or LMHP.** **Position Purpose:** Leads and directs the behavioral health (BH) utilization management team to ensure appropriate member care. . Ensures ... consistency of policies, procedures, and processes. Leads and develops BH utilization management strategies and objectives within utilization management … more
- Commonwealth Care Alliance (Boston, MA)
- …of service decisions and organizational determinations. Essential Duties & Responsibilities: The Manager, Utilization Management reports to the Director of ... & Utilization Mgmt Position Summary: Commonwealth Care Alliance's (CCA) Utilization Management (Authorization) Unit is primarily responsible for the… more
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