- 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)
- ; **Responsibilities:** The Medical Director , Utilization Management provides organizational leadership in the operational areas of care management , ... and related policy and practice initiatives in collaboration with the Corporate Medical Director (s), Utilization Management and the Vice President, Medical… more
- Wellpath (Lemoyne, PA)
- …for training, education, and point of care support. **About this role** 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
- 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… more
- Commonwealth Care Alliance (Boston, MA)
- … will be responsible for providing leadership and subject matter expertise to our utilization management (UM) group. This role is a key role in helping ... other medical management team members. + Support the development of utilization management policy initiatives. + Support the development and implementation… more
- Elevance Health (Winston Salem, NC)
- ** Utilization Management Medical Director - NC Medicaid** Location: This role enables associates to work virtually full-time, with the exception of required ... The **Medical Director ** will be responsible for utilization review case management for North Carolina...to increase effectiveness and quality. **Minimum Requirements:** + Requires MD or DO and Board certification approved by one… more
- Humana (St. Paul, MN)
- … 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 (Raleigh, NC)
- … 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 (Baton Rouge, LA)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... skills, with prior experience participating in teams focusing on quality management , utilization management , and acute inpatient rehabilitation.… more
- ERP International (Barksdale AFB, LA)
- …co-workers, families, peers, and other health team members. Submits all concerns through Utilization Management Director ; be able to identify, analyze and ... **Overview** ERP International is seeking a ** Utilization Management Registered Nurse (RN)** for...states. Founded in 2006, ERP is headquartered in Laurel, MD and maintains satellite offices in Montgomery, AL and… more