- Premera Blue Cross (Mountlake Terrace, WA)
- …are seeking an experienced ** MD ** to join our team as an **Assistant Medical Director ( Utilization Management - Oncology)** . The AMD will leverage their ... addition, they will support clinical programs (disease and case management ), as well as the review and adoption of...**What you will bring:** + Physicians license with an MD or DO degree. (Required) + Current board certification… more
- Daiichi Sankyo, Inc. (Bernards, NJ)
- …areas centered around rare diseases and immune disorders. Summary The Associate Director , Global Oncology Medical Affairs, Medical Analytics will be responsible for ... managing the digital analytics infrastructure and developing and executing...stakeholders, including senior leadership and medical affairs teams. Ensure utilization of advanced analytics techniques to identify HCP sentiment… more
- Molina Healthcare (Houston, TX)
- …health oversight and clinical leadership for health plan and/or market specific utilization management and care management behavioral health programs ... - working closely with regional medical directors to standardize behavioral health utilization management policies and procedures to improve quality outcomes and… more
- Lyric (Newtown Square, PA)
- …clients. + Familiarity with affordability, claims operations, payment integrity, utilization management , medical policy and/or benefit policy development. ... opportunities at lyric.ai/careers and drive innovation with #YouToThePowerOfAI. The Senior Medical Director is a senior clinical leader who will represent Lyric in… more
- 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
- 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
- Integra Partners (Troy, MI)
- …needs require. The Senior MD provides clinical oversight to the Utilization Review Medical Director (s), ensures consistent application of criteria, leads ... The Senior Medical Director (Senior MD ) serves as the...serves as the clinical and strategic leader for Integra's Utilization Management (UM) and Credentialing programs. This… more
- Integra Partners (Troy, MI)
- …of Durable Medical Equipment (DME) and related requests to support Integra's Utilization Management (UM) operations. This full-time, salaried role functions ... The Utilization Review Medical Director is responsible...or past OIG or state sanctions + Experience performing utilization management or clinical review activities +… more
- Elevance Health (Indianapolis, IN)
- ** Utilization Management Medical Director - Indiana Medicaid** **Location:** This role enables associates to work virtually full-time, with the exception of ... Internal Medicine, and Family Medicine specialties preferred. + 3-5 years of Utilization Management experience preferred. + Indiana license or the ability… more
- Huron Consulting Group (Chicago, IL)
- …regulatory agencies, and hospital contractual payor agreements. This position reports to the Director of Utilization Management and works with hospital ... and quality patient care. Position is located in Annapolis, MD + Staff Acquisition and Support: Leads and manages...staff and function for the system, reporting to the Director of Utilization Management within… more
