- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- Position Summary: The Director of Medical Management is responsible for the strategic direction, leadership, and oversight of all medical management ... accreditation requirements. This position is responsible for the day-to-day management of the Medical Management ...+ At least 3-5 years in a leadership or director -level role managing teams. + Strong knowledge of regulatory… more
- UPMC (Pittsburgh, PA)
- The UPMC Health Plan is seeking a licensed MD or DO for a fully remote Medical Director , Utilization Management role. The Medical Director , ... role._ Responsibilities: + Actively participates in the daily utilization management and quality improvement review processes, including concurrent, prospective and… more
- AmeriHealth Caritas (Philadelphia, PA)
- **Role Overview:** The Medical Director , Utilization Management , provides organizational leadership in the operational areas of appeals, utilization review, ... to develop interventions to improve the clinical effectiveness of medical management strategies. ;Work closely with a multidisciplinary team to ensure… more
- OhioHealth (Columbus, OH)
- …the patient grievance process at GMC and RMH. **Responsibilities And Duties:** 60% The Medical Director , Risk Management ("MDRM) will provide expertise and ... The MDRM's general function is to be the primary medical expert/resource/advisor to the Risk Management department and the Office of the General Counsel ("OGC).… 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 ... happen. **Responsibilities:** + Actively participates in the daily utilization management and quality improvement review processes, including concurrent, prospective… 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 ... MD or DO. Two (2) years of physician advisor and/or utilization management experience. Medical Staff membership in good standing at Henry Ford Macomb Hospital… more
- Takeda Pharmaceuticals (Boston, MA)
- …innovation-driven company to inspire you and empower you to shine? Join us as a Director , Clinical Data Management Medical Coding based remotely reporting to ... of GCP, regulatory and ICH guidelines as applicable to clinical data management and medical coding; clinical experience in the one or more of the following… more
- Elevance Health (Wallingford, CT)
- **Utilization Management Medical Director - NC Medicaid** Location: This role enables associates to work virtually full-time, with the exception of required ... in North Carolina but not required. Alternate locations may be considered. The ** Medical Director ** will be responsible for utilization review case management… more
- Sharp HealthCare (San Diego, CA)
- …for the position, and employer business practices. **What You Will Do** This Senior Medical Director position provides critical management and oversight for ... Management Program and Quality Improvement Program, in conjunction with the Director of PHM/ Medical Management and Quality Improvement Director . +… more
- AbbVie (Mettawa, IL)
- …YouTube, LinkedIn and Tik Tok (https://www.tiktok.com/@abbvie) . Job Description Purpose The Medical Program Management (MPM) team focuses on driving performance ... that solve serious health issues today and address the medical challenges of tomorrow. We strive to have a...should include at least 3 years of direct program management or at least 5 years of functional roles… more