• Director Centralized Utilization…

    Houston Methodist (Katy, TX)
    At Houston Methodist, the Director Centralized Utilization Review (UR) position is responsible for strategic, administrative, and operational leadership for ... across the Houston Methodist system. This position oversees all aspects of utilization review to ensure medical necessity, level of care appropriateness,… more
    Houston Methodist (01/16/26)
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  • Senior Utilization Review Medical…

    Integra Partners (Troy, MI)
    …as operational needs require. The Senior MD provides clinical oversight to the Utilization Review Medical Director (s), ensures consistent application of ... representing Integra's clinical position to internal and external stakeholders. The Senior Utilization Review Medical Director 's responsibilities include but… more
    Integra Partners (12/03/25)
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  • Utilization Review Medical…

    Integra Partners (Troy, MI)
    The Utilization Review Medical Director is responsible for conducting clinical reviews of Durable Medical Equipment (DME) and related requests to support ... and are committed to consistency, compliance, and evidence-based decision making. The Utilization Review Medical Director 's responsibilities include but… more
    Integra Partners (12/02/25)
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  • Centralized Utilization Review…

    Houston Methodist (Katy, TX)
    …for medical necessity, level of care, and payer requirements. Reporting to the Director of Centralized Utilization Review , the Centralized Manager, UR ... At Houston Methodist, the Manager Centralized Utilization Review (UR) position is responsible for leading the daily operations of the Utilization Review … more
    Houston Methodist (01/16/26)
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  • Utilization Management Coordinator-…

    Houston Behavioral Healthcare Hospital (Houston, TX)
    … Management Coordinator. The Utilization Management Coordinator will report to the Director of Utilization Review and will be responsible to provide ... quality case management services to all patients and their families, to serve as a member of interdisciplinary team supporting the organization's treatment program and philosophy, and assure the deliverance of quality treatment to patients and their families.… more
    Houston Behavioral Healthcare Hospital (01/07/26)
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  • Senior Director , Case Management

    Houston Methodist (Katy, TX)
    …and strategic oversight for all hospital-based Case Management Directors and the Central Utilization Review Director across the system. This position is ... At Houston Methodist, the Sr Director Case Management position is responsible for providing...initiatives aimed at optimizing patient progression of care, aligning utilization review practices, enhancing discharge planning processes,… more
    Houston Methodist (01/16/26)
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  • Medical Director (Hybrid)

    CareFirst (Baltimore, MD)
    …& Qualifications** **PURPOSE:** The Medical Director oversees all activities of utilization review , care management and quality to determine the medical ... for peer-to-peer case discussion. + Provides clinical support for utilization review , care management and quality to determine the medical effectiveness… more
    CareFirst (11/20/25)
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  • RN Director , Utilization Management…

    Fallon Health (Worcester, MA)
    … Director to identify and prioritize the cost of care opportunities related to Utilization Management. + Works with VP/ Medical Director to set agenda related ... of purpose:** With the general direction from the VP Sr. Medical Director Clinical Management and SVP/Chief Medical Officer will provide strategic leadership and… more
    Fallon Health (12/14/25)
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  • Director , Utilization Management

    Alameda Health System (Oakland, CA)
    …each individual in the classification. + Lead and manage a team of utilization review professionals providing guidance, training, and performance evaluations. + ... Director , Utilization Management + Oakland, CA...reviews and determine program improvements. + Develop and implement utilization review policies and procedures in accordance… more
    Alameda Health System (11/07/25)
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  • Executive System Director…

    UNC Health Care (Morrisville, NC)
    …People** - Operational oversight of centralized and site-specific UM teams, including utilization review nurses and support staff. Cultivate and empower ... well-being of the unique communities we serve. **Summary** : The **Executive System Director of Utilization Management (UM)** is a strategic and operational… more
    UNC Health Care (10/29/25)
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