• Medical Director

    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 , ... full remote role._ Responsibilities: + Actively participates in the daily utilization management and quality improvement review processes, including concurrent,… more
    UPMC (10/03/25)
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  • Medical Director

    UPMC (Pittsburgh, PA)
    The Medical Director , Utilization Management is responsible for assuring physician commitment and delivery of comprehensive high-quality health care to ... Changing Medicine happen. **Responsibilities:** + Actively participates in the daily utilization management and quality improvement review processes, including… more
    UPMC (09/11/25)
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  • Medical Director Utilization

    AmeriHealth Caritas (Philadelphia, PA)
    **Role Overview:** The Medical Director , Utilization Management , provides organizational leadership in the operational areas of appeals, utilization ... and related policy and practice initiatives in collaboration with the Corporate Medical Directors, Utilization Management and the Vice President, Medical more
    AmeriHealth Caritas (10/17/25)
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  • Medical Director Utilization

    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 ... REQUIRED: MD or DO. Two (2) years of physician advisor and/or utilization management experience. Medical Staff membership in good standing at Henry… more
    Henry Ford Health System (08/13/25)
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  • Director Utilization Mgmt (Do Or MD…

    Wellpath (Lemoyne, PA)
    …and point of care support. **How you make a difference** The Medical Director of Utilization Management leads and oversees utilization review, ... appropriate utilization of medical services. The Medical Director of Utilization Management serves as a key liaison with external partners and… more
    Wellpath (08/08/25)
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  • Medical Director - Medicaid N.…

    Humana (Indianapolis, IN)
    Medical Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of the care received by members in the ... caring community and help us put health first** The Medical Director relies on medical ...healthcare providers, clinical group practice management . + Utilization management experience in a medical more
    Humana (10/25/25)
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  • Medical Director -National UM Team…

    Humana (Lincoln, NE)
    Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an ... caring community and help us put health first** The Medical Director relies on medical ...healthcare providers, clinical group practice management . + Utilization management experience in a medical more
    Humana (10/25/25)
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  • Medical Director - Medical

    CVS Health (Springfield, IL)
    Management in support of Key Clients as assigned. The Medical Director transacts Utilization Management UM activities (prior authorization and ... Fortune 6 company, has an outstanding opportunity for a Medical Director - Medical Affairs...commercial client program support. Will share in reviews of utilization management (PA) criteria and clinical policy… more
    CVS Health (10/23/25)
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  • Medical Director - Mid West Region

    Humana (San Juan, PR)
    Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an ... healthcare providers, clinical group practice management . + Utilization management experience in a medical... management operational improvements, including those within the medical director area + Participate in call… more
    Humana (09/16/25)
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  • Medical Director Managed Care…

    Dignity Health (Bakersfield, CA)
    …remote patient monitoring, and CRM. - Provide backup support to the Medical Director of Utilization Management in medical review activities, ... offices primarily in the Bakersfield/Central CA region.** **Position Summary:** The Medical Director of Physician Engagement is responsible for developing… more
    Dignity Health (10/17/25)
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