• System VP Utilization…

    CommonSpirit Health (Phoenix, AZ)
    **Responsibilities** The System Vice President of Utilization Management is a key member of the healthcare organization's leadership team and is ... leadership team, the System Vice President of Utilization management will...10 years of experience working with health care delivery systems , required. + Minimum 5 years experience in physician… more
    CommonSpirit Health (09/05/25)
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  • Director Utilization Management

    Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
    About The Role The Director, Utilization Management (UM) will manage the Utilization Management team consisting of Clinicians and Non-Clinical support ... and Appeals and Grievances processing. Primary Responsibilities + Reporting to the Vice President of Clinical Operations, will also collaborate with other… more
    Brighton Health Plan Solutions, LLC (07/18/25)
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  • Medical Director Utilization…

    AmeriHealth Caritas (Philadelphia, PA)
    …practice initiatives in collaboration with the Corporate Medical Director(s), Utilization Management and the Vice President , Medical Affairs. ;The ... ; **Responsibilities:** The Medical Director, Utilization Management provides organizational leadership in...in the HEDIS program. + Assuring a high-performing Medical Management system that adheres to the terms… more
    AmeriHealth Caritas (08/12/25)
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  • Regional Medical Director, Care Management…

    UPMC (Pittsburgh, PA)
    …of stay (LOS) strategic oversight. The Medical Director will report to the Vice President of Care Coordination, Discharge Planning, and Hospital Medicine, and ... hospital in their region. Key Responsibilities + Leadership & Management **: + Oversee Utilization Management ...of all physician advisory activities in the UPMC Care Management information system . + Conduct or coordinate… more
    UPMC (07/11/25)
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  • Utilization Review Medical Director

    Commonwealth Care Alliance (Boston, MA)
    …Director will be responsible for providing leadership and subject matter expertise to our utilization management (UM) group. This role is a key role in helping ... management team members. + Support the development of utilization management policy initiatives. + Support the...to enhance efficiency and effectiveness. + Partner with the VP of UM to direct the efforts of the… more
    Commonwealth Care Alliance (09/05/25)
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  • Vice President - Pharmacy Health…

    Henry Ford Health System (Bingham Farms, MI)
    The Vice President , Pharmacy Health Plan Administration, leads pharmacy strategy across Health Alliance Plan (HAP) to ensure cost-effective, high-quality drug ... pharmacy solutions with clinical excellence, affordability, and patient-centered care. The Vice President is accountable for transforming pharmacy benefit… more
    Henry Ford Health System (09/04/25)
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  • Assistant Vice President /Associate…

    Texas Health Resources (Plano, TX)
    The Assistant Vice President /Associate Chief Medical Officer will provide administrative oversight and assistance with hospital's medical staff, physician ... also providing quality medical care. 5. Support effective patient throughput, utilization management , and compliant documentation. MEDICAL STAFF GOVERNANCE: 1.… more
    Texas Health Resources (08/26/25)
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  • Vice President - Pharmacy

    GEHA (Lee's Summit, MO)
    …a personalized customer experience, sustained by a nimble and efficient organization. The Vice President , Pharmacy is a senior executive leader responsible for ... Ratio (MLR), and ensuring integration of pharmacy strategy across population health, utilization management , and quality initiatives for all GEHA products and… more
    GEHA (06/13/25)
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  • Vice President , Strategic Accounts

    Evolent (Helena, MT)
    …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** The ** Vice President , Strategic Accounts** will serve as a senior leader responsible for ... seek to connect the pieces of fragmented health care system and ensure people get the same level of...customer accounts + Strong knowledge of health plan operations, care/ utilization management , claims processing, value-based care, and… more
    Evolent (08/29/25)
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  • Assistant Vice President (AVP)…

    RWJBarnabas Health (Jersey City, NJ)
    …Office and VP of Oncology Services- Northern Region. The Assistant Vice President provides overall leadership for the administrative functions for the ... Assistant Vice President (AVP) Cancer CenterReq #:47365...for all clinical service line metrics, physician performance, volume, utilization reports etc. Quality Management + Monitors… more
    RWJBarnabas Health (09/04/25)
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