• Ami Network (Pasadena, CA)
    …AMI Network is partnered with a large healthplan organization to find their next Utilization Management Director in Pasadena. Our client is a leading ... Plans like Anthem, SCAN, and Alignment Health. As the Utilization Review Director , you'll oversee 4 direct...time. Requirements: Healthplan Experience + Medicare Advantage 3-5 years Management Experience RN in CA Daily audits of UM… more
    job goal (01/12/26)
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  • Healthcare Staffing (Zanesville, OH)
    Utilization Management & CDI Director page is loaded## Utilization Management & CDI Directorlocations: Genesis Hospitaltime type: Full timeposted on: ... Position Details:Work Shift:Day Shift (United States of America)Scheduled Weekly Hours:40Department: Utilization Management ## Overview of Position:The Director… more
    job goal (01/13/26)
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  • Deltadentalin (Okemos, MI)
    … Utilization Management Plan are enforced on a day-to-day basis by the Utilization Management Director . The Utilization Management Director ... Director , Government Programs Dental Consulting and Utilization Management page is loaded## Director , Government Programs Dental Consulting and … more
    job goal (01/12/26)
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  • Healthcare Staffing (Zanesville, OH)
    A healthcare organization in Ohio is seeking a Utilization Management & CDI Director to oversee strategic management and clinical documentation ... initiatives. This role involves leadership of utilization review processes, collaboration across multidisciplinary teams, and adherence to regulatory standards. The… more
    job goal (01/13/26)
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  • CareMore Health System (California, MO)
    …Medical Director who will provide clinical leadership for utilization management . Responsibilities include overseeing review guidelines, collaborating with ... teams, and ensuring quality care. Candidates must hold a medical degree and have extensive clinical experience along with some background in managed care. The role involves mentoring and analyzing data to improve care standards. This position is ideal for… more
    job goal (01/13/26)
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  • Premera (Olympia, WA)
    …seeking an experienced **Oncologist** to join our team as an **Assistant Medical Director (AMD)**. The AMD will leverage their specialization in Oncology to provide ... member contracts. In addition, they will support clinical programs (disease and case management ), as well as the review and adoption of health plan developed review… more
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  • Humana Inc (Boston, MA)
    …of clinical experience, and strong communication skills. Responsibilities include conducting utilization management and participating in appeals. The position is ... A leading health insurance provider is seeking a Medical Director to interpret medical services and support healthcare professionals. The ideal candidate will… more
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  • Humana Inc (Honolulu, HI)
    … Director . The role involves providing medical interpretations, managing utilization of care, and collaborating with external healthcare providers. Applicants ... should hold an MD or DO degree with over 5 years of experience in clinical settings. The position is remote, requiring occasional travel, and offers competitive compensation along with comprehensive benefits, including health insurance and retirement plans.… more
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  • Humana Inc (Charleston, WV)
    A leading health services organization is seeking a Medical Director in Charleston, West Virginia. The role involves utilizing medical expertise to evaluate health ... services and ensure compliance with guidelines. The ideal candidate will have an MD or DO degree with a minimum of 5 years clinical experience, including inpatient care. Enjoy flexibility with remote work options while fulfilling regulatory compliance and… more
    job goal (01/13/26)
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  • UnitedHealth Group (Baltimore, MD)
    A healthcare organization is seeking a Medical Director to lead clinical reviews and support operations in Baltimore, Maryland. This role requires an MD or DO with ... board certification in Cardiology and over 5 years of clinical practice experience. Responsibilities include conducting coverage reviews, documenting clinical findings, and collaborating with healthcare providers. It offers an opportunity to work remotely… more
    job goal (01/13/26)
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