• Director , Utilization

    Centene Corporation (Richmond, VA)
    …including a fresh perspective on workplace flexibility. **Position Purpose:** Directs the utilization management team to ensure the appropriate application of ... policy procedures and processes to help support best member outcomes. Oversees and manages ...Utilization Operations specific to the daily operations of Utilization Management including timeliness, quality and performance… more
    Centene Corporation (10/30/25)
    - Related Jobs
  • Director , Utilization

    Centene Corporation (Richmond, VA)
    …efficiency to support timely and compliant claims outcomes. + Leads utilization management team on performance, improvement, and career growth path ... including a fresh perspective on workplace flexibility. **Position Purpose:** Directs the utilization management team to ensure the appropriate application of… more
    Centene Corporation (10/31/25)
    - Related Jobs
  • Medical Director - Claims Management

    Humana (Richmond, VA)
    …a Lead Medical Director , depending on the line of business. The Medical Director conducts Utilization Management or clinical validation of the care ... interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , discharge… more
    Humana (11/01/25)
    - Related Jobs
  • Director -Rehab Clinical

    Genesis Healthcare (Woodstock, VA)
    …Area Director ). 11. Assumes responsibility for daily staffing and utilization with input from treating therapists, consideration of clinical requirements, and ... management of the rehab department, including oversight related to case management , quality improvement, care planning, clinical utilization , and patient… more
    Genesis Healthcare (10/22/25)
    - Related Jobs
  • Medical Director - Medicaid N. Central

    Humana (Richmond, VA)
    …to the Lead Medical Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....with prior experience participating in teams focusing on quality management , utilization management , case … more
    Humana (10/25/25)
    - Related Jobs
  • Field Medical Director , Interventional…

    Evolent (Richmond, VA)
    …impact on patient care in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your ... Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support .… more
    Evolent (10/29/25)
    - Related Jobs
  • Medical Director - Florida

    Humana (Richmond, VA)
    Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... value based care, population health, or disease or care management . Medical Directors support Humana values, and...with prior experience participating in teams focusing on quality management , utilization management , case … more
    Humana (10/03/25)
    - Related Jobs
  • Field Medical Director - Vascular Surgery

    Evolent (Richmond, VA)
    …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support . ... **What You'll Be Doing:** As a Vascular Surgery, Field Medical Director you will be a key member of the utilization management team. We can offer you a… more
    Evolent (10/10/25)
    - Related Jobs
  • Field Medical Director , Cardiology

    Evolent (Richmond, VA)
    …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support . ... culture. **What You'll Be Doing:** As a Cardiology, Field Medical Director you will be a key member of the utilization management team. We can offer you a… more
    Evolent (10/01/25)
    - Related Jobs
  • Medical Director - Mid West Region

    Humana (Richmond, VA)
    Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... with prior experience participating in teams focusing on quality management , utilization management , case ...management operational improvements, including those within the medical director area + Participate in call rotation + Develop… more
    Humana (09/16/25)
    - Related Jobs