- 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. ... plans Role Overview: Alameda Health System is hiring! The Director of Utilization Management holds a critical... reviews and determine program improvements. Develop and implement utilization review policies and procedures in accordance… more
- AmeriHealth Caritas (Newtown Square, PA)
- …in a managed care organization Proficiency in Electronic Medical Record Systems and Utilization Review Systems (eg, JIVA) to efficiently document and assess ... policies. When necessary, cases are escalated to the Medical Director for further review . The reviewer independently...patient cases Strong understanding of utilization review processes, including medical necessity criteria,… more
- AmeriHealth Caritas (Newtown Square, PA)
- …Current driver's license required Skills & Abilities; Strong understanding of utilization review processes, including medical necessity criteria, care ... policies. When necessary, cases are escalated to the Medical Director for further review . The reviewer independently...order to meet productivity standards in a fast-paced, high-volume utilization review environment Ability to gather and… more
- AmeriHealth Caritas (Newtown Square, PA)
- …CHC process for requesting additional information. Refers cases to the Plan Medical Director for medical necessity review when medical information provided does ... collect all information necessary to perform a thorough needs review . It is at the Reviewer's discretion to request...and appropriately identify and refer requests to the Medical Director when guidelines are unmet. The Reviewer will maintain… more
- Saint Francis Health System (Tulsa, OK)
- …participates in the Patient Care Committee for patient care reviews, and in Utilization Review Staff Committee, providing data and contributing to improvement of ... administrative and clinical support to the hospital and treatment team throughout the review of patients, their placement in various levels of care and their receipt… more
- Tris Pharma (Monmouth Junction, NJ)
- …have an opening in our Monmouth Junction, NJ facility for a Director , Market Access, OperationsThis position is responsible for managing the operational ... contracting, pricing governance, government compliance, and vendor management. The Director orchestrates complex cross-functional workflows, manages day-to-day vendor relationships… more
- CVS Health (Columbus, OH)
- …claims processing, contractual oversight, formulary management and updates, medication utilization review , prior authorization processes in alignment with ... in all state meetings regarding pharmacy program initiatives, new legislation, Drug Utilization Review (DUR) and formulary/guideline changes. Provider and Vendor… more
- Cardinal Health (Tewksbury, MA)
- …the Commonwealth of Massachusetts. JOB OBJECTIVE Reporting to the Health System Director of Pharmacy (HSD), Director of Pharmacy Operations and Account ... Management, and Cardinal Health Clinical Director , the Health System Clinical Director plans,...initiatives, updates to the Policy and Procedure manual, annual review of order sets and protocols, black box warning,… more
- Humana (Phoenix, AZ)
- …a part of our caring community and help us put health first The Medical Director relies on broad clinical expertise to review Medicare drug appeals (Part D ... and will understand how to operationalize this in their daily work. The Medical Director 's work includes computer based review of moderately complex to complex… more
- Carnegie Mellon University (Pittsburgh, PA)
- …areas to investigate and solve real-world problems. We are seeking a Director of Accounting Operations. This position provides strategic and operational leadership ... and Social Sciences. Reporting to the Chief Business Officer, the Director oversees all aspects of accounting operations, including financial transactions,… more
- University of Pennsylvania (Philadelphia, PA)
- …guidelines. In collaboration with the Medical Director and Associate Medical Director develop, review , and revise patient care policies and procedures. ... and wellness programs and resources, and much more. Posted Job Title Assistant Medical Director , Gender & Sexual Health Job Profile Title Director C, Healthcare… more
- Oracle (Columbus, OH)
- Job Description The Data Center Facility Engineering Director individual will lead an organization of Data Center Facility Engineers and Technicians, responsible for ... are achieved, maintenances are performed with minimal risk, manage capacity utilization , address local maintenance requirements, and support technical projects. The… more
- ENFRA (Charlotte, NC)
- …just values-they are the pillars of our continued success. Overview The Director of Construction will be responsible, in collaboration with regional leadership, for ... ensuring our projects are on schedule and meeting client expectations. The Director of Construction will participate in the development and implementation of… more
- The Cigna Group (St. Louis, MO)
- JOB SUMMARY The Director Health Systems Sales will lead a Sales Manager and a team of Account Managers and Business Development Managers responsible for the ... a strategic growth priority for Evernorth Health Services (HSS). This Sales Director will be instrumental in expanding our Health System Offering, driving… more
- Battelle Memorial Institute (Columbus, OH)
- …and welcome all qualified individuals to apply. Job Summary The Sr. Director , Procurement is responsible for directing the procurement and subcontracts functions for ... objectives within contractual agreements, required laws, and regulations. The Sr. Director role will be developing and implementing procurement strategies; managing… more
- Encore (Kansas City, MO)
- Position Overview The Director , Event Technology II (DET II) is responsible for leading a successful sales and operations team to achieve the revenue and ... $8M in revenue and will report to a Regional Director , Venues or an RVP, Venues. Key Job Responsibilities...Leadership on sales strategies Creates and participate in business review presentations. Financial Management & Reporting Drive Results by… more
- CBRE (Springfield, MA)
- Sr Facilities Director - Hartford, CT Job ID 244120 Posted 22-Oct-2025 Service line GWS Segment Role type Full-time Areas of Interest Facilities Management ... of America About the Role: As a CBRE Facilities Director , you will serve as the primary client contact...staff and department deadlines. Mentor and coach as needed. Review the client's strategic plans for appropriate staffing levels… more
- Arrow Electronics (Dayton, OH)
- Position: Sales Engineering Director - Cloud, Data/AI Job Description: The start date for this position is estimated to be in January 2026. Arrow is seeking a Sales ... Engineering Director (SED) to provide strategy, technical direction and business...product and proof of concept demonstrations, solution consultation, architecture review , and enablement of Arrow partners. The SED possesses… more
- Concentrix (Raleigh, NC)
- …(https://jobs.concentrix.com/) "Job Details Director , Account Management Account Management (https://jobs.concentrix.com/job-search/?category=Account Management) ... Location United States Of America Language English Apply Now (https://cnx.wd1.myworkdayjobs.com/external_global/job/USA-Work-at-Home/ Director --Account-Management_R1676422-1/apply?1=1) Summary Director , Account Management, Mobility Sector… more
- Cardinal Health (Columbus, OH)
- …healthcare services and products company headquartered in Dublin, OH. The National Director of Sales, Market Access serves as the dynamic commercial leader for ... access sales strategy into actionable, target-exceeding results. Furthermore, the National Director of Sales, Market Access will directly support the team's diverse… more
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