- Organon & Co. (Plymouth Meeting, PA)
- **Job Description** **The Position** The Regional Payer Account Director (RPAD) reports directly to the Executive Director , Regional Payer Accounts. The RPAD ... generating potential solutions that enhance partnership. Collaborating with the National Account Director , the RPAD participates in the development of, as well as… more
- CSL Behring (King Of Prussia, PA)
- …to support their appropriate use. + Collaborate with business teams, marketing and medical affairs to ensure alignment and full utilization of resources at ... The Associate Director , Corporate Accounts is responsible for managing all...close relationship with cross functional Team colleagues in Sales, Medical Affairs, Marketing and Market Access to implement corporate,… more
- Lyric (Newtown Square, PA)
- …inform Lyric's clients. + Familiarity with affordability, claims operations, payment integrity, utilization management , medical policy and/or benefit policy ... Explore opportunities at lyric.ai/careers and drive innovation with #YouToThePowerOfAI. The Senior Medical Director is a senior clinical leader who will… more
- Carnegie Mellon University (Pittsburgh, PA)
- …Provide analytical support and financial insight for audits, facilities projects, space utilization , grants management , and special projects. + Coordinate with ... areas to investigate and solve real-world problems. We are seeking a Director of Accounting Operations. This position provides strategic and operational leadership… more
- CSL Behring (King Of Prussia, PA)
- …collection and submit all reports needed for compliance. 4. Work with Senior Director , Policy Advocacy & Government Affairs, & Legal to interpret and implement ... and compliance support for Audit, Legal or Finance as requested 9. Provide management oversight on the records supporting the disclosure of data to federal and… more
- CSL Behring (King Of Prussia, PA)
- …Sales Managers, Sr. Director (s) of Field Sales, Sales Training and Marketing, Medical Affairs and Customer Service. + Responsible to assure field utilization ... of sales representatives through effective coaching. Works closely with the Senior Director of Field Sales to establish strategic and tactical approaches to the… more
- CSL Behring (King Of Prussia, PA)
- **The Opportunity:** Reporting to the Director Strategic Sourcing Logistics & Warehousing, as the **Sr. Manager, Regional Category - Logistics & Warehousing** , you ... innovation, customer service, compliance and quality. _Establish and Maintain Effective Category Management and Bid Management :_ + Drive value from the regional… more
- UPMC (Pittsburgh, PA)
- …The UMPC Health Plan is seeking a licensed MD or DO for a fully remote Medical Director , Utilization Management role. The Medical ... full remote role._ Responsibilities: + Actively participates in the daily utilization management and quality improvement review processes, including concurrent,… more
- 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
- Humana (Harrisburg, PA)
- … Director , depending on the line of business. The Medical Director conducts Utilization Management or clinical validation of the care received ... caring community and help us put health first** The Medical Director actively uses their medical...healthcare providers, clinical group practice management . + Utilization management experience in a medical… more
- Humana (Harrisburg, PA)
- … 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 (Harrisburg, PA)
- … 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
- CenterWell (Harrisburg, PA)
- …**Additional Information** Will report to the Director of Physician Strategy at Utilization Management . The Medical Director conducts Utilization ... **Become a part of our caring community and help us put health first** The Medical Director , Primary Care relies on medical background and reviews health… more
- Evolent (Harrisburg, PA)
- …for utilization management while working in conjunction with the Senior Medical Director . May assist the Senior Medical Director in ... , you will be a key member of the utilization management team. We can offer you...process. + On a requested basis, may function as Medical Director for selecting health plans or… more
- Centene Corporation (Harrisburg, PA)
- …the Chief Medical Director to direct and coordinate the medical management , quality improvement and credentialing functions for the business unit. + ... fresh perspective on workplace flexibility. We are hiring a Medical Director for our New Jersey market....Provides medical leadership of all for utilization management , cost containment, and medical… more
- Evolent (Harrisburg, PA)
- …setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional cardiology ... per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management … more
- Evolent (Harrisburg, PA)
- …per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management ... you will be a key member of the utilization management team. We can offer you...management while working in conjunction with the Senior Medical Director . **Qualifications - Required and Preferred:**… more
- Evolent (Harrisburg, PA)
- …per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management ... you will be a key member of the utilization management team. We can offer you...management while working in conjunction with the Senior Medical Director . **Qualifications - Required and Preferred:**… more
- Humana (Harrisburg, PA)
- …health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a medical management ... caring community and help us put health first** The Medical Director actively uses their medical...with prior experience participating in teams focusing on quality management , utilization management , case … more
- Highmark Health (Harrisburg, PA)
- …:** **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and ... and DOL regulations at all times. In addition to utilization review, the incumbent participates as the physician member...DOL regulations, etc.). Ensure that all aspects of the medical management process are consistent with community… more
