- Premera Blue Cross (Mountlake Terrace, WA)
- …are seeking an experienced ** MD ** to join our team as an **Assistant Medical Director ( Utilization Management - Oncology)** . The AMD will leverage their ... addition, they will support clinical programs (disease and case management ), as well as the review and adoption of...**What you will bring:** + Physicians license with an MD or DO degree. (Required) + Current board certification… more
- Lyric (Newtown Square, PA)
- …clients. + Familiarity with affordability, claims operations, payment integrity, utilization management , medical policy and/or benefit policy development. ... opportunities at lyric.ai/careers and drive innovation with #YouToThePowerOfAI. The Senior Medical Director is a senior clinical leader who will represent Lyric in… more
- UPMC (Pittsburgh, PA)
- …Health Plan is seeking a licensed MD or DO for a fully remote Medical Director , Utilization Management role. The Medical Director , Utilization ... full remote role._ Responsibilities: + Actively participates in the daily utilization management and quality improvement review processes, including concurrent,… more
- Wellpath (Lemoyne, PA)
- …education, and point of care support. **How you make a difference** The Medical Director of Utilization Management leads and oversees utilization ... quality patient care and the appropriate utilization of medical services. The Medical Director of Utilization Management serves as a key liaison with… more
- Integra Partners (Troy, MI)
- …needs require. The Senior MD provides clinical oversight to the Utilization Review Medical Director (s), ensures consistent application of criteria, leads ... The Senior Medical Director (Senior MD ) serves as the...serves as the clinical and strategic leader for Integra's Utilization Management (UM) and Credentialing programs. This… more
- Elevance Health (Durham, NC)
- ** Utilization Management Medical Director - NC Medicaid** Location: This role enables associates to work virtually full-time, with the exception of required ... The **Medical Director ** will be responsible for utilization review case management for North Carolina...to increase effectiveness and quality. **Minimum Requirements:** + Requires MD or DO and Board certification approved by one… more
- Integra Partners (Troy, MI)
- …of Durable Medical Equipment (DME) and related requests to support Integra's Utilization Management (UM) operations. This full-time, salaried role functions ... The Utilization Review Medical Director is responsible...or past OIG or state sanctions + Experience performing utilization management or clinical review activities +… more
- Huron Consulting Group (Chicago, IL)
- …regulatory agencies, and hospital contractual payor agreements. This position reports to the Director of Utilization Management and works with hospital ... and quality patient care. Position is located in Annapolis, MD + Staff Acquisition and Support: Leads and manages...staff and function for the system, reporting to the Director of Utilization Management within… more
- Humana (Juneau, AK)
- …reports to Lead depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement...with prior experience participating in teams focusing on quality management , utilization management , case … more
- Point32Health (MA)
- …Summary** The Medical Director , Clinical reviews will primarily perform utilization management and provider payment reviews for all Point32Health products, ... any partner entities at the direction of the Medical Director for Utilization Management . These...medical or osteopathic doctor. Education + Required (minimum): Board-Certified MD or DO in one of the American Board… more
- Humana (Indianapolis, IN)
- …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
- CVS Health (Springfield, IL)
- …Account Management in support of Key Clients as assigned. The Medical Director transacts Utilization Management UM activities (prior authorization and ... 6 company, has an outstanding opportunity for a Medical Director - Medical Affairs (Oncology) We need a Board...commercial client program support. Will share in reviews of utilization management (PA) criteria and clinical policy… more
- CenterWell (Boston, MA)
- …**Additional Information** Will report to the Director of Physician Strategy at Utilization Management . The Medical Director conducts Utilization ... a part of our caring community and help us put health first** The Medical Director , Primary Care relies on medical background and reviews health claims. The Medical … more
- Dignity Health (Bakersfield, CA)
- …, remote patient monitoring, and CRM. - Provide backup support to the Medical Director of Utilization Management in medical review activities, peer-to-peer ... primarily in the Bakersfield/Central CA region.** **Position Summary:** The Medical Director of Physician Engagement is responsible for developing and driving… more
- GMHC (New York, NY)
- Managing Director , Housing WFH Flexible * New York, NY (http://maps.google.com/maps?q=New+York+NY+USA+10018) Description TheManaging Director , Housingis a ... HIV/AIDS. Reporting to theVice President, Housing & Operations, the Managing Director supervises a team of senior...Excel, including: + Data tracking and analysis for case management and program reporting. + Creating and managing… more
- WSP USA (Atlanta, GA)
- …US Advisory & Planning Business Line's Energy Advisory Practice as the Managing Director , shaping transformative strategies that strengthen WSP's position as ... organizations, and community partners. **Technical Expertise and Industry Knowledge** The Managing Director must bring deep technical expertise and broad… more
- CoreCivic (Brentwood, TN)
- …a responsibility to better the public good. CoreCivic is currently seeking a Managing Director , Operations Strategic Finance and Excellence (MUST HAVE ORACLE ... is a hybrid position requiring 3days onsite in Brentwood, TN._ **SUMMARY:** The Managing Director , Operations Strategic Finance and Excellence is responsible for… more
- Ankura (VA)
- …objectives, streamline processes, and foster sustainable growth. Role Overview: This Senior Managing Director will join the leadership team of Strategy & ... capabilities, and sets the overall strategy for the practice. Additionally, the Senior Managing Director will lead and oversee multiple client engagements within… more
- Grant Thornton (New York, NY)
- As a Managing Director within our Regulatory Compliance & Risk Consulting practice, you will get the opportunity to contribute to our clients' business needs by ... providing in-depth technical knowledge on enterprise risk management , risk management frameworks, and compliance ...client concerns + Meet or exceed targeted billing hours ( utilization ) + Manage firm risk and service quality by… more
- PNC (New York, NY)
- …valued and have an opportunity to contribute to the company's success. As the Managing Director , MBS Portfolio Manager within PNC's Asset & Liability ... + Manages various projects and analytics which may include creation, maintenance and utilization of management reports to help the group meet their goals… more
