- OhioHealth (Columbus, OH)
- …the patient grievance process at GMC and RMH. **Responsibilities And Duties:** 60% The Medical Director , Risk Management ("MDRM) will provide expertise and ... The MDRM's general function is to be the primary medical expert/resource/advisor to the Risk Management department and the Office of the General Counsel ("OGC).… more
- Humana (Raleigh, NC)
- …a Lead Medical Director , depending on the line of business. The Medical Director conducts Utilization Management or clinical validation of the care ... **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement… more
- Elevance Health (Indianapolis, IN)
- **Utilization Management Medical Director - Indiana Medicaid** **Location:** This role enables associates to work virtually full-time, with the exception of ... is granted as required by law. Alternate locations may be considered. The ** Medical Director ** is responsible for reviewing cases for IN Medicaid members.… more
- Evolent (Madison, WI)
- …accountability for utilization management while working in conjunction with the Senior Medical Director . May assist the Senior Medical Director ... Be Doing:** As a Physician Clinical Reviewer, Interventional Pain Management , you will be a key member of the...process. + On a requested basis, may function as Medical Director for selecting health plans or… more
- Centene Corporation (Indianapolis, IN)
- …the Chief Medical Director to direct and coordinate the medical management , quality improvement and credentialing functions for the business unit. + ... Doctor or Doctor of Osteopathy, Indiana-licensed Geriatrician that assists the Chief Medical Director , Utilization Management , Care Management , and… more
- Fallon Health (Worcester, MA)
- …and LinkedIn. **Brief summary of purpose:** With the general direction from the VP Sr. Medical Director Clinical Management and SVP/Chief Medical Officer ... of care opportunities related to Utilization Management . + Works with VP/ Medical Director to set agenda related to UM and represent the plan at clinical… more
- Highmark Health (Tallahassee, FL)
- …URAC, CMS, DOH, and DOL regulations, etc.). Ensure that all aspects of the medical management process are consistent with community standards of care. + ... care (hospital, outpatient, or private practice) **Preferred** + 1 year in Medical Management in a Health Insurance Plan; strong knowledge of managed care… more
- Insight Global (New York, NY)
- Job Description This role determines the medical appropriateness of inpatient, outpatient, and pharmacy services by reviewing clinical information and applying ... strategy, leading and overseeing a team of physicians ensuring efficient management and adherence to quality standards. Primary Duties and Responsibilities *… more
- UPMC (Pittsburgh, PA)
- The UPMC Health Plan is seeking a licensed MD or DO for a fully remote Medical Director , Utilization Management role. The Medical Director , ... Physicians must devote sufficient time to the CHC-MCO to provide timely medical decisions, including after-hours consultation, as needed + Provide leadership and… more
- Humana (Little Rock, AR)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members ... **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The … more
- Ascendis Pharma (Princeton, NJ)
- …Associate Medical Director supports the US Medical Director for deliverables and activities associated with management and implementation of phase ... Global Communications, and other functional group contributors to support the US Medical Director in successful management of Medical Affairs projects.… more
- WestCare Foundation (Fresno, CA)
- …oversight and assistance to all treatment programs in the region; + To assist the Medical Director and management staff with the design of treatment ... Position Type Full Time Education Level Graduate Degree Category Management Description Position Summary: Person in this position will...to identify clinical trends and provides analysis to the Medical Director ; + Assists in grant planning… more
- Wellpath (Cleveland, OH)
- …training, education, and point of care support. **How you make a difference** The Medical Director of Utilization Management leads and oversees utilization ... patient care and the appropriate utilization of medical services. The Medical Director of Utilization Management serves as a key liaison with external… more
- Select Medical (Scottsdale, AZ)
- **Overview** **Hospital Name: HonorHealth Rehabilitation Hospital** **Joint venture with Select Medical ** **Position:** Director of Case Management ... management criteria, and implementation of safe and appropriate discharge plans. The Director of Case management is also responsible for maintaining a patient… more
- Ethos Veterinary Health (Williston, VT)
- …they will need to build strong partnerships with the local team; including the Medical Director (and Hospital Management team, JV Partners) to support ... 14,000-square-foot hospital located in beautiful Williston, Vermont. As our Hospital Director of Operations, you'll guide a thriving, multi-specialty team dedicated… more
- McLaren Health Care (Flint, MI)
- …to help people live healthier and more satisfying lives. We are looking for a Director , Medical Management to join in leading the organization forward. MHP ... management and direction for the assigned Plan's health services and medical management activities to meet organizational goals. Assumes responsibility for… more
- UNC Health Care (Chapel Hill, NC)
- …0.25 FTE administrative role and reports to the UNC HCS Executive Medical Director for Capacity Creation & Management , while partnering with the Executive ... **Description** **Position Summary** The Executive Medical Director for the East Region...accelerate process pace related to patient flow and capacity management + Serves as a role model by demonstrating… more
- University of Miami (Miami, FL)
- …of Supply Chain has an exciting opportunity for a Full Time Director , Materials Management to work at the UHealth Medical Campus. The Director , Materials ... Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . Director , Materials Management The University of Miami/UHealth… more
- Elevance Health (GA)
- …for employment, unless an accommodation is granted as required by law. The ** Medical Director ** will have program management responsibilities including ... ** Medical Director ** Location: This role enables...overseeing clinical/non-clinical activities. Will also be responsible for utilization review/ management . May be responsible for developing and implementing programs… more
- Elevance Health (Chicago, IL)
- **Clinical Operations Associate Medical Director ** **Carelon Medical Benefit Management ** **Genetic Testing Utilization Management /Review** ... Operations Associate Medical Director ** is responsible for supporting the medical management staff ensuring timely and consistent medical decisions… more
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