• Novo Nordisk Inc. (Plainsboro, NJ)
    …a difference? The Position Position provides field coaching, mentorship and management to the field-based Medical Liaisons, and develops and implements strategies: ... the US affiliate and globally if needed; responsible for administrative and management support of field-based FMA Program at Novo Nordisk Inc (NNI). Accountable… more
    HireLifeScience (07/22/25)
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  • Eisai, Inc (Nutley, NJ)
    …If this is your profile, we want to hear from you. The Associate Director (AD), Global Medical Affairs Training and Education is responsible for the planning and ... and MSL managers. Develop congress abstract tracker, assign MSL coverage, review MSL reporting responsibilities, collate and distribute Congress Report, execute pre-… more
    HireLifeScience (06/28/25)
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  • Novo Nordisk Inc. (Plainsboro, NJ)
    …need them most, by creating an environment where innovation and chronic disease management drive optimal health outcomes. Are you ready to realize your potential? ... customers. Relationships This position reports into a Vice President or Sr. Director within the National Account Market Access Teams. Internally, this position has… more
    HireLifeScience (06/27/25)
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  • Novo Nordisk Inc. (Boston, MA)
    …the business potential o the territory. Relationships Reports to the Regional Director - Rare Endocrine. External relationships include those with the following: ... Kit, consistent with AMCP guidelines and NNI policies Supports the Regional Director - Rare Endocrine in planning and implementing regional functions/POA meetings… more
    HireLifeScience (06/12/25)
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  • Regional Medical Director , Care…

    UPMC (Pittsburgh, PA)
    The Regional Medical Director , CC/DP and Utilization Review , provides clinical and management leadership across multiple hospitals within the region. ... hospital in their region. Key Responsibilities + Leadership & Management **: + Oversee Utilization Management ...care organizations, providers, and payers to address benefit coverage, utilization review , and quality assurance. + Promote… more
    UPMC (07/11/25)
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  • Utilization Review Medical…

    Commonwealth Care Alliance (Boston, MA)
    …**Position Summary:** Reporting to the Senior Medical Director of Medical Policy and Utilization Review , the Utilization Review Medical Director ... Serve as the lead for CCA's Utilization Review functions working closely with other medical management...+ Primary care discipline, prior experience as Associate Medical Director (or equivalent) or physician reviewer in a Managed… more
    Commonwealth Care Alliance (06/27/25)
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  • Utilization Review Care…

    Intermountain Health (Las Vegas, NV)
    **Job Description:** The Utilization Review Care Management Director is responsible for providing leadership and administrative direction for ... Utilization Management and Review for...Utilization Management and Review for the Enterprise. The...and attainment of financial goals. Reporting to the Sr. Director /AVP/VP Utilization Management , the role… more
    Intermountain Health (07/02/25)
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  • Director Utilization Mgmt

    Wellpath (Lemoyne, PA)
    …**How you make a difference** The Medical Director of Utilization Management leads and oversees utilization review , case management , quality ... quality patient care and the appropriate utilization of medical services. The Medical Director of Utilization Management serves as a key liaison with… more
    Wellpath (06/23/25)
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  • Manager, Utilization Management

    Commonwealth Care Alliance (Boston, MA)
    Management reports to the Director of Utilization Management * Oversees clinical decision review for services requiring prior authorization in a ... Mgmt Position Summary: Commonwealth Care Alliance's (CCA) Utilization Management (Authorization) Unit is primarily responsible...for overseeing and managing the daily operation of the Utilization Management Review Nurse and… more
    Commonwealth Care Alliance (05/21/25)
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  • Med Mgmt Clinician Sr (US)

    Elevance Health (Las Vegas, NV)
    …or equivalent. + Requires a minimum of 6 years of clinical experience and/or utilization review experience. + Current active, valid and unrestricted RN license ... in process improvement initiatives to improve the efficiency and effectiveness of the utilization reviews within the medical management processes. + Assesses and… more
    Elevance Health (07/23/25)
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  • Director of Case Management (RN…

    Select Medical (Mesa, AZ)
    …and Care Planning Management , Fiscal Management and Payer/Referral Management , Utilization Review . The Director of Case Management is also ... allotted time frame; assuring payments of hospital-based services meeting patient-related utilization management criteria, and implementation of safe and… more
    Select Medical (07/09/25)
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  • Supv Regional Care Mgmt - Integrated Care…

    Sharp HealthCare (San Diego, CA)
    …the direction of the manager of in-patient care management and the Director of Utilization Management . **Required Qualifications** + 3 Years Experience ... Facility/Regional - SCMG Operations meetings and task forces.Facilitate regional Utilization Management committees and other working regional… more
    Sharp HealthCare (07/09/25)
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  • Medical Director - Commercial

    Elevance Health (Dearborn, MI)
    …East Coast time zone hours.** The **Medical Director ** will be responsible for utilization review case management for Commercial business in the New ... **Medical Director - Commercial** Location: This role enables associates to...state or territory of the United States when conducting utilization review or an appeals consideration and… more
    Elevance Health (07/25/25)
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  • Med Mgmt Nurse (US)

    Elevance Health (Tampa, FL)
    …or case management experience and requires a minimum of 2 years clinical, utilization review , or managed care experience; or any combination of education and ... - 6pm EST and will include weekends. The **Medical Management Nurse** will be responsible for review ...treatment is medically necessary and provides consultation to Medical Director on cases that are unclear or do not… more
    Elevance Health (07/30/25)
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  • Med Mgmt Nurse (US)

    Elevance Health (Atlanta, GA)
    …or case management experience and requires a minimum of 2 years clinical, utilization review , or managed care experience; or any combination of education and ... **Medical Management Nurse** **Location:** This role enables associates to...is medically necessary and provides consultation to the Medical Director on cases that are unclear or do not… more
    Elevance Health (07/29/25)
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  • Director , Utilization

    Alameda Health System (Oakland, CA)
    Director , Utilization Management + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day + Nursing + Req ... plans **Role Overview:** Alameda Health System is hiring! The Director of Utilization Management holds...the classification. + Lead and manage a team of utilization review professionals providing guidance, training, and… more
    Alameda Health System (05/06/25)
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  • Executive System Director

    UNC Health Care (Morrisville, NC)
    …and well-being of the unique communities we serve. **Summary** : The **Executive System Director of Utilization Management (UM)** is a strategic and ... operational leader responsible for designing, implementing, and standardizing utilization management functions across a large healthcare system, including a… more
    UNC Health Care (07/27/25)
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  • Director Utilization

    Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
    About The Role The Director , Utilization Management (UM) will manage the Utilization Management team consisting of Clinicians and Non-Clinical ... onboardings with time sensitive requirements. + Support and grow the utilization management team through strong professional relationships, mentorship, modelling… more
    Brighton Health Plan Solutions, LLC (07/18/25)
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  • Medical Director - Utilization

    UPMC (Pittsburgh, PA)
    The Medical Director , Utilization Management is responsible for assuring physician commitment and delivery of comprehensive high-quality health care to UPMC ... Life Changing Medicine happen. **Responsibilities:** + Actively participates in the daily utilization management and quality improvement review processes,… more
    UPMC (06/12/25)
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  • Director of Case Management

    Prime Healthcare (Inglewood, CA)
    …provides leadership and supervision to case managers, social workers and case management coordinators/discharge planners, utilization review coordinators and ... Workers, and Clinical Coordinators. This leader will oversee all facets of utilization management , discharge planning, and care coordination to ensure patiens… more
    Prime Healthcare (07/18/25)
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