- Eisai, Inc (Nutley, NJ)
- …research activities and development of external communication materials. The Director facilitates coverage, reimbursement and appropriate utilization based ... your profile, we want to hear from you. The Director , US HEOR and RWE (field) is responsible for...develop compelling value proposition that drives optimal access and utilization of Eisai marketed products in the United States.Provide… more
- Daiichi Sankyo, Inc. (Bernards, NJ)
- …areas centered around rare diseases and immune disorders. Summary The Associate Director , Global Oncology Medical Affairs, Medical Analytics will be responsible for ... managing the digital analytics infrastructure and developing and executing...stakeholders, including senior leadership and medical affairs teams. Ensure utilization of advanced analytics techniques to identify HCP sentiment… 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
- UPMC (Pittsburgh, PA)
- The Medical Director , Utilization Management is responsible for assuring physician commitment and delivery of comprehensive high-quality health care to UPMC ... Changing Medicine happen. **Responsibilities:** + Actively participates in the daily utilization management and quality improvement review processes, including… more
- AmeriHealth Caritas (Philadelphia, PA)
- **Role Overview:** The Medical Director , Utilization Management , provides organizational leadership in the operational areas of appeals, utilization ... policy and practice initiatives in collaboration with the Corporate Medical Directors, Utilization Management and the Vice President, Medical Affairs. ; **Work… 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
- Henry Ford Health System (Clinton Township, MI)
- GENERAL SUMMARY: The Medical Director of Utilization Management shall have responsibility for the medical oversight of activities related to Henry Ford ... REQUIRED: MD or DO. Two (2) years of physician advisor and/or utilization management experience. Medical Staff membership in good standing at Henry Ford… more
- Elevance Health (Wallingford, CT)
- ** 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
- Centene Corporation (Tallahassee, FL)
- …Doctor or Doctor of Osteopathy, Indiana-licensed Geriatrician that assists the Chief Medical Director , Utilization Management , Care Management , and ... functions for the business unit. + Provides medical leadership of all for utilization management , cost containment, and medical quality improvement activities. +… more
- Humana (Montgomery, AL)
- … Director , 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 relies on medical background and reviews health claims....with prior experience participating in teams focusing on quality management , utilization management , case … more
- Humana (San Juan, PR)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... with prior experience participating in teams focusing on quality management , utilization management , case ...management operational improvements, including those within the medical director area + Participate in call rotation + Develop… more
- Humana (Raleigh, NC)
- … Director , 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 relies on medical background and reviews health claims....with prior experience participating in teams focusing on quality management , utilization management , case … more
- ERP International (Barksdale AFB, LA)
- …co-workers, families, peers, and other health team members. Submits all concerns through Utilization Management Director ; be able to identify, analyze and ... **Overview** ERP International is seeking a ** Utilization Management Registered Nurse (RN)** for...states. Founded in 2006, ERP is headquartered in Laurel, MD and maintains satellite offices in Montgomery, AL and… more
- Elevance Health (Overland Park, KS)
- …clinical responsibilities means that the medical director is directly involved in Utilization Management and Case Management . + Daily case reviews for ... director provides clinical expertise in all aspects of utilization review and case management . Provides input...of medical services by members. Involved in identifying and managing medical utilization trends, emerging trends and… more
- Palo Alto Networks (Arlington, VA)
- …personalized learning opportunities - just to name a few! **Your Career** The Managing Director , Incident Response, is responsible for leading Unit 42's Incident ... in the day to day delivery aspects and functional management of the consulting organization, but is also responsible...Response (IR) practice + Lead the IR practice by managing goals and milestones to achieve quarterly, annual and… more
- The Cigna Group (Bloomfield, CT)
- …Summary:** Cigna Healthcare seeks a visionary and results-oriented leader to serve as Managing Director - Local Network Solutions Lead. This role is responsible ... go-to-market product commercialization and provider strategy & solutions, including Utilization Management , EMR integration, and Collaborative Care Agreements.… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …depending on customer and departmental needs. + Plans, implements, and documents utilization management activities which incorporate a thorough understanding of ... and gain efficiencies for performance improvement opportunities in the Utilization Management Department. + Assists in updating...to successfully engage members into care. + Assists Medical Director ( MD ) in projects as needed. Minimum… 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
- Ankura (IL)
- …of their real estate portfolios and capital investments. Role Overview This Senior Managing Director will support Construction Disputes & Advisory - one of ... platform (20+ years total experience) + Ideal candidate will have Construction Management and Project Control experience and experience managing and growing… more
- CVS Health (IL)
- …regional role that primarily supports the Aetna Better Health Plan of Illinois. This UM ( Utilization Management ) Medical Director will be a "Work from Home" ... every day. **Position Summary:** Ready to take your Medical Director skills to the next level with a Fortune...and appeal request. This position is primarily responsible for Utilization Management , including prior authorization as well… more
