• Recovery Coordinator 1 ( UM Laora) (h)

    University of Miami (Miami, FL)
    …abdominal organs in approximately 50% of cases. + In conjunction with the Medical Director assumes ultimate responsibility for donor management and the process ... the LAORA electronic medical record. + Shares on-call responsibility with Medical Director to oversee clinical evaluation and management of potential organ… more
    University of Miami (05/09/25)
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  • Medical Director ( Medical

    CVS Health (Springfield, IL)
    …will participate in inter-rater review activities and other quality oversight processes for internal Director UM decisions. If specifically assigned to one ... Management in support of Key Clients as assigned. The Medical Director transacts Utilization Management UM...Medical Affairs). **Required Qualifications** * Family Medicine or Internal Medicine Board Certification. * Minimum of 5 years… more
    CVS Health (04/20/25)
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  • Medical Director , Children's…

    Excellus BlueCross BlueShield (Buffalo, NY)
    …the Quality Management/Utilization Management (QM/ UM ) Plan, including having the BH Medical Director for Children's Services and participate on the BH ... of the Children's Behavioral Health (BH) Carve-In program. The Medical Director for BH Children's Services has...clinical setting). + A minimum of ten (10) years medical experience and strong working knowledge of QM/ UM more
    Excellus BlueCross BlueShield (05/10/25)
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  • Senior Medical Director - Sharp…

    Sharp HealthCare (San Diego, CA)
    …the position, and employer business practices. **What You Will Do** This Senior Medical Director position provides critical management and oversight for Sharp ... Officer. **Required Qualifications** + Doctor of Medicine (MD) - Internal Medicine or Family Practice + **OR** Doctor of...+ 5 years' experience as an HMO Health Plan Medical Director . + California Physicians and Surgeons… more
    Sharp HealthCare (04/20/25)
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  • Medical Director - Medicaid (IL)

    CVS Health (Springfield, IL)
    …Michigan, Kansas and Oklahoma. Support for other regions may occasionally be required. The UM Medical Director will ensure timely and consistent responses to ... supports the Aetna Better Health Plan of Illinois. This UM (Utilization Management) Medical Director ...care experience - Board certification in Family Medicine or Internal Medicine / Pediatrics - Prior UM more
    CVS Health (05/07/25)
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  • Medical Director , Safety Net…

    Excellus BlueCross BlueShield (Rochester, NY)
    …you see is right for you, we encourage you to apply! Job Description: The Medical Director participates in the broad array of activities of the Medical ... reviews and may require peer-to-peer discussions with providers regarding UM case review determinations. + Provides clinical expertise on...and medical criteria. + Assists with training medical director colleagues and nursing staff ,… more
    Excellus BlueCross BlueShield (05/15/25)
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  • Director Utilization Mgmt

    Wellpath (Lemoyne, PA)
    …education, and point of care support. **How you make a difference** The Medical Director of Utilization Management leads and oversees utilization review, case ... in their efforts to ensure quality patient care and the appropriate utilization of medical services. The Medical Director of Utilization Management serves as… more
    Wellpath (03/25/25)
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  • Medical Director - North Central

    CVS Health (Columbus, OH)
    medical license without encumbrances in one of these states.** + In the Medical Director role you will provide oversight for medical policy ... staff ensuring timely and consistent responses to members and providers. + As a Medical Director you will focus primarily on overseeing utilization review and… more
    CVS Health (05/30/25)
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  • Director of Finance and Administration

    University of Maryland, Baltimore (Baltimore, MD)
    *The University of Maryland Institute for Health Computing ( UM -IHC)*is a $70M initiative in North Bethesda funded by Montgomery County and the University of Maryland ... Strategic Partnership: MPowering the State. The UM -IHC aims to build a learning health system for...the State of Maryland that leverages advanced computation and medical innovation to advance health equity and improve quality… more
    University of Maryland, Baltimore (05/19/25)
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  • Medical Director - Assistant…

    University of Maryland, Baltimore (Baltimore, MD)
    …Professor*level (non-tenure track) to join our dynamic team and serve as* Medical Director *of our vibrant community-based academic radiation oncology practice ... **Faculty* **Organization:** **School of Medicine - Clinical Departments* **Title:** * Medical Director - Assistant or Associate Professor Community-Based… more
    University of Maryland, Baltimore (03/29/25)
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  • Director of the University of Maryland St.…

    University of Maryland, Baltimore (Baltimore, MD)
    …Comprehensive Cancer Center (UMGCCC), located in Baltimore, MD are recruiting for a*full-time Medical Director of the University of Maryland St. Joseph Cancer ... in Towson, MD.**_ Administrative duties and responsibilities of the Medical Director role will include, but not...be board certified or board-eligible by the ABIM in Internal Medicine and Hematology and/or Medical Oncology… more
    University of Maryland, Baltimore (03/29/25)
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  • Group Director Utilization Review

    Tenet Healthcare (Detroit, MI)
    Group Director Utilization Review - 2506000536 Description : The Detroit Medical Center (DMC) is a nationally recognized health care system that serves patients ... to help people live happier, healthier lives. The hospitals of the Detroit Medical Center are the Children's Hospital of Michigan, Detroit Receiving Hospital, Harper… more
    Tenet Healthcare (04/20/25)
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  • Director , Utilization Management

    Alameda Health System (Oakland, CA)
    Director , Utilization Management + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day + Nursing + Req #:40826-30155 + FTE:1 + ... time off plans **Role Overview:** Alameda Health System is hiring! The Director of Utilization Management holds a critical role encompassing operational oversight,… more
    Alameda Health System (05/06/25)
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  • Medical Director - Commercial…

    CVS Health (Annapolis, MD)
    Internal Medicine or Internal Medicine/Pediatrics (Med/Peds) Board Certification. In the Medical Director role, you will provide oversight for medical ... and consistent responses to members and providers. As a Medical Director you will focus primarily on...UM (Utilization Management) experience *Active and current state medical license without encumbrances *M.D. or DO, Board Certification… more
    CVS Health (05/16/25)
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  • Physician (Community Living Center Medical

    Veterans Affairs, Veterans Health Administration (Albuquerque, NM)
    …& Extended Care Service is recruiting a Physician for the Community Living Center (CLC), Medical Director position. Join us and help shape the Future of Veteran ... in Albuquerque, NM. Responsibilities Position duties for the CLC Medical Director include but are not limited...and oversight of screening process; collaborates with the hospital UR/ UM team to maximize as appropriate patient movement from… more
    Veterans Affairs, Veterans Health Administration (04/18/25)
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  • Medical Director - Commercial

    CVS Health (Sacramento, CA)
    …(work from home) role preferably resides in Pacific or Mountain Time Zone. In the Medical Director role you will provide oversight for medical policy ... staff ensuring timely and consistent responses to members and providers. As a Medical Director you will focus primarily on overseeing utilization review /… more
    CVS Health (05/08/25)
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  • Director , Strategic & Administrative…

    University of Michigan (Ann Arbor, MI)
    …review of issues among Michigan Medicine executive leadership, including the EVPMA/CEO, the UM Health Regional Network President, the Medical School Dean, UM ... Director , Strategic & Administrative Operations, Office of CEO/EVPMA...**This position is presently only accepting Michigan Medicine employee internal applicants.** **Job Summary** Michigan Medicine is seeking a… more
    University of Michigan (05/24/25)
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  • Medical Director - Kentucky Medicaid

    CVS Health (Frankfort, KY)
    …do it all with heart, each and every day. **Position Summary:** Ready to take your Medical Director skills to the next level with a Fortune 6 company? Checkout ... and the Southeast Region (FL, LA and WV). This Medical Director will be a "Work from...direct patient care experience - Family Medicine, Emergency Medicine, Internal Medicine-Pediatrics Specialty Preferred. - Prior UM more
    CVS Health (05/03/25)
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  • Medical Director - Health Services…

    Sharp HealthCare (San Diego, CA)
    …as a physician executive in a managed care environment, preferably as an HMO Medical Director . + California Physicians and Surgeons License - Medical ... of CA -REQUIRED **Other Qualification Requirements** + Board certified in a medical discipline ( internal medicine or family practice preferred). **Essential… more
    Sharp HealthCare (05/18/25)
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  • Utilization Review Medical Director

    Intermountain Health (Las Vegas, NV)
    …utilization management, care management, claims, network management, and finance. As the Medical Director for Utilization Management, you are responsible, in ... be engaged in these important projects along with traditional UM activities: Member of the Medical Leadership...and claims appeals levels 1-3. + Board Certified in Internal Medicine, Family Practice, or other primary care specialty.… more
    Intermountain Health (03/04/25)
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