• Commonwealth Care Alliance (Boston, MA)
    …responsibility for managing the effective utilization of healthcare services, case / disease management , program development/ management /evaluation and ... Mgmt - Directs, coordinates and evaluates efficiency and productivity of utilization management functions for physical health services and long term… more
    DirectEmployers Association (10/02/25)
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  • Premera Blue Cross (Mountlake Terrace, WA)
    …We are seeking an experienced **MD** to join our team as an **Assistant Medical Director ( Utilization Management - Oncology)** . The AMD will leverage their ... In addition, they will support clinical programs (disease and case management ), as well as the review...of Internal Medicine is preferred for the Assistant Medical Director with an Oncology focus. (Required) + Unrestricted Washington… more
    DirectEmployers Association (10/22/25)
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  • Insmed Incorporated (NJ)
    …and business partners. Through these relationships, the DCA will lead the account management efforts and support appropriate utilization of Insmed brands so that ... other, and for the future of science, we're in. Are you?About the Role:The Director , Channel Accounts (DCA) role will be responsible for specialty pharmacy account … more
    HireLifeScience (09/17/25)
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  • Henkel (Westlake, OH)
    Director of Commercial Excellence North America **_About_** **_this_** **_Position_** At Henkel, you'll be part of an organization that's shaping the future through ... initiatives on sales excellence & strategic pricing + Drive professional key account management + Lead, develop and implement Category Management strategy +… more
    DirectEmployers Association (10/21/25)
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  • Luke Staffing (Yigo, GU)
    …co-workers, families, peers, and other health team members. + Submits all concerns through Utilization Management Director ; be able to identify, analyze, and ... of clinical nursing experience is required. One year of previous experience in Utilization Management is required. Full time employment in a nursing field… more
    DirectEmployers Association (11/13/25)
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  • Stanford Health Care (Palo Alto, CA)
    …flow of information to and from the supplier. The position reports to the Assistant Director - Category Management & Value Based Selection who is a direct report ... changes in process and operations to include standardization and utilization of resources (supplies, equipment, services, people, etc.). The...This role will work in conjunction with the Assistant Director - Category Management & Value Based… more
    DirectEmployers Association (11/12/25)
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  • Commonwealth Care Alliance (Boston, MA)
    …member experience. - Address provider inquiries related to care coordination, utilization management , and program participation, collaborating with internal ... quality care. The BH Provider Engagement Program Manager reports to the Director of Delegation Partnerships and Provider Engagement. Supervision Exercised: - No,… more
    DirectEmployers Association (10/18/25)
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  • Stanford Health Care (Palo Alto, CA)
    …the clinical, operational, and administrative initiatives of the service line Medical Director and unit nursing management team. . Conduct regularly scheduled ... competency and adherence to policy through practice analysis and case review of APPs with physicians. . Investigate and...operational, and administrative initiatives of the service line Medical Director and unit nursing management team. +… more
    DirectEmployers Association (11/13/25)
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  • Cordis (Norfolk, VA)
    …in-servicing.?? Responsible for direct revenue generation (transactional Business) through direct case support. ?Reports to National Clinical Sales Director .? ... or annual basis. + Focused on driving depth and increasing Cordis product utilization in existing accounts through the cultivation of new physician users and… more
    DirectEmployers Association (11/15/25)
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  • BroadPath Healthcare Solutions (Tucson, AZ)
    …of Texas or compact license + 3+ years Nursing experience + 1+ years Utilization Management and Appeals experience + Excellent verbal, written and computer ... Members/LARs, physicians, hospital representatives, and other + Providers regarding case status, due process, rationale, and regulatory requirements + Coordinates… more
    DirectEmployers Association (11/13/25)
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  • Stanford Health Care (Palo Alto, CA)
    …the clinical, operational, and administrative initiatives of the service line Medical Director and unit nursing management team. + Conduct regularly scheduled ... is a Stanford Health Care job.** **A Brief Overview** Provides supervision and management of advanced practice providers (APPs) in a distinct clinical service line.… more
    DirectEmployers Association (11/04/25)
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  • Monte Nido (Waltham, MA)
    …programs utilizing Family Based Treatment (FBT) methods. + Provide clinical care and case management in a manner consistent with the philosophy and objectives ... care for patients with eating disorders under the supervision of the Program Director . **This is a Full time position Mon-Fri with 1-2 evenings included… more
    DirectEmployers Association (09/19/25)
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  • Director of Case Management

    Prime Healthcare (Inglewood, CA)
    …status, ie full-time or part-time. Responsibilities We are seeking a strategic and compassionate Director of Case Management to lead our dynamic Case ... of staff and systems to effectively operate a comprehensive Case Management Program. The Director ...supervision to case managers, social workers and case management coordinators/discharge planners, utilization more
    Prime Healthcare (10/18/25)
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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 ... The Executive Director works closely with leaders from various departments- case management , physician advisors, revenue cycle, medical staff, nursing, and… more
    UNC Health Care (10/29/25)
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  • Director , Utilization

    Commonwealth Care Alliance (Boston, MA)
    …responsibility for managing the effective utilization of healthcare services, case / disease management , program development/ management /evaluation and ... Mgmt * Directs, coordinates and evaluates efficiency and productivity of utilization management functions for physical health services and long term… more
    Commonwealth Care Alliance (10/02/25)
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  • Utilization Management Medical…

    Elevance Health (Durham, NC)
    ** Utilization Management Medical Director - NC...The **Medical Director ** will be responsible for utilization review case management for North ... May serve as a resource to staff including Medical Director Associates. **How you will make an impact:** +...and external physicians. + May conduct peer-to-peer clinical appeal case reviews with attending physicians or other ordering providers… more
    Elevance Health (11/12/25)
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  • LPN- Utilization Mgmt Reviewer…

    Guthrie (Cortland, NY)
    Summary The LPN Utilization Management (UM) Reviewer, in collaboration with Care Coordination, Guthrie Clinic offices, other physician offices, and the Robert ... Hospital Business Office, is responsible for the coordination of Utilization Management (UM) processes and requirements of...with members of the healthcare team. + Proactively researches case findings related to payer audits of UM decisions… more
    Guthrie (10/28/25)
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  • Director Utilization Mgmt (Do Or MD…

    Wellpath (Lemoyne, PA)
    …education, and point of care support. **How you make a difference** The Medical Director of Utilization Management leads and oversees utilization ... care and the appropriate utilization of medical services. The Medical Director of Utilization Management serves as a key liaison with external partners… more
    Wellpath (11/07/25)
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  • Senior Director Case

    Houston Methodist (Houston, TX)
    …for all hospital-based Case Management Directors and the Central Utilization Review Director across the system. This position is responsible for the ... At Houston Methodist, the Sr Director Case Management position... initiatives. + Provides strategic vision and execution for case management and utilization review… more
    Houston Methodist (10/16/25)
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  • Director Case Management

    Brockton Hospital (Brockton, MA)
    PURPOSE OF POSITION: The Director of Case Management is responsible for planning, directing, and managing of the activities of the Case Management ... solves problems, referring exceptional issues to Vice President. The Director of Case Management is...resource utilization . Provides training to staff on case management methods and techniques. Establishes monitoring… more
    Brockton Hospital (09/12/25)
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