- Premera Blue Cross (Mountlake Terrace, WA)
- …are seeking an experienced ** MD ** to join our team as an **Assistant Medical Director ( Utilization Management - Oncology)** . The AMD will leverage their ... addition, they will support clinical programs (disease and case management ), as well as the review and adoption of...**What you will bring:** + Physicians license with an MD or DO degree. (Required) + Current board certification… more
- 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
- Novo Nordisk Inc. (Seattle, WA)
- …directors, and other customer groups within Managed Markets. Accountable for managing multiple internal relationships (mainly Market Access, Medical Operations, HEOR ... strategic and priority Managed Markets accounts. Position reports to Field Director /Senior Field Director /Executive Director . Essential Functions… more
- Merck & Co. (Rahway, NJ)
- Job DescriptionThe Executive Director , Value & Implementation (V&I) Outcomes Research, position resides in the V&I organization, which includes Global Medical and ... cross-functional teams is a critical part of this role. The Executive Director has scientific and budgetary oversight for all outcomes research activities conducted… more
- Lyric (Newtown Square, PA)
- …clients. + Familiarity with affordability, claims operations, payment integrity, utilization management , medical policy and/or benefit policy development. ... opportunities at lyric.ai/careers and drive innovation with #YouToThePowerOfAI. The Senior Medical Director is a senior clinical leader who will represent Lyric in… more
- Washington Metropolitan Area Transit Authority (New Carrollton, MD)
- Manager Application Systems Job ID: 251034 Location: MD -Metro Bldg New Carrollton Full/Part Time: Full-Time Posting Open-Close 11/14/2025 - 11/19/2025 Union NRP ... ServiceNow to craft secure, scalable, and user-centric solutions for management decision making and workforce availability controls. Collaborate with… 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
- 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 (Durham, NC)
- ** 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
- Humana (Lansing, MI)
- …a Lead Medical Director , depending on the line of business. The Medical Director conducts Utilization Management or clinical validation of the care ... community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement...with prior experience participating in teams focusing on quality management , utilization management , case … more
- Humana (Indianapolis, IN)
- …to the Lead Medical Director - North Central Medicaid Markets. 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 (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 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
- CVS Health (Springfield, IL)
- …Account Management in support of Key Clients as assigned. The Medical Director transacts Utilization Management UM activities (prior authorization and ... 6 company, has an outstanding opportunity for a Medical Director - Medical Affairs (Oncology) We need a Board...commercial client program support. Will share in reviews of utilization management (PA) criteria and clinical policy… more
- CenterWell (Boston, MA)
- …**Additional Information** Will report to the Director of Physician Strategy at Utilization Management . The Medical Director conducts Utilization ... a part of our caring community and help us put health first** The Medical Director , Primary Care relies on medical background and reviews health claims. The Medical … more
- Humana (Tallahassee, FL)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... skills, with prior experience participating in teams focusing on quality management , utilization management , and acute inpatient rehabilitation.… more
- Dignity Health (Bakersfield, CA)
- …, remote patient monitoring, and CRM. - Provide backup support to the Medical Director of Utilization Management in medical review activities, peer-to-peer ... primarily in the Bakersfield/Central CA region.** **Position Summary:** The Medical Director of Physician Engagement is responsible for developing and driving… 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
- GMHC (New York, NY)
- Managing Director , Housing WFH Flexible * New York, NY (http://maps.google.com/maps?q=New+York+NY+USA+10018) Description TheManaging Director , Housingis a ... HIV/AIDS. Reporting to theVice President, Housing & Operations, the Managing Director supervises a team of senior...Excel, including: + Data tracking and analysis for case management and program reporting. + Creating and managing… more
