- Humana (Dover, DE)
- …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
- Evolent (Dover, DE)
- …Clinical Reviewer, Interventional Pain Management , you will be a key member of the utilization management team. We can offer you a meaningful way to make a ... for selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with the Senior Medical… more
- Humana (Dover, DE)
- …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 (Dover, DE)
- … 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 (Dover, DE)
- …we do it all with heart, each and every day. **POSITION SUMMARY** The Director of Knowledge Management will lead the strategy, implementation, and governance of ... an Infrastructure & Security-wide Knowledge Management program. Reporting to the Executive Director ...to incorporate emerging trends (AI, automation) that enhance knowledge utilization . + Lead the migration to ServiceNow Knowledge Base… more
- Evolent (Dover, DE)
- …impact on patient care in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your ... Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. +… more
- Genesis Healthcare (Hockessin, DE)
- …Area Director ). 9. Assumes responsibility for daily staffing and utilization with input from treating therapists, consideration of clinical requirements, and ... of the rehabilitation department, including oversight related to case management , quality improvement, care planning, clinical utilization , and patient… more
- CBRE (Dover, DE)
- Data Center Design and Engineering Team Lead - Project Management Senior Director Job ID 246110 Posted 07-Nov-2025 Service line PJM Segment Role type Full-time ... - United States of America **About the Role:** The Director of Project Management is a senior...approval. + Monitors appropriate staffing levels and reports on utilization and deployment of human resources. Leads and supports… more
- Evolent (Dover, DE)
- …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + ... you will be a key member of the utilization management team. We can offer you... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National … more
- Evolent (Dover, DE)
- …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + ... you will be a key member of the utilization management team. We can offer you... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National … more
- Humana (Dover, DE)
- …interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , discharge ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a… more
- Organon & Co. (Dover, DE)
- …needs while generating potential solutions that enhance partnership. Collaborating with the National Account Director , the RPAD participates in the development ... **Job Description** **The Position** The Regional Payer Account Director (RPAD) reports directly to the Executive Director , Regional Payer Accounts. The RPAD… more
- Humana (Dover, DE)
- …+ Demonstrate adaptability and willingness to learn evolving workflows, tools, and utilization management practices **Work Schedule Monday - Friday w/standard ... hospitals/ Integrated Delivery Systems, health insurance, or other healthcare providers. + Utilization management experience in a medical management review… more
- Evolent (Dover, DE)
- …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. . ... Oncology, you will be a key member of the utilization management team. We can offer you... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National … more
- Humana (Dover, DE)
- …interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , or similar activities **Preferred ... community and help us put health first** The Medical Director relies on broad clinical expertise to review Medicare...Integrated Delivery Systems, health insurance, or clinical group practice management + Utilization management experience… more
- Evolent (Dover, DE)
- …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + ... Radiology you will be a key member of the utilization management team. We can offer you... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National … more
- Evolent (Dover, DE)
- …public plans such as Medicaid is preferred. + Experience with value-based care, utilization management , or regulatory reporting (eg, HEDIS, NCQA, Milliman) is ... of our specialty programs and administrative platform. **Role Overview** The Senior Director role on Client Analytics will lead the development and execution of… more
- CVS Health (Dover, DE)
- …utilization -based performance metrics. + Executive presence and stakeholder management experience. **Preferred Skills and Qualifications** + Experience building ... to candidates residing in the eastern time zone._ **Position Summary** The Lead Director of Product Operations will assume full ownership of Mental Well Being (MWB)… more
- Elevance Health (Wilmington, DE)
- …experience, which would provide an equivalent background. **Preferred Qualifications:** + Utilization management experience preferred. For candidates working in ... **Medical Director Associate - CarelonRx** **Location:** This role enables...locations may be considered. CarelonRx delivers market-leading pharmacy benefit management and medication dispensing services to drive affordability and… more
- Oracle (Dover, DE)
- …power and cooling in the data center. Critical responsibilities include change management , incident & event support, space utilization , efficiency upgrades, and ... **Job Description** The Data Center Facility Engineering Director individual will lead an organization of Data Center Facility Engineers and Technicians, responsible… more