• National Utilization

    Humana (Jefferson City, MO)
    **Become a part of our caring community and help us put health first** The Utilization Management (UM) Director , Clinical Strategy and Practice for Medicaid ... of how organization capabilities interrelate across the function or segment. The Utilization Management (UM) Director , Clinical Strategy and Practice… more
    Humana (06/06/25)
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  • Remote Medical Director

    Centene Corporation (Jefferson City, MO)
    …functions for the business unit. + Provides medical leadership of all for utilization management , cost containment, and medical quality improvement activities. + ... Provides medical expertise in the operation of approved quality improvement and utilization management programs in accordance with regulatory, state, corporate,… more
    Centene Corporation (06/13/25)
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  • Medical Director , MSK Surgery

    Evolent (Jefferson City, MO)
    …classes as needed for new hires to educate and train on Utilization management system and Field Medical Director process, standards and resources. + Acts as ... for the culture. **What You'll Be Doing:** The Medical Director for MSK Surgery is a key member of...reviews appeal cases and/or attends hearings for discussion of utilization management decisions. + Strong partnership with… more
    Evolent (05/20/25)
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  • Field Medical Director , Interventional…

    Evolent (Jefferson City, MO)
    …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
    Evolent (04/30/25)
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  • Medical Director - Mid West Region

    Humana (Jefferson City, MO)
    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 actively uses their medical background, experience, and judgement...with prior experience participating in teams focusing on quality management , utilization management , case … more
    Humana (05/14/25)
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  • Medical Director - OneHome

    Humana (Jefferson City, MO)
    …Medical Director , depending on size of team 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 fundamentals of CMS Medicare Guidance on...with prior experience participating in teams focusing on quality management , utilization management , case … more
    Humana (05/31/25)
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  • Field Medical Director , Vascular Surgery

    Evolent (Jefferson City, MO)
    …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 (06/06/25)
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  • Field Medical Director , Cardiology

    Evolent (Jefferson City, MO)
    …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 (05/16/25)
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  • Regional Field Director , RNS Program…

    United Therapeutics (Jefferson City, MO)
    …is innovative and inspiring where you can truly make a difference. The Regional Field Director , RNS Program Management serves as a director of all clinical ... the commercial non-promotional team. In addition, the Regional Field Director , RNS Program Management will: + Serve...initiation of a UT product, adverse effect mitigation, device utilization , and dosing upon request + Support the Clinical… more
    United Therapeutics (06/05/25)
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  • Field Medical Director , Musculoskeletal…

    Evolent (Jefferson City, MO)
    …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + ... Surgery 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 (06/11/25)
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  • Field Medical Director , Oncology

    Evolent (Jefferson City, MO)
    …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
    Evolent (05/20/25)
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  • Director , Vendor Management

    Centene Corporation (Jefferson City, MO)
    …including a fresh perspective on workplace flexibility. **Position Purpose:** Manage Utilization Management vendor relationships and ensure vendor compliance ... monitor, and report on vendor performance metrics to business unit management + Communicate expectations and vendor performance against established performance… more
    Centene Corporation (06/11/25)
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  • Associate Director , Channel Strategy…

    Otsuka America Pharmaceutical Inc. (Jefferson City, MO)
    **Associate Director , Channel Strategy and Patient Affordability** The Associate Director , Channel Strategy and Patient Affordability reports to the Executive ... Director , Channel Strategy and Patient Affordability. The Associate ...resources effectively across the team to ensure efficient budget utilization , while identifying cost saving opportunities + Design operational… more
    Otsuka America Pharmaceutical Inc. (05/29/25)
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  • Associate Medical Director , Cardiology

    Evolent (Jefferson City, MO)
    …critical role in **Performance Suite risk arrangements with payers and strategic utilization management initiatives.** This is an opportunity for a ... developing cardiovascular programs that include improvements to clinical effectiveness of utilization management (UM) and risk-based models.** + Process… more
    Evolent (06/03/25)
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  • Senior Director , Edge Platform Engineering…

    Ford Motor Company (Jefferson City, MO)
    …relationship with key technology vendors, negotiating contracts and ensuring optimal utilization . + **Financial Management :** Manage budgets and resources ... Enterprise Technology is searching for Senior Director , Edge Platform Engineering and DevOps Services, who will be responsible for driving strategic direction and… more
    Ford Motor Company (06/14/25)
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  • Associate Director , Field Technology

    Otsuka America Pharmaceutical Inc. (Jefferson City, MO)
    …Associate Director , Field Technology is responsible for leading the management , optimization, and field adoption of sales systems, including CRM, Field ... **Associate Director , Field Technology [CNS or Nephrology]** **Position Summary**...governance, and compliance within sales systems. + Assess system utilization data to provide strategic recommendations to leadership. **Stakeholder… more
    Otsuka America Pharmaceutical Inc. (05/20/25)
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