- 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
- Humana (Harrisburg, PA)
- … 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
- Humana (Harrisburg, PA)
- … 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 (Harrisburg, PA)
- …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
- Select Medical (Camp Hill, PA)
- …focus on resource management . + Demonstrating compliance with facility-wide Utilization Management policies and procedures. + Coordinating UR compliance with ... **Overview** **Critical Illness Recovery Hospital** ** Director of Case Management ** **_Clinical license...growth of the department, including, but not limited to: Utilization Review (UR) and resource management , discharge… more
- Centene Corporation (Harrisburg, PA)
- …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
- Evolent (Harrisburg, PA)
- …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 (Harrisburg, PA)
- …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 (Harrisburg, PA)
- …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + ... **What You'll Be Doing:** As a Vascular Surgery, Field Medical Director you will be a key member of the utilization management team. We can offer you a… more
- Evolent (Harrisburg, PA)
- …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + ... culture. **What You'll Be Doing:** As a Cardiology, Field Medical Director you will be a key member of the utilization management team. We can offer you a… more
- United Therapeutics (Harrisburg, PA)
- …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
- Cardinal Health (Harrisburg, PA)
- …and integrates vendor tasks and deliverables into project plans. **_Job Summary_** The Director , IT Program/Project Management is a key leader in the IT ... **_What IT Program & Project Management contributes to Cardinal Health_** Transformation enables the organization to drive complex and transformational programs… more
- Humana (Harrisburg, PA)
- …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
- Lumen (Harrisburg, PA)
- …we digitally connect the world and shape the future. **The Role** The Audience Management Director will be responsible for leading the strategy and execution of ... them into actionable insights that drive competitive advantage and innovation. Strategic Utilization of Adobe CDP and Advanced Toolsets: + Implement a cohesive… more
- Evolent (Harrisburg, PA)
- …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + ... culture. **What You'll Be Doing:** As a Field Medical Director , MSK Surgery you will be a key member of the utilization management team. We can offer you a… more
- Evolent (Harrisburg, PA)
- …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. . ... the culture. **What You'll Be Doing:** As a Field Medical Director , Oncology, you will be a key member of the utilization management team. We can offer you a… more
- CVS Health (Harrisburg, PA)
- …Delivery System eg, Clinical Practice and Health Care Industry. *Prior UM ( Utilization Management ) experience *Active and current state medical license without ... coding, and reimbursement expertise as well as directing case management when necessary. The Medical Director will act as a business and clinical liaison to… more
- UPMC (Harrisburg, PA)
- …Our unit is fast-paced and is a great environment to learn time management skills, prioritization abilities, assessment skills, and clinical reasoning. The Unit ... Director maintains 24-hour accountability for leading and managing their...department orientation, and fostering a culture of continuous performance management . This includes completing and delivering employee evaluations, managing… more
- CBRE (Harrisburg, PA)
- Digital Strategy & Innovation Director Job ID 213761 Posted 21-Apr-2025 Service line GWS Segment Role type Full-time Areas of Interest Digital & ... We are seeking a visionary and dynamic Digital Strategy & Innovation Director to lead our organization's digital transformation initiatives. As a CBRE Digital… more
- Humana (Harrisburg, PA)
- …focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience + Working with health insurance ... and help us put health first** The Corporate Medical Director (CMD) relies on medical background to review health...review health claims and preservice appeals. The Corporate Medical Director works on problems of diverse scope and complexity… more