- AmeriHealth Caritas (Newtown Square, PA)
- …administrative services. Discover more about us at www.amerihealthcaritas.com. **Responsibilities:** The Medical Director , Utilization Management ... and related policy and practice initiatives in collaboration with the Corporate Medical Director (s), Utilization Management and the Vice President, … more
- Humana (Trenton, NJ)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an ... caring community and help us put health first** The Medical Director relies on medical ...healthcare providers, clinical group practice management . + Utilization management experience in a medical… more
- Humana (Trenton, NJ)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an ... caring community and help us put health first** The Medical Director actively uses their medical...healthcare providers, clinical group practice management . + Utilization management experience in a medical… more
- Humana (Trenton, NJ)
- … Director , depending on size of team or line of business. The Medical Director conducts Utilization Management of the care received by members in an ... caring community and help us put health first** The Medical Director relies on fundamentals of CMS...healthcare providers, clinical group practice management . + Utilization management experience in a medical… more
- Humana (Trenton, NJ)
- **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
- The Cigna Group (Philadelphia, PA)
- **Overall** Responsible for leading clinical strategy development and product management for pharmacy utilization management and the coordination of rebate ... contracting efforts to ensure alignment across formulary, utilization management , SafeGuard, and other trend solutions. **Essential Functions:** + Ability to… more
- AmeriHealth Caritas (Philadelphia, PA)
- …and goals. Following the shift care workflow the case is presented to the Medical Director for medical necessity review. Upon approval of services, ... pediatric patients in a clinical setting. + Minimum of 3 years of Utilization Management experience, preferably within a managed care organization. + Experience… more
- Evolent (Trenton, NJ)
- …classes as needed for new hires to educate and train on Utilization management system and Field Medical Director process, standards and resources. + ... Stay for the culture. **What You'll Be Doing:** The Medical Director for MSK Surgery is a...practice of Orthopedic Spine Surgery is preferred. + Administrative Medical Experience- Utilization Management , Leadership… more
- Evolent (Trenton, NJ)
- …setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional cardiology ... per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management … more
- Evolent (Trenton, NJ)
- …per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management ... you will be a key member of the utilization management team. We can offer you...management while working in conjunction with the Senior Medical Director . **Qualifications - Required and Preferred:**… more
- Evolent (Trenton, NJ)
- …per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management ... you will be a key member of the utilization management team. We can offer you...management while working in conjunction with the Senior Medical Director . **Qualifications - Required and Preferred:**… more
- Humana (Trenton, NJ)
- …health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a medical management ... caring community and help us put health first** The Medical Director actively uses their medical...with prior experience participating in teams focusing on quality management , utilization management , case … more
- Evolent (Trenton, NJ)
- …in a timely and accurate manner. . May assist the Senior Medical Director in research activities/questions related to the Utilization Management process, ... the culture. **What You'll Be Doing:** As a Field Medical Director , Oncology, you will be a...Oncology, you will be a key member of the utilization management team. We can offer you… more
- Evolent (Trenton, NJ)
- …in a timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management process, ... the culture. **What You'll Be Doing:** As a Field Medical Director , MSK Surgery you will be...Surgery you will be a key member of the utilization management team. We can offer you… more
- Genesis Healthcare (Norristown, PA)
- …Area Director ). 11. Assumes responsibility for daily staffing and utilization with input from treating therapists, consideration of clinical requirements, and ... management of the rehab department, including oversight related to case management , quality improvement, care planning, clinical utilization , and patient… more
- Genesis Healthcare (Reading, PA)
- …Responsibilities The Assistant Director of Rehab is responsible for assisting the Director of Rehab in the efficient management of rehabilitation services in ... of the rehabilitation department, including oversight related to case management , quality improvement, care planning, clinical utilization , and patient… more
- IQVIA (Wayne, PA)
- ** Director , Strategic Account Management ** The **Digital Products & Solutions (DP&S)** business unit at IQVIA is a function-led organization encompassing ... design, implementation, post-implementation support, and technical advisory services. As ** Director , Strategic Account Management ** within the **Clinical Trial… more
- CVS Health (Trenton, NJ)
- …timely and consistent responses to members and providers. As a Medical Director you will focus primarily on overseeing utilization review / quality assurance ... the ability to obtain a NJ License. In the Medical Director role you will provide oversight...clinical / medical programs and expand Aetna's medical management programs to address member needs… more
- University of Pennsylvania (Philadelphia, PA)
- …of health and wellness programs and resources, and much more. Posted Job Title Assistant Medical Director , Gender & Sexual Health Job Profile Title Director ... C, Healthcare Job Description Summary Reporting to the Medical Director , the Assistant Medical Director , Gender and Sexual Health oversees gender… more
- CVS Health (Trenton, NJ)
- … will provide clinical, coding, and reimbursement expertise as well as directing case management when necessary. The Medical Director will act as a ... eg, Clinical Practice and Health Care Industry. *Prior UM ( Utilization Management ) experience *Active and current state medical license without encumbrances… more