- Tempur Sealy (Philadelphia, PA)
- …hours (10 vacation days) 56 sick leave hours (7 sick days) Competitive Medical , Dental & other wellness programs Disability and Life Company Paid 401(k) Retirement ... You'll Do (Essential Duties and Responsibilities): Maintain responsibility for the overall management and leadership of a Tempur Sealy retail store. Maintain primary… more
- Highmark Health (Harrisburg, PA)
- …URAC, CMS, DOH, and DOL regulations, etc.). Ensure that all aspects of the medical management process are consistent with community standards of care. + ... care (hospital, outpatient, or private practice) **Preferred** + 1 year in Medical Management in a Health Insurance Plan; strong knowledge of managed care… more
- Humana (Harrisburg, PA)
- …reports to the Lead Medical Director .** **Other duties:** + Identify medical management operational improvements, including those within the medical ... part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home… more
- Humana (Harrisburg, PA)
- …reports to the Lead Medical Director . **Other duties:** + Identify medical management operational improvements, including those within the medical ... part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home… more
- UPMC (Pittsburgh, PA)
- The UPMC Health Plan is seeking a licensed MD or DO for a fully remote Medical Director , Utilization Management role. The Medical Director , ... role._ Responsibilities: + Actively participates in the daily utilization management and quality improvement review processes, including concurrent, prospective and… more
- Wellpath (Lemoyne, PA)
- …training, education, and point of care support. **How you make a difference** The Medical Director of Utilization Management leads and oversees utilization ... patient care and the appropriate utilization of medical services. The Medical Director of Utilization Management serves as a key liaison with external… more
- Humana (Harrisburg, PA)
- …a Lead Medical Director , depending on the line of business. The Medical Director conducts Utilization Management or clinical validation of the care ... **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement… more
- Evolent (Harrisburg, PA)
- …accountability for utilization management while working in conjunction with the Senior Medical Director . May assist the Senior Medical Director ... Be Doing:** As a Physician Clinical Reviewer, Interventional Pain Management , you will be a key member of the...process. + On a requested basis, may function as Medical Director for selecting health plans or… more
- Select Medical (Hummelstown, PA)
- …**Hospital Name: Penn State Health Rehabilitation Hospital** **Partnership with Select Medical ** **Position:** Director of Case Management **Schedule:** ... management criteria, and implementation of safe and appropriate discharge plans. The Director of Case management is also responsible for maintaining a patient… more
- AmeriHealth Caritas (Philadelphia, PA)
- **Role Overview:** The Medical Director , Utilization Management , provides organizational leadership in the operational areas of appeals, utilization review, ... to develop interventions to improve the clinical effectiveness of medical management strategies. ;Work closely with a multidisciplinary team to ensure… more
- Select Medical (Harrisburg, PA)
- …Calendar + Receiving and reviewing quarterly quality improvement reports. + Assisting the Medical Director and Quality Program Director with development and ... **Overview** **Critical Illness Recovery Hospital** ** Director of Quality Management ** At Select...** At Select Specialty/Regency Hospitals, a division of Select Medical , we care for chronically and critically ill or… 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 ... **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The … more
- UPMC (West Mifflin, PA)
- …is housed. Works directly with, and under the direction of, the STAT MedEvac Medical Director and his/her Associate Medical Directors regarding all clinical ... moves or closings. + Participate/oversee special project development as designated by the Medical Director and/or the President/CEO. + Protect the privacy of all… more
- UPMC (Media, PA)
- …Behavioral Health (CCBH) is seeking a qualified individual to fulfill the role of Regional Medical Director in Delaware County, PA. The Regional Medical ... for the clinical needs of Community Care members. The Medical Director also participates in regional leadership... aspects of cost and utilization reports generated by Medical Management Information System. + Acts as… more
- Grifols Shared Services North America, Inc (Wilkes Barre, PA)
- …in more than 110 countries and regions. The primary responsibility of the MSL Field Director is the management , performance, and coaching of a team of MSL direct ... (MSL primary call points include Immunology, Neurology, Hematology/Oncology). The Field Director ensures compliant execution of field medical plans, strategy,… more
- Humana (Harrisburg, PA)
- … medical management operational improvements, including those within the medical director area + Participate in call rotation + Develop collaborative ... Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an… more
- Humana (Harrisburg, PA)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to… 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 ... happen. **Responsibilities:** + Actively participates in the daily utilization management and quality improvement review processes, including concurrent, prospective… more
- Teleflex (Wayne, PA)
- Medical Director , Interventional Urology and Urology Care (REMOTE) **Date:** Oct 2, 2025 **Location:** Wayne, PA, US **Company:** Teleflex **Expected Travel** : ... and other pelvic malignancies (the BarrigelTM rectal spacer). The Medical Director , Interventional Urology and Urology Care,...Care, is an experienced Urologist with advanced expertise in management of prostate cancer. As a senior member of… more
- CenterWell (Harrisburg, PA)
- …a part of our caring community and help us put health first** The National Medical Director for Home-Based Care Programs is a key clinical leadership position ... polychronic, and high-risk Medicare patients within a full-risk, value-based framework. The Medical Director collaborates in a dyad partnership with the Strategy… more
