A company is looking for a Medical Director for their Clinical Review Team.Key ResponsibilitiesOversee workforce management to ensure timely medical reviews meet quality parametersPartner with the Senior Medical Director on Utilization Management program strategy and executionManage direct reports, overseeing their performance and professional developmentRequired QualificationsBoard certified or eligible MD or DO with an unrestricted license to practice medicine in the US10+ years of experience in the healthcare industry3+ years of clinical practice in a relevant specialty3+ years of utilization review experience in a managed care plan3+ years of leadership experience as a people manager
Market Medical Director, Utilization Management - WellMed - Remote
The Market Medical Director for Utilization Management will support WellMed Medical Management, Inc. WellMed, part of the Optum family of businesses, is seeking a Market Medical Director, Utilization Management to join our team in Dallas, Austin, San Antonio, El Paso, Tampa, Orlando, Miami, Atlanta,...
Inpatient Care Management Medical Director - Remote
Inpatient Care Management Medical Director. The Medical Directors work with groups of nurses and support staff to manage inpatient care utilization at a hospital, market, regional or national level. Although not a primary job function, Medical Directors with the interest in doing so often can be inv...
Inpatient Care Management Medical Director
A company is looking for an Inpatient Care Management Medical Director to manage inpatient care utilization and collaborate with healthcare providers. ...
Director of Emergency Management & Business Continuity
The medical center has four degree-granting institutions: UT Southwestern Medical School, UT Southwestern Graduate School of Biomedical Sciences, UT Southwestern School of Health Professions, and the UT Southwestern School of Public Health. Director of Emergency Management & Business Continuity....
Utilization Management Coordinator PRN-Coverage 7 days/week as needed - DAY SHIFT
Utilization Management Coordinator PRN Days - Coverage 7 days per week as needed. Processes incoming faxes, scans documents and other clerical duties as deemed necessary to assist with the facilitation of Utilization Management functions. As a world-renowned medical and research center, we strive to...
Utilization Management Director
Utilization Management Director. Oversite of granting authorizations and conducting utilization reviews for behavioral health services per clinical information given by providers and internal criteria for medical necessity and appropriateness of care. At least five years' experience in direct care o...
Utilization Management Coordinator PRN-Coverage 7 days/week as needed - DAY SHIFT
Utilization Management Coordinator PRN Days - Coverage 7 days per week as needed. Processes incoming faxes, scans documents and other clerical duties as deemed necessary to assist with the facilitation of Utilization Management functions. As a world-renowned medical and research center, we strive to...
Medical Director Case Management
The Duals Care Management (CM) Medical Director will participate in designing, developing and deploying our Models of Care across all markets. Provides clinical oversight of the Dual Eligible Special Needs Plan (DSNP) and Medicare-Medicaid Plan (MMP) care management teams and the Interdisciplinary C...
Nurse Medical Management II - Utilization Management
Consults with clinical reviewers and/or medical directors to ensure medically appropriate, high quality, cost effective care throughout the medical management process. Nurse Medical Management II - Utilization Management. Ensures medically appropriate, high quality, cost effective care through asses...
Medical Director - (Pain Management SME)
The Medical Director (Pain Management) will be a Subject Matter Expert (SME) with a background in Pain Management specialty, including post-graduate direct patient care experience specifically. Aetna, a CVS Health Company, has an exciting opportunity for a Medical Director (Pain Management) that can...