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Keywords: Utilization Management Medical Director - CA Licensed, Location: USA

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Director of Pharmacy

Responsibilities Pharmacy Director Aiken Regional Medical Centers, located in Aiken, South Carolina, is a 273-bed... as Director of Pharmacy Current licensed pharmacist in South Carolina. Knowledge of systems used in Pharmacy. EEO Statement...

Posted Date: 17 Oct 2025

Director of Rehab - Clinical

. Responsibilities: The Director of Rehab is responsible for the efficient management of rehabilitation services in their assigned... department, including oversight related to case management, quality improvement, care planning, clinical utilization, and patient...

Posted Date: 16 Oct 2025

Director-Rehab Clinical

. Responsibilities: The Director of Rehab OT is responsible for the efficient management of rehabilitation services in their assigned...: We offer Medical, Dental, and Vision plans to Full-Time team members. We offer Dental and Vision to Part-Time team members. Paid Time...

Posted Date: 09 Oct 2025

Atlanta Market - Medical Director

. The Regional Medical Director (RMD) is a developmental, pathway role to Market Chief Medical Officer which is responsible... and community-based organizations (CBOs) In addition to their administrative duties, as a licensed Medical Doctor (MD) or Doctor...

Company: ChenMed
Location: Atlanta, GA
Posted Date: 03 Oct 2025

Medical Director

and medical directors to ensure compliance with guidelines along with participating in risk and quality management programs... decisions re: goals of care, palliative care and hospice. Utilization/Financial Management-managing resource utilization...

Company: ChenMed
Location: Louisville, KY
Posted Date: 03 Oct 2025

Associate Medical Director

and medical directors to ensure compliance with guidelines along with participating in risk and quality management programs... decisions re: goals of care, palliative care and hospice. Utilization/Financial Management-managing resource utilization...

Company: ChenMed
Location: Louisville, KY
Posted Date: 03 Oct 2025

Utilization Management Medical Director - TX Licensed

with utilization management nurses and clinical staff to support timely decision-making. Review appeals and grievances related..., NCQA/URAC standards, and MCO policies. Serve as a liaison between the medical management department and providers...

Location: Texas
Posted Date: 24 Oct 2025

Utilization Management Medical Director - CA Licensed

with utilization management nurses and clinical staff to support timely decision-making. Review appeals and grievances related..., NCQA/URAC standards, and MCO policies. Serve as a liaison between the medical management department and providers...

Location: USA
Posted Date: 19 Oct 2025

Sr Medical Director – Utilization Management (Remote eligible w/ some travel)

Director - Utilization Management: a. Demonstrate ownership of overall effectiveness and efficiency of UM process... flight to Des Moines, Iowa are preferred. Central Time Zone preferred. About the opportunity: As Senior Medical Director...

Company: Wellmark
Location: Des Moines, IA
Posted Date: 19 Oct 2025

Sr Medical Director – Utilization Management (Remote eligible w/ some travel)

Director - Utilization Management: a. Demonstrate ownership of overall effectiveness and efficiency of UM process... flight to Des Moines, Iowa are preferred. Central Time Zone preferred. About the opportunity: As Senior Medical Director...

Company: Wellmark
Location: Cedar Rapids, IA
Posted Date: 08 Oct 2025

Sr Medical Director – Utilization Management (Remote eligible w/ some travel)

Director - Utilization Management: a. Demonstrate ownership of overall effectiveness and efficiency of UM process... flight to Des Moines, Iowa are preferred. Central Time Zone preferred. About the opportunity: As Senior Medical Director...

Company: Wellmark
Location: Sioux Falls, SD
Posted Date: 08 Oct 2025

Medical Director - Utilization Management

The UPMC Health Plan is seeking a licensed MD or DO for a fully remote Medical Director, Utilization Management role.... The Medical Director, Utilization Management is responsible for assuring physician commitment and delivery...

Company: UPMC
Location: Pittsburgh, PA
Posted Date: 02 Oct 2025

Per Diem Medical Director Utilization Management

. Must be licensed to practice in the Pennsylvania as a medical director; additional state licensure required in all states where ACFC... Senior Medical Director of UM, the Per Diem UM Medical Director will be responsible for: Performing daily medical reviews...

Location: USA
Posted Date: 22 Sep 2025

Utilization Management / Medical Management Nurse CA

Anticipated End Date: 2025-11-10 Position Title: Utilization Management / Medical Management Nurse... CA Job Description: Utilization Management / Medical Management Nurse – CA (JR169412) Virtual: This role enables associates to work virtually full...

Company: Elevance Health
Location: Woodland Hills, CA
Posted Date: 22 Oct 2025

Director of Case Management - Utilization Management

-time. Responsibilities: We are seeking a strategic and compassionate Director of Case Management to lead our dynamic... all facets of utilization management, discharge planning, and care coordination to ensure patients receive timely, appropriate...

Posted Date: 19 Oct 2025
Salary: $108160 - 163800 per year

Director of Case Management - Utilization Management

Responsibilities We are seeking a strategic and compassionate Director of Case Management to lead our dynamic Case... of utilization management, discharge planning, and care coordination to ensure patients receive timely, appropriate, and efficient...

Company: Prime Healthcare
Location: Inglewood, CA
Posted Date: 19 Oct 2025
Salary: $108160 - 163800 per year

Director of Utilization Review and Case Management

of Utilization Review (UR) and Case Management!*** The UR and Case Management Director assists admissions in screening patients... years of experience in utilization review and case management. RN, LCSW, LPC, LMFT, or LCP in Virginia preferred. Current...

Location: Leesburg, VA
Posted Date: 10 Sep 2025

Director of Utilization Review and Case Management

of Utilization Review (UR) and Case Management!*** The UR and Case Management Director assists admissions in screening patients... years of experience in utilization review and case management. RN, LCSW, LPC, LMFT, or LCP in Virginia preferred. Current...

Posted Date: 10 Sep 2025

Senior Director, Behavioral Health Utilization Management

: Leads and directs the behavioral health (BH) utilization management team to ensure appropriate member care. . Ensures... consistency of policies, procedures, and processes. Leads and develops BH utilization management strategies and objectives...

Company: Centene
Location: USA
Posted Date: 19 Oct 2025

Behavioral Health Utilization Management Review

Role Overview: Under the direction of the Supervisor, the Behavioral Health Utilization Management Reviewer... to integrated care management as needed. The BH UM Reviewer will apply medical health benefit policy and medical management...

Location: USA
Posted Date: 23 Oct 2025