60 medical director utilization management jobs found

POSITION SUMMARY/RESPONSIBILITIES This position provides clinical leadership and oversight of the population health management program including utilization management, case management, preventive health/disease management, and quality management while supporting the multidisciplinary member-centric approach to care management. Actively participates with staff across the organization - this is essential to facilitate integrated service delivery, planning, quality assurance, and risk management and to address the needs of members and their families to protect and promote the healthcare of members. EDUCATION/EXPERIENCE A medical degree as Doctor of Medicine (MD) or Osteopathy (DO) and an active and unrestricted Texas Medical License, free of sanctions from Medicaid or Medicare is required. Minimum of five year of direct clinical patient care experience post-residency is required. Minimum two years' experience in a medical leadership role is preferred. Previous experience...

Reporting to the Vice President of Strategic Planning, Performance, and Digital Health, the Senior Director, Digital Adoption & Enablement provides strategic and operational leadership for enterprise efforts to drive successful adoption, sustained utilization, and value realization of digital tools, platforms, and workflows across Dana-Farber. This role establishes the vision, operating model, and priorities for digital adoption and enablement services supporting major institutional applications and platforms, including Epic, Microsoft 365 technologies, Workday, UKG, and other enterprise clinical, administrative, productivity, and collaboration systems. The Senior Director leads a multidisciplinary function that may include adoption and enablement managers, trainers, instructional designers, content developers, change management specialists, and organizational readiness professionals, and works closely with the Project & Portfolio Management Office, the Digital Consulting...

Lexington County Detention Center is seeking an experienced and dedicated Medical Director to oversee and lead the delivery of comprehensive healthcare services within a correctional setting. This role is ideal for a physician who is committed to quality, safety, and continuity of care for an incarcerated population, while providing strong clinical leadership and collaboration with custody and administrative partners. The Medical Director is responsible for the overall medical management of healthcare services at the detention center, ensuring care is clinically appropriate, compliant with applicable standards, and delivered with professionalism and compassion. Required Qualifications : MD or DO with an active, unrestricted medical license in the state of South Carolina (or eligibility for licensure). Board certification preferred, experience in correctional medicine, primary care, emergency medicine, internal medicine, or family medicine strongly desired....

SSM Health is an Equal Opportunity Employer: Community Description: About SSM Health: Position Summary The Regional Associate Medical Director for Foot and Ankle Surgery and Podiatry provides physician leadership for clinical alignment, quality, access, operational consistency, and provider engagement across SSM Health's Wisconsin Region. In partnership with the Regional Clinical Program Medical Director for Musculoskeletal Services and operational leaders, this role supports orthopedic foot and ankle and podiatric providers, APPs, nursing, perioperative, ambulatory, wound care, rehabilitation, and related teams. The leader helps establish a consistent regional structure for foot and ankle care, including meeting cadence, communication, escalation pathways, standardized care delivery, and support for regional wound care and limb salvage strategy development. Administrative FTE and Term This is anticipated to be a 0.10 administrative FTE leadership role, inclusive of...

Compensation Disclaimer Compensation for this role is based on a number of factors, including but not limited to experience, education, and other business and organizational considerations. Department: UPC Inpatient Adult Services FTE: 1.00 Full Time Shift: Days Position Summary: Direct and coordinate the clinical and management activities of one or more unit (s) in order to provide quality patient care. Actively supports programs and services that are in line with long-range strategic objectives. Support education and research in conjunction with Unit Medical Director. Ensure adherence to Hospitals and departmental policies and procedures. Patient care assignment may include neonate, pediatric, adolescent, adult and geriatric age groups. Detailed responsibilities: SUPERVISION - Plan, coordinate and direct activities of supervisory, technical professional and support staff; conduct staff meetings MANAGE - Interview applicants, hire, train, supervise, evaluate,...

Job Description: Medical Group Medical Director of Specialty Care in Montana Market, Billings is a leadership position reporting to and collaborating with the market Medical Group Associate Chief Medical Officer. Together, and in dyad partnership with market operations directors sustain healthy relationships among providers and Intermountain Health. The Medical Director must be a patient centric leader who is an excellent trusted clinician with strong interpersonal and organizational skills. They must have a strong commitment to improving the processes at Intermountain Health working with other departments, clinical programs, service-lines, clinical shared services, markets, and clinics in the organization through development of standard work and process improvement. The Medical Director will collaborate with all team members and all providers to deliver services that are high in measurable quality, value, and service, while also furthering the mission, the Framework for...

Spectrum Healthcare Resources is excited to offer a potential career opportunity for a Behavioral Health Medical Director supporting the TriCare/Department of Defense and Community Care Network/Department of Veterans Affairs. This remote-based civilian position is an outstanding chance to make a meaningful contribution to the healthcare of veterans and military beneficiaries while benefiting from work-life flexibility, professional collaboration, and impactful leadership. Join us in leading high-quality care initiatives for those who have served our country, with a focus on system-wide clinical improvement, peer collaboration, and mission-driven support!Requirements:Doctor of Medicine (MD) or Doctor of Osteopathy (DO) from an accredited medical school.Active, unrestricted license to practice medicine in the United States.Board certification or board eligibility through a recognized specialty board.U.S. Citizenship.Favorable background investigation through the Department of Defense...

#nowhiring Lutheran Services Florida (LSF) envisions a world where children are safe, families are strong, and communities are vibrant . LSF is looking for talented Director of Clinical Services who want to make an impact in the lives of others.  Purpose & Impact: The Director of Clinical Services provides centralized clinical, operational, and quality leadership for LSF programs serving youth, families, and vulnerable populations across CINS/FINS shelters, group homes, emergency shelters, SNAP programs, Community Counseling and Unaccompanied Children (UAC) refugee programs. The position is responsible for ensuring consistent, trauma-informed, culturally responsive, clinically sound, and contract-compliant service delivery across assigned programs. The director leads clinical practice standards, program performance, continuous quality improvement, staff development, risk mitigation, and cross-program integration to promote service excellence, regulatory...

Hello, Thank you for your interest in career opportunities with the University of Mississippi Medical Center.  Please review the following instructions prior to submitting your job application: Provide all of your employment history, education, and licenses/certifications/registrations.  You will be unable to modify your application after you have submitted it. You must meet all of the job requirements at the time of submitting the application.  You can only apply one time to a job requisition.  Once you start the application process you cannot save your work. Please ensure you have all required attachment(s) available to complete your application before you begin the process. Applications must be submitted prior to the close of the recruitment. Once recruitment has closed, applications will no longer be accepted. After you apply, we will review your qualifications and contact you if your application is among the most highly qualified. Due to the...

Department: 04170 WFBMG University Group Practice: WFBMC Main - Hospitalists Status: Full time Benefits Eligible: Yes Hou rs Per Week: 40 Schedule Details/Additional Information: Clinical FTE 0.8 Administrative FTE 0.2 Pay Range: $51.05 - $76.60 If it’s possible,...

Do you have the career opportunities as a(an) RN Manager Case Management you want with your current employer? We have an exciting opportunity for you to join Research Medical Center which is part of the nation's leading provider of healthcare services, HCA Healthcare. Job Summary and Qualifications The ma nager of c a s e m anagement provides supervision and oversees the functional operations of c ase m anagement and s ocial s ervices. The m anager leads a team of clinical professionals to achieve optimal outcomes for patient throughput. What you will do in this role: You will provide oversight for the day-to-day department activities including but not limited to, education, productivity monitoring, staffing support, communication and scheduling. You will have case management, utilization review and /or discharge planning responsibilities. You will collaborate with clinicians and support staff in designing and implementing processes to comply...

Do you have the career opportunities as a(an) RN Manager Case Management you want with your current employer? We have an exciting opportunity for you to join Research Medical Center which is part of the nation's leading provider of healthcare services, HCA Healthcare. Job Summary and Qualifications The ma nager of c a s e m anagement provides supervision and oversees the functional operations of c ase m anagement and s ocial s ervices. The m anager leads a team of clinical professionals to achieve optimal outcomes for patient throughput. What you will do in this role: You will provide oversight for the day-to-day department activities including but not limited to, education, productivity monitoring, staffing support, communication and scheduling. You will have case management, utilization review and /or discharge planning responsibilities. You will collaborate with clinicians and support staff in designing and implementing processes to comply...

Do you have the career opportunities as a(an) RN Manager Case Management you want with your current employer? We have an exciting opportunity for you to join Research Medical Center which is part of the nation's leading provider of healthcare services, HCA Healthcare. Job Summary and Qualifications The ma nager of c a s e m anagement provides supervision and oversees the functional operations of c ase m anagement and s ocial s ervices. The m anager leads a team of clinical professionals to achieve optimal outcomes for patient throughput. What you will do in this role: You will provide oversight for the day-to-day department activities including but not limited to, education, productivity monitoring, staffing support, communication and scheduling. You will have case management, utilization review and /or discharge planning responsibilities. You will collaborate with clinicians and support staff in designing and implementing processes to comply...

Do you have the career opportunities as a(an) RN Manager Case Management you want with your current employer? We have an exciting opportunity for you to join Research Medical Center which is part of the nation's leading provider of healthcare services, HCA Healthcare. Job Summary and Qualifications The ma nager of c a s e m anagement provides supervision and oversees the functional operations of c ase m anagement and s ocial s ervices. The m anager leads a team of clinical professionals to achieve optimal outcomes for patient throughput. What you will do in this role: You will provide oversight for the day-to-day department activities including but not limited to, education, productivity monitoring, staffing support, communication and scheduling. You will have case management, utilization review and /or discharge planning responsibilities. You will collaborate with clinicians and support staff in designing and implementing processes to comply...

Compensation Disclaimer Compensation for this role is based on a number of factors, including but not limited to experience, education, and other business and organizational considerations. Department: Neuroscience ICU FTE: 1.00 Full Time Shift: Days UNM Health provides the highest quality of care for more than 200,000 New Mexicans each year. In 1952, UNM Hospital was built on Native American grounds, with the promise to provide culturally competent and inclusive care to all New Mexicans. UNM Health is New Mexico's only Level I Trauma Center-we care for patients with the most complex conditions from across the state. Additionally, we are the first NIH-designated Comprehensive Cancer Center and award-winning Advanced Care Stroke Center. UNM Health providers specialize in over 150 areas of medicine and employ over 7,000 professionals. Together, we receive 900,000 outpatient visits, 22,000 surgical cases and 100,000 emergency room visits each year. Position Summary: Direct...

$ 48.43/hr. Maximum Offer $ 75.10/hr. Compensation Disclaimer Compensation for this role is based on a number of factors, including but not limited to experience, education, and other business and organizational considerations. Department: Intermediate Critical Care FTE: 1.00 Full Time Shift: Days The director of the Intermediate Critical Care (ICC) will take part in setting up a brand-new unit for a growing service line. The director of this unit will have a unique opportunity to work with a specialized and complex population and will work hand in hand with critical care leadership to establish high quality patient centered care for the people of New Mexico and beyond. Position Summary: Direct and coordinate the clinical and management activities of one or more unit (s) in order to provide quality patient care. Actively supports programs and services that are in line with long-range strategic objectives. Support education and research in conjunction with Unit...

About University Health At University Health, we are dedicated to improving the health of our community through exceptional patient care, education, and innovation. Our team embodies a strong commitment to excellence, and we are seeking a dynamic and compassionate leader to guide our Dialysis Services team. Position Overview As the Director of Outpatient Clinical Dialysis , you will provide administrative and clinical leadership for University Health's outpatient hemodialysis clinics. Working collaboratively with the Medical Director, Executive Director of Dialysis Services, physicians, and interdisciplinary teams, you will oversee daily clinical operations, quality outcomes, regulatory compliance, staff development, and patient care initiatives. This position plays a critical role in ensuring operational excellence while fostering a culture of safety, accountability, and continuous improvement. Key Responsibilities Clinical Operations: Direct and oversee...

About University Health At University Health, we are dedicated to improving the health of our community through exceptional patient care, education, and innovation. Our team embodies a strong commitment to excellence, and we are seeking a dynamic and compassionate leader to guide our Dialysis Services team. Position Overview As the Director of Outpatient Clinical Dialysis , you will provide administrative and clinical leadership for University Health's outpatient hemodialysis clinics. Working collaboratively with the Medical Director, Executive Director of Dialysis Services, physicians, and interdisciplinary teams, you will oversee daily clinical operations, quality outcomes, regulatory compliance, staff development, and patient care initiatives. This position plays a critical role in ensuring operational excellence while fostering a culture of safety, accountability, and continuous improvement. Key Responsibilities Clinical Operations: Direct and oversee...

About University Health At University Health, we are dedicated to improving the health of our community through exceptional patient care, education, and innovation. Our team embodies a strong commitment to excellence, and we are seeking a dynamic and compassionate leader to guide our Dialysis Services team. Position Overview As the Director of Outpatient Clinical Dialysis , you will provide administrative and clinical leadership for University Health's outpatient hemodialysis clinics. Working collaboratively with the Medical Director, Executive Director of Dialysis Services, physicians, and interdisciplinary teams, you will oversee daily clinical operations, quality outcomes, regulatory compliance, staff development, and patient care initiatives. This position plays a critical role in ensuring operational excellence while fostering a culture of safety, accountability, and continuous improvement. Key Responsibilities Clinical Operations: Direct and oversee...

About University Health At University Health, we are dedicated to improving the health of our community through exceptional patient care, education, and innovation. Our team embodies a strong commitment to excellence, and we are seeking a dynamic and compassionate leader to guide our Dialysis Services team. Position Overview As the Director of Outpatient Clinical Dialysis , you will provide administrative and clinical leadership for University Health's outpatient hemodialysis clinics. Working collaboratively with the Medical Director, Executive Director of Dialysis Services, physicians, and interdisciplinary teams, you will oversee daily clinical operations, quality outcomes, regulatory compliance, staff development, and patient care initiatives. This position plays a critical role in ensuring operational excellence while fostering a culture of safety, accountability, and continuous improvement. Key Responsibilities Clinical Operations: Direct and oversee...