Strategic Medical Director: Utilization Management

A leading healthcare organization in New York seeks a Medical Director (Utilization Management). This role involves leading the utilization management function with a focus on ensuring appropriate care determinations for Medicare Advantage members. Responsibilities include conducting utilization reviews, collaborating with care management teams, and ensuring...

DescriptionThe Medical Director (Utilization Management) plays a critical role in leading and supporting the clinical integrity of the utilization management function, with a specific focus on inpatient and post‑acute care reviews. This physician leader ensures timely and appropriate care determinations for Medicare Advantage members, guided by clinical...

Description The Medical Director (Utilization Management) plays a critical role in leading and supporting the clinical integrity of the utilization management function, with a specific focus on inpatient and post‑acute care reviews. This physician leader ensures timely and appropriate care determinations for Medicare Advantage members, guided by clinical...

Director, Utilization Management Authorization and Claims 1 day ago Be among the first 25 applicants You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on...

A leading healthcare organization is seeking a Director of Utilization Management Authorization and Claims to oversee operations focused on member outcomes. This role involves directing the utilization management team, ensuring compliance with regulations, and leading process improvements. Candidates should possess a Bachelor’s degree and at least 7 years...

A nonprofit innovation organization is seeking a Director of Strategic Philanthropy to lead fundraising efforts. The ideal candidate will have significant experience in philanthropy and a track record of securing major funding. Responsibilities include developing fundraising strategies and cultivating donor relationships. This position, based in New York,...

A nonprofit innovation organization is seeking a Director of Strategic Philanthropy to lead fundraising efforts. The ideal candidate will have significant experience in philanthropy and a track record of securing major funding. Responsibilities include developing fundraising strategies and cultivating donor relationships. This position, based in New York,...

Executive Medical Director, Clinical Development US- Remote Spyre Therapeutics is a clinical‑stage biotechnology company that aims to create next‑generation inflammatory bowel disease (IBD) and other immune‑mediated disease products by combining best‑in‑class antibody engineering, dose optimization, and rational therapeutic combinations. Spyre's...

We’re seeking a dedicated and detail-oriented Utilization Management Registered Nurse (UM RN) to join our growing healthcare team. In this role, you’ll perform both inpatient and outpatient utilization reviews while supporting transitions of care and ensuring patients receive appropriate, timely, and high-quality services. The ideal candidate will bring...

The Strategic Deals and Partnerships role will have global responsibility for driving strategic partnerships across biopharma accounts and other key organizations, including financial entities supporting clinical trial funding. This position leads cross‑functional Deal Teams to design enterprise‑level solutions, innovative commercial structures, and...