Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

Senior Medical Director, Utilization & Care Management

Visa Hunt

Florida Blue seeks an experienced Medical Director consultant to lead utilization management reviews and policy development. In a dynamic healthcare setting, you will collaborate with case managers and physicians to render timely medical necessity decisions. The role requires an unrestricted Florida medical license or equivalent board certification. Excellent communication and the ability to work independently and in teams are essential. #J-18808-Ljbffr Visa Hunt

Vacancy posted 2 days ago
Similar jobs that could be interesting for youBased on the Senior Medical Director, Utilization & Care Management in Florida, NY vacancy
  • Centene Management Company LLC is seeking a remote Utilization Management leader to oversee BH UM clinicians and ensure appropriate care for members. The role involves guiding UM practices, tracking performance, and aligning with regulatory standards. Requires nursing... 
    Senior
    Remote job
    Flexible hours

    Centene Management Company LLC

    Florida, NY
    3 days ago
  • $102.9k - $190.5k

    Position Purpose Manages the behavioral health (BH) utilization review clinicians to ensure appropriate care to members. Oversees and works with senior leadership on utilization management issues related...  .... Advanced understanding of medical necessity criteria for a broad... 
    Senior
    Work at office
    Remote work
    Flexible hours

    Centene Management Company LLC

    Florida, NY
    3 days ago
  • Centene Corporation seeks a senior leader to manage BH utilization review clinicians in a remote capacity, ensuring compliant, cost-effective member care and coordinating with BH senior leadership on UM strategies. The role requires an active clinical license (LCSW, LMHC... 
    Senior
    Remote job

    Centene Corporation

    Florida, NY
    3 days ago
  • Medical Director - Sphere Senior (Part-Time) Department: Clinical Leadership, Sphere...  ...native, home-based primary care program built for the most...  ...primary care, complex care management, care transitions support,...  ...structures: M&M review, utilization review, care committee meetings... 
    Senior
    Full time
    Contract work
    Part time
    Work at office
    Remote work
    Shift work
    Weekend work

    Di Rezze Family Office

    Florida, NY
    2 days ago
  •  ...organization located in the Town of Florida, NY, seeks a Medical Director for Case Management and Utilization Review. The ideal candidate will lead hospital...  ...initiatives, improve resource management, and enhance patient care quality. Required qualifications include a Medical... 
    Suggested

    National Medical Association

    Florida, NY
    2 days ago
  • Overview The Medical Director of Case Management and Utilization Review leads the hospital-specific execution of Case Management...  ...and the quality of patient care. Assists the Case Management staff...  .... This position reports to the Senior Medical Director of Case Management... 

    Aoiassn

    Florida, NY
    2 days ago
  • Memorial Healthcare System in Hollywood, Florida seeks a Medical Director to lead Case Management and Utilization Review, shaping clinical pathways and ensuring high‑quality patient care. The ideal candidate has 5+ years in medical staff administration within a large acute... 

    Endocrine

    Florida, NY
    2 days ago
  • # Medical Director - Case Management and Utilization ReviewHollywood, FloridaHospitalComplexity of Work: Essential Competencies and Skills: Excellent customer...  .../administrative experience in a large acute care hospital.Other Information: Additional Education Info... 
    Work experience placement

    American Geriatrics Society

    Florida, NY
    2 days ago
  • Memorial Healthcare System is seeking a Medical Director of Case Management and Utilization Review to lead hospital-specific CM/UR execution and act as the primary...  ...the UR Committee to improve resource use and patient care quality. The position requires a Medical Doctor... 

    American Academy of Family Physicians

    Florida, NY
    2 days ago
  • Aoiassn in Florida seeks a Medical Director of Case Management and Utilization Review to lead CM/UR activities and to serve as the hospital's primary physician...  ...management, and provide physician education. This senior role reports to the Senior Medical Director and... 

    Aoiassn

    Florida, NY
    2 days ago
  • Memorial Healthcare System seeks a Medical Director for Case Management and Utilization Review. The role oversees clinical decision making, ensures efficient use of resources, and leads cross-functional teams in a large academic/community hospital setting. The ideal candidate... 

    American Geriatrics Society

    Florida, NY
    2 days ago
  • AdventHealth Zephyrhills is seeking an experienced nurse manager to lead hospital personnel and resources, ensuring standards and goals...  ...events while mentoring staff and ensuring high-quality patient care. The role requires an RN license with BLS/ACLS/PALS certifications... 
    Senior

    adventhealth

    Florida, NY
    11 hours ago
  •  ...Dallas, Texas, is seeking an RN Supervisor to lead a clinical team within a Florida community, delivering person-centered home health care and ensuring resident well-being. You will review referrals, coordinate assessments, develop care plans with physicians, and work to... 
    Senior

    Lifespacecareers

    Florida, NY
    4 days ago
  •  ...compassionate Health and Wellness Coordinator to support the health and wellness director by supervising care staff, overseeing medication management, and ensuring personalized, high-quality care for senior residents. The role emphasizes teamwork, on-call duties, and ongoing... 
    Senior

    Brookdale Senior Living

    Florida, NY
    3 days ago
  • Pine Trail Nursing and Rehab Center seeks an experienced Unit Manager RN to oversee care delivery on the unit in a Florida facility. You will supervise CNAs, assess resident needs, develop care plans, and ensure accurate documentation for quality care and billing. The... 
    Senior

    Pine Trail Nursing and Rehab Center

    Florida, NY
    5 days ago
  •  ...United States seeks a clinical professional to lead Medical Management/Health Services, driving utilization review, cost containment, and medical quality improvement...  ...for 28 million members. This role collaborates with care management, providers, and committees to ensure... 
    Remote job
    Work at office

    Centene Corporation

    Florida, NY
    2 days ago
  •  ...hundred thousand patients. And a utilization function about to be built from the...  ...builds it. This is the first Regional Medical Director for Utilization Management in the company's history. You...  ...Run panel risk stratification and care gap closure with the care management... 
    Relocation package

    StaffMed Health Partners

    Florida, NY
    2 days ago
  • StaffMed Health Partners is seeking a Regional Medical Director for Utilization Management to author policy, establish medical necessity criteria, and shape...  ...lead utilization governance, network building, and care-management collaboration, with a focus on quality, cost... 

    StaffMed Health Partners

    Florida, NY
    2 days ago
  • T2 Utility Engineers, Inc. is seeking a Senior Utility Coordinator in Altamonte Springs, FL. This role plays a vital part in reducing utility risks for...  ...projects through effective utility information management and coordination. The ideal candidate will have extensive... 
    Senior

    T2 Utility Engineers, Inc.

    Florida, NY
    2 days ago
  • Greenbrook Medical is building the new standard in primary care. We deliver high‑touch,...  ...simple belief: every senior deserves the kind...  ...Market Medical Director is the senior clinical...  ..., ED use, SNF utilization, and readmissions...  ...Experience coaching and managing physicians... 
    Local area

    TGH Senior Center Powered by Greenbrook Medical

    Florida, NY
    2 days ago
  • Greenbrook Medical is building a new standard in primary care for seniors in the Greater Tampa Bay Area. As Complex Care Manager, you will coordinate high-risk patients across hospitals, SNFs...  ...to prevent unnecessary hospital utilization, drive timely follow-ups, and improve... 
    Senior
    Work at office

    TGH Senior Center Powered by Greenbrook Medical

    Florida, NY
    11 hours ago
  • $250k - $300k

     ...0 About Infinite Medical P.C. Infinite Medical...  ..., proactive care directly to residents...  ...MedElite Healthcare Management Group empowers us...  ...to redefine senior care across the country...  ...a Travel Medical Director to provide clinical...  ...quality metrics, and utilization data to drive... 
    Contract work

    MedElite Group, LLC.

    Florida, NY
    2 days ago
  • GSK is seeking a Hospital Senior Account Manager to lead strategic hospital accounts and drive formulary access in a national footprint...  ...adherence to industry standards while advancing patient outcomes and product utilization across multiple care #J-18808-Ljbffr OneWe Reach
    Senior

    OneWe Reach

    Florida, NY
    2 days ago
  • $94.9k - $130.5k

    Become a part of our caring community The...  ...Integration Team Manager is responsible for...  ...and post-acute care utilization. The Manager role...  ...Care Integration Director as appropriate. Interviews...  ..., or Emergency Medical Technician...  ...and working with senior populations Excellent... 
    Full time
    Temporary work
    Apprenticeship
    Work at office
    Local area
    Home office

    Conviva Senior Primary Care

    Florida, NY
    3 days ago
  • $96.27k - $179.05k

    Job Description Manages and monitors the financial performance of the agency, monitoring...  ...to support the standards of care established by the department. Directs...  ...intake, scheduling, quality review, utilization management medical records as needed. Ensures the agency... 
    Contract work
    Work experience placement
    Work at office
    Local area
    Work from home

    AdventHealth

    Florida, NY
    2 days ago
  • $20k

     ...of Casselberry is to provide compassionate, quality veterinary care for every pet who walks through our doors. We are committed to...  ...a Legacy. Inspire a Team. Practice Exceptional Medicine. Medical Director (MDVM) Animal Clinic of Casselberry | Casselberry, Florida Up... 
    Local area
    Relocation package
    Flexible hours

    Heartland Veterinary Partners

    Florida, NY
    3 days ago
  • All Creatures Animal Hospital in Stuart, FL is seeking a Medical Director to lead our growing veterinary team while continuing to provide exceptional patient care. This is an exciting opportunity for an experienced veterinarian to shape medical direction and mentor clinicians... 

    Valley Veterinary Hospital

    Florida, NY
    2 days ago
  •  ...high-quality, coordinated care. By uniquely aligning...  ...Centrum Health and Premier Medical - as well as unique...  ...Summary The Clinical Program Director of Pharmacy Solutions will develop and manage pharmacy pathways for...  ...evaluate ongoing performance. Utilize clinical data and system... 
    Work at office

    NeueHealth

    Florida, NY
    2 days ago
  • $25k

     ...Become a part of our caring community As a Clinical Manager at CenterWell Home...  ...to the Branch Director, you will lead and...  ...documentation review, utilization review findings, and...  ...benefits, Humana provides medical, dental and vision...  ...provider of senior-focused primary care... 
    Full time
    Temporary work
    Apprenticeship
    Work at office

    CenterWell Home Health

    Florida, NY
    1 hour ago
  • Accel Research Sites in Maitland, FL is seeking a Clinical Site Director to lead site operations and ensure compliance with ICH-GCP and FDA guidelines. You will manage site performance, coordinate with departments, review dashboards, supervise staff and training, and implement... 
    Senior

    Accel Research Sites

    Florida, NY
    2 days ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Senior Medical Director, Utilization & Care Management. Be the first to apply!