Medical Director, Utilization Management
Caremore Health
CareMore Health in California seeks a Medical Director of Utilization Management to oversee clinical reviews for medical necessity and cost-effective care. You will ensure decisions align with evidence-based guidelines and regulatory standards, working with nurses, case managers, and providers. Responsibilities include peer-to-peer consultations, supporting appeals, documenting decisions, and participating in quality improvement initiatives while ensuring compliance with NCQA/URAC standards and #J-18808-Ljbffr Caremore Health
Vacancy posted 15 hours ago
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