Medical Director, Utilization & Care Management
$227.6k - $385kHighmark Health
Highmark Health in Phoenix, Arizona, is looking for a physician to manage utilization review, ensuring compliance with clinical standards and regulations. The role includes reviewing cases, participating in a multidisciplinary team, and developing protocols. Required qualifications are an MD or DO, with 5 years in clinical patient care. Additional skills in critical thinking, case management, and communication are essential. The pay range is between $227,600 and $385,000 annually. #J-18808-Ljbffr
$140 - $145 per hour
TEEMA is seeking a Medical Director to provide utilization management, medical necessity review, and operational leadership support. The ideal candidate will have a strong managed care background, experience in peer-to-peer reviews, and expertise in various medical specialties...SuggestedRemote jobHourly pay$269.5k - $425.5k
...Primary Care Medical Director Optum Arizona is seeking a Primary Care Medical Director to join... ...and mentoring of primary care staff. Manage patient care activities, including... ...value-based care models. Analyze and utilize data to drive decision-making and improve...SuggestedMinimum wageWork experience placementLocal areaWork from homeRelocation- ...Regional Medical Director - Value Based Care The Regional Medical Director for musculoskeletal Value Based... ...closely with value-based care managers, operational leaders, network managers... ...with organizational quality, utilization, and cost-management goals. Guide...SuggestedContract workWork at officeLocal area
- Help change health care; help change the world. We... ...be eligible for our Management Incentive Program as part... ...services in a medically safe, recovery-focused... ...and Division Medical Director for designated healthcare... ...measures for key initiatives utilizing a systems perspective;...Suggested
$223.8k - $313.1k
A leading healthcare company in Arizona is seeking a Medical Director to conduct clinical reviews of inpatient records and support decision-making for patient care. The role requires an MD or DO with over five years of clinical experience and strong analytical and communication...SuggestedRemote jobMonday to Friday- ...Tasks Documentation Management Comprehensive Record... ...lapses in compliance. Care Coordination Appointment... ...Behavioral Health Medical Providers (BHMP) and Case... ...with the SMI Clinical Director to discuss case... ...case review meetings. Utilizes various communication...
- ...fully equipped in‑house lab. Medical records are completely paperless... ...standards to support patient care and client trust. You will... ...radiographs, consistent pain management, and radiographs reviewed by... ...Systems & Records: You will utilize hospital computer systems to...Temporary workWork at officeLocal areaFlexible hoursShift work
- Phoenix Children’s is hiring a Medical Director for Adult Congenital Heart Disease (ACHD) in Phoenix, Arizona. This key position focuses on leading... ...recognized ACHD program, advocating for high-quality patient care, and mentoring future medical professionals. The ideal...
- ...eligibility and appropriate levels of care. Assess the impact of the... ...an individualized pain management plan. Assess the ability of the... .... Implement the care plan utilizing appropriate preventative and... ...correctly use and direct the use of medical supplies and equipment....Immediate start
$98.63k - $107.99k
...goal - high-quality patient care. We are seeking a quality-drivenphysicianto... .../week)rounding and providing medical directorship in skilled... ...are met. Our Medical Director Leadership Academy (MDLA) will... ...and families on health management and preventive strategies Maintain...Part timeRelocationNight shift2 days per week- Concentra in Phoenix, Arizona, is seeking a Medical Director who will provide direct patient care while managing clinic operations. This role combines medical leadership with business management, ensuring exceptional patient experiences and optimal clinical outcomes. Candidates...
- ...promoting continuity of care through a collaborative... ...description is primary for case management functions but can assist with utilization management if a business... ...networks, etc. Analyze medical records and apply... ...indicated, to the medical director. Consult and coordinate...Remote jobFull timeContract workWork experience placementWork at office1 day per week
$92.6k - $127.4k
...Become a part of our caring community and help us... ...reporting to the Branch Director of the Portland/Lake Oswego... ...policy. As Clinical Manager , you will manage all... ...recommendations by Utilization Review staff. Upon completion... ..., Humana provides medical, dental and vision...Full timeTemporary workApprenticeshipImmediate startRelocation packageFlexible hours- ...provides clinical leadership of patient care services and directs supervision of nursing... ...in an efficient work environment. 1. Manages patient throughput - balances unit patient... ..., and disciplinary action as appropriate utilizing just culture concepts/processes. 4. Collaborates...InternshipShift work
- ...partnerships that expand access to care and connect more patients to... ...needs/concerns, and manage expectations, as needed. Takes... ...between individuals involved. Utilizes current Agency and department-... ...Working Conditions: Works in medical practice locations and homes in...Base plus commissionReliefWork at officeLocal areaFlexible hours
- Nbutexas, a growing healthcare organization, is seeking a Medical Director (Physician) to lead a patient-centered care model in Phoenix, Arizona. This role emphasizes functional and preventive medicine, allowing for hands-on patient care and shaping a modern healthcare...
$80k - $91k
...Telephonic Medical Case Manager, RN AmTrust Financial Services, a fast growing commercial... ...responsibilities may include utilization review, pharmacy oversight and care coordination. This position... ...advisor, peer reviews, medical director). Partner with adjuster to...Work experience placementWork at officeFlexible hours$60.52k - $129.62k
...by passionate colleagues who care deeply, innovate with purpose,... ...Position Summary The Clinical Case Manager, Behavioral Health is a full-... ...Responsibilities General Utilize clinical skills to coordinate,... ...treatment, evidence-based care and medical necessity criteria for members...Hourly payFull timeTemporary workWork at officeLocal areaRemote workMonday to Friday- ...physician experienced in venous disease for a full-time role in Phoenix, Arizona. This position offers the chance to step into a Medical Director role, overseeing clinical quality and collaborating with a dedicated team. The ideal candidate should have a strong background...Full timeRelocation package
$37.4 - $55.63 per hour
...department. With department Director and Practice Manager has the responsibility for... ...development, quality patient care, efficiency, and financial... ...to severity of infraction utilizing organization personnel policies... ...Dignity Health Medical Group is the employed physician...- ...Pharmacy Clinical Manager Location: HonorHealth... ...Days, 9am-5pm Great care starts with great people... ...based, cost-effective medication therapies and monitors... ...including; drug utilization evaluation, medication... ...Works with the Pharmacy Director(s) and System Director...Full timeLocal area
- ...lives every day? Benefits Medical, Dental, and Vision 403b and... ...agencies to ensure coordination of care. This includes assisting with... ...support services like case management, personal assistance, family... ...diversity. Must be able to utilize DSM-5-TR to diagnose older children...Contract workTemporary workWork at officeFlexible hoursWeekend work
- ...a Hospice RN to connect and care for our patients. Assisteo is... ...professional nursing care by utilizing all elements of nursing process... ...procedures. Administers medications and treatments as prescribed... ...comfort care. 10. Acts as Case Manager when assigned by Clinical Supervisor...
$50k
...which every patient gets the care they need. Valeris works on behalf... ...and adhere to critical medications. Backed by proven industry expertise... ...join the team as the Case Manager, you'll have the opportunity... ...with business requirements Utilize Valeris’ values as the...Full timeTemporary workWork at officeImmediate startHome officeMonday to FridayShift work- ...a national leader in hospice care and has been serving the Phoenix... ...! Position Profile RN case managers have the primary... ...and accurate documentation. Utilizes resources effectively and efficiently... ...year of recent experience in medical, surgical or critical care as...Flexible hours
$66.9k - $91k
AmTrust Financial Services, Inc. is seeking a Telephonic Medical Case Manager, RN to provide quality telephonic case management to... ...and nursing, with responsibilities including care coordination, utilization review, and communication with injured employees and healthcare...$80k
...About This Role The RN Case Manager serves as the primary clinical... ...patients, employers, and care teams, ensuring employees in... ...coordination. Collaborate with Medical Directors, Medical Assistants,... ...management, and reducing unnecessary utilization. Advocate for members by...Remote work- The CORE Institute is seeking a Regional Medical Director for Value Based Care in Phoenix, Arizona. This leadership role focuses on the oversight of musculoskeletal value-based care initiatives, aiming to improve quality, outcomes, and patient experience. The candidate...
- ...provide professional oversight for medical management activities related to utilization management, case management,... ...utilization review and other managed care functions Required Education... ...Credentialing Committee, Medical Directors Committee, and Medical Management...Full timeWork experience placement1 day per week
$248.5k - $373k
...Medical Director Optum is a global organization that delivers care, aided by technology to help millions of people live healthier... ...seamless experience, and manage health care costs. The Medical... ...clinical knowledge in various utilization management activities with a focus...Remote jobMinimum wageWork experience placementLocal area
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