Top 8 Utilization review Jobs in Great Falls, Mt

Medical Director
Elk Ridge Recovery —Great Falls, MT
- $63,909.32 - $76,966.06 a year
- Part-time
- Hybrid work
- Medicine
- Anatomy knowledge
- Hospital
- Flexible schedule
Quick Apply
RN CASE MANAGER
Distinctive Home Care Inc —Malmstrom AFB, MT
- Full-time
- Nursing
- Mid-level
- Outpatient experience
Quick Apply
Registered Nurse | Review Analyst I | Remote | Detroit, MI | Contract
Walker Healthforce, LLC —United States
- Contract
- Remote
- Nursing
- RN License
- 3 years
- Health insurance
- Dental insurance
Quick Apply
2d
Remote Registered Nurse (RN) | $34/hr
Carenet Health —United States
- $34 an hour
- Weekends as needed
- Remote
- Bilingual
- Nursing
- RN License
- Continuing education credits
- Paid holidays

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Utilization Review Specialist - Autism
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Bachelor’s Degree in Social Work, Psychology, or related field, required. Documents all case reviews and maintains accurate records of all clinical activities…
Homecare Prior Authorization Supervisor
Nationwide Children's Hospital —Columbus, OH
Assists with compliance to applicable laws and regulations from federal, state, and local bodies, and from accrediting organizations.

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Medical Director

Elk Ridge Recovery
Great Falls, MT

Quick Apply

Job Details

Part-time | Contract
$63,909.32 - $76,966.06 a year

Benefits

Flexible schedule

Qualifications

Health sciences research
Clinical research methods
Clinical program budget management
Doctor of Medicine
Direct patient care
Medicine
Anatomy knowledge
Strategic goal setting
Strategic management
Hospital patient safety
Clinical program implementation
Academic research projects
Utilization review
Treating patients as a physician
Accreditation standards (regulatory compliance area)
Managing healthcare operations budgets
Quality of care (regulatory compliance area)
Hospital strategic planning
Patient safety measures implementation
Hospital quality control
Controlled substance management
State healthcare regulations
Academic leadership
Professional development support
Records management
Post residency experience
Project management experience in healthcare
Healthcare practice operations management
Managing clinical research teams
Clinical outcome improvement

Full Job Description

Job Overview

We are seeking an energetic and highly experienced Medical Director to lead our clinical operations and ensure the delivery of exceptional patient care. This pivotal role involves overseeing medical management, maintaining compliance with healthcare regulations, and guiding clinical research initiatives. The ideal candidate will possess strong leadership skills, extensive clinical expertise, and a passion for advancing healthcare quality. As a Medical Director, you will play a vital role in shaping our medical strategies, fostering innovation, and upholding the highest standards of medical practice.

Responsibilities

Provide strategic leadership in clinical development, healthcare management, and medical research to enhance patient outcomes and operational efficiency.
Oversee the implementation and management of Electronic Health Records (EHR) systems and Electronic Medical Records (EMR) to ensure accurate documentation and compliance with healthcare regulations such as HIPAA and FDA standards.
Supervise medical staff, including physicians and clinicians, ensuring adherence to NCQA standards, healthcare compliance, and quality improvement initiatives.
Lead efforts in utilization management, ensuring appropriate resource utilization while maintaining high-quality patient care.
Ensure compliance with Drug Enforcement Administration (DEA) regulations, HIPAA privacy rules, and other federal or state healthcare laws.
Collaborate with hospital administration on practice management, budgeting, and strategic planning to optimize clinical operations.
Serve as an academic leader by participating in teaching activities, supervising research projects, and promoting continuous professional development among staff.
Maintain active involvement in treating patients as a physician when necessary to stay connected with frontline clinical practices.
Drive initiatives in healthcare quality improvement, risk management, and patient safety programs to uphold excellence across all services.

Qualifications

Medical degree (MD or DO) with post-residency experience in a relevant specialty; prior hospital experience is highly preferred.
Proven leadership experience in medical management or executive leadership roles within healthcare organizations.
Extensive knowledge of EMR/EHR systems, medical terminology, anatomy, physiology, and clinical development processes.
Familiarity with FDA regulations, HIPAA compliance requirements, NCQA standards, and healthcare accreditation processes.
Strong project management skills with the ability to oversee multiple initiatives simultaneously.
Supervisory experience supervising medical staff or teams within a hospital or clinical setting.
Demonstrated expertise in research activities related to clinical practices or healthcare innovations.
Excellent communication skills for effective collaboration with multidisciplinary teams and stakeholders.
Knowledge of managed care principles, utilization management strategies, and practice management best practices.

Join us as a Medical Director to lead transformative healthcare initiatives that make a real difference! We value innovation, dedication to excellence in patient care, and a commitment to continuous improvement—if you’re ready to elevate your career while shaping the future of healthcare delivery, we want to hear from you!

Pay: $63,909.32 - $76,966.06 per year

Benefits:

Flexible schedule

Work Location: Hybrid remote in Great Falls, MT 59404

Quick Apply

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utilization review jobs in great falls, mt

Medical Director

RN CASE MANAGER

Registered Nurse | Review Analyst I | Remote | Detroit, MI | Contract

Remote Registered Nurse (RN) | $34/hr

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