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Medical Director Utilization Management Jobs in Puerto Rico

Head of Operations Yauco

Yauco, PR · On-site

$150 - $190/hr

Sartorius has partnered exclusively with Russell Reynolds to manage this search. To ensure your ... Medical, Dental and Vision insurance along with Company Retirement PlanOn-site cafeteria and coffee ...

Industry/Sector Not Applicable Specialism Functional & Industry Technologies Management Level ... PwC offers a wide range of benefits, including medical, dental, vision, 401k, holiday pay, vacation ...

New

... utilization among our customers. Also providing support and top-notch customer service experience ... Cultivate and manage positive client relationships with corporate relocation management companies ...

Directing teams through complexity, you will demonstrate composure in ambiguous situations, deepen ... PwC offers a wide range of benefits, including medical, dental, vision, 401k, holiday pay, vacation ...

Establish direct communication with leaders and representatives of the Behavioral Health Contact ... Provide backup to Utilization Review Department out of business hours including document in the ...

PR · On-site

Establish direct communication with leaders and representatives of the Behavioral Health Contact ... Provide backup to Utilization Review Department out of business hours including document in the ...

PR · On-site

Establish direct communication with leaders and representatives of the Behavioral Health Contact ... Provide backup to Utilization Review Department out of business hours including document in the ...

Division Director, Home

Caguas, PR · On-site

$129K - $205K/yr

... management experience; preferable in the health care setting * Bachelor's degree, Master ... Medical, dental, vision, 401(k) match, paid time off, PTO cash out. * Support for you and your ...

Manage financial and revenue growth, operations, and labor management, contract management, and ... Medical, dental, vision, 401(k) match, paid time off, PTO cash out * Support for you and your ...

PR · On-site

Maintain medical records and educate patients and their families about various physical and ... Demonstrate knowledge and utilization of universal precautions in providing direct patient care.

Showing results 21-40

Medical Director Utilization Management information

What is a medical director utilization management?

A Medical Director of Utilization Management is a physician who oversees and ensures the appropriate use of medical resources within a healthcare organization or insurance company. Their responsibilities include reviewing clinical cases, developing utilization review policies, and working with healthcare providers to ensure that treatment plans are medically necessary and cost-effective. They play a key role in balancing patient care quality with regulatory and financial considerations, helping to improve healthcare outcomes and system efficiency.

What are the key skills and qualifications needed to thrive as a medical director utilization management?

To thrive as a Medical Director Utilization Management, you need a medical degree (MD or DO), board certification, and extensive clinical experience, often in internal medicine or a related specialty. Familiarity with utilization review processes, case management software, and regulatory frameworks such as CMS guidelines is essential. Strong leadership, analytical thinking, and effective communication skills are crucial for guiding teams and collaborating with diverse stakeholders. These competencies ensure appropriate resource utilization, regulatory compliance, and high-quality patient care within healthcare organizations.

How does a medical director utilization management typically collaborate with clinical teams and insurance providers?

A Medical Director in Utilization Management frequently works at the intersection of healthcare providers, clinical teams, and insurance companies. Their role involves reviewing clinical cases, making coverage determinations, and consulting with physicians to ensure that medical treatments are both necessary and cost-effective. Collaboration often includes participating in interdisciplinary meetings, providing guidance on complex cases, and communicating policy updates or clinical guidelines. This ensures that patient care decisions align with best practices, regulatory requirements, and payer policies.

What is the difference between Medical Director Utilization Management vs Medical Director Case Management?

AspectMedical Director Utilization ManagementMedical Director Case Management
CredentialsMedical degree, medical license, possibly board certificationMedical degree, medical license, possibly board certification
Work EnvironmentUtilization review departments, insurance companies, healthcare organizationsCase management teams, hospitals, healthcare providers
Employer & IndustryInsurance companies, managed care organizationsHospitals, healthcare systems, community health agencies
Primary FocusReviewing medical necessity and approving servicesCoordinating patient care and discharge planning

Both roles require medical credentials and involve improving patient care, but Medical Director Utilization Management primarily focuses on reviewing and approving healthcare services for insurance purposes, while Medical Director Case Management emphasizes coordinating ongoing patient care and discharge planning within healthcare settings.

What are popular job titles related to Medical Director Utilization Management jobs in Puerto Rico?

For Medical Director Utilization Management jobs in Puerto Rico, the most frequently searched job titles are:

What job categories do people searching Medical Director Utilization Management jobs in Puerto Rico look for?

The top searched job categories for Medical Director Utilization Management jobs in Puerto Rico are:

Infographic showing various Medical Director Utilization Management job openings in Puerto Rico as of August 2026, with employment types broken down into 1% As Needed, 78% Full Time, 15% Part Time, and 6% Contract. Highlights an 92% Physical, 1% Hybrid, and 7% Remote job distribution.

Assistant Store Director

Saks OFF 5TH

Las Piedras, PR

Full-time

Medical, Dental, Vision

Re-posted 29 days ago


Saks OFF 5TH rating

5.0

Company rating: 5.0 out of 10

Based on 25 frontline employees who took The Breakroom Quiz

17th of 21 rated department stores


Job description

Saks OFF 5TH is the premier online luxury off-price destination. Through its website and app, Saks OFF 5TH provides a compelling assortment of brands to fashion-seeking customers at the best prices. The company is reimagining traditional off-price with a digitally-native model focused on customer experience.
What This Position Is All About:

We are looking for a reliable, trustworthy, and team-focused Assistant Store Director. A driven and aspiring leader, focused on driving sales by building the Saks OFF 5TH clienteling experience and exceeding customer expectations. The Assistant Store Director is responsible for driving sales and profit in their identified area of business within the particular store, supporting overall store performance and achievement of all company objectives; as well as leading and inspiring a high-performance team. The Assistant Store Director is also responsible for supporting a high level of engagement and a people development culture throughout the store. If you enjoy creating a memorable experience for each customer, and inspiring others to do the same along the way, this could be your chance to take your retail career to the next level

Who Are You:

  • Establish positive interpersonal relationships and actively collaborates and contributes to a positive team dynamic

  • Inspirational leader through both action and collaboration who acts as a coach and role model to bring out the best in their teams

  • Can easily adapt to changes and can be relied upon to consistently deliver exceptional results

  • Consistently generate and share original ideas, tackling both simple and complex problems

You Also Have:

  • College Associate diploma, Bachelor's degree preferred

  • 3+ years of management experience with comparable volume and/or proven track record of success managing a selling workforce and achieving results

  • Proficiency in utilizing available technology including Microsoft Office (Outlook, Excel, Word, and PowerPoint)

  • Proven sales track record and results driven approach

  • Proven time management skills and comfortable managing multiple projects with shifting priorities

  • Demonstrated ability to deliver a high standard of customer service and build exceptional customer relationships

  • Thorough knowledge of the fashion industry and a passion for sharing your expertise

  • Ability to act promptly in routine situations and see a clear plan of action to a positive result in the customer's eyes

  • Ability to operate equipment such as radios, POS register, ticket scanners, and sensor removers

  • Flexibility to work evenings, weekends and public holidays

As the Assistant Store Director, you will:

  • Be responsible for achievement of sales, controllable profit, EBITDA, payroll management, P&L performance, email capture rate, shipping process, etc.

  • Oversee the selling and service processes; provide leadership and motivation to team in achieving sales goals, drive omni-channel growth and execution of company initiatives

  • Monitor store payroll rate and expense; monitor staffing in his/ her area, ensure scheduling aligns with overall business needs and traffic flow

  • Develop and retain direct reports, ensure their readiness for increased responsibilities and provide a bench of internal talent who are upwardly mobile to fill critical positions

  • Participate and support in training for new company programs, procedures, and technologies

  • Consistently model and coach the selling behaviors to meet or exceed key performance indicators

  • Adhere to Asset Protection control and compliance procedures; maintain knowledge of all Health and Safety protocols and Emergency procedures to ensure the safety of our associates and customers alike

Your Life and Career at Saks OFF 5TH:

  • Be part of an empowered, innovative team; work with an adventurous spirit and a customer-centric mindset; play a critical role in making decisions that will position us to win
  • Exposure to rewarding career advancement opportunities across different functions within our corporate offices, retail stores, photo studios, and distribution centers
  • A culture that promotes a flexible work environment
  • Benefits package for all eligible full-time employees (including medical, dental and vision)
  • An amazing employee discount and other exciting perks

Thank you for your interest with Saks OFF 5TH. We look forward to reviewing your application.

We believe that our differences not only make us stronger, but also guide our evolution and future growth. All associates are expected to create an inclusive environment free from harassment, discrimination, and bullying.Together, we celebrate, advocate for, and learn from our colleagues, customers and communities to create the best environment to shop and work for all.


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