• Corporate Director

    Prime Healthcare (Ontario, CA)
    …Responsibilities The Corporate Director of Clinical ... to individual and Company performance. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/172723/ corporate - director -of- clinical - utilization -management/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilityPrime… more
    Prime Healthcare (08/29/24)
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  • Utilization Management Director

    CareFirst (Baltimore, MD)
    …location based on business needs and work activities/deliverables that week. The Director , Utilization Management provides strategic leadership of the ... plans and sets goals within the context of the corporate policies and procedures. Develops annual goals, and prepares,...Upon Hire Required. **Experience:** 8 years' Experience in a clinical and utilization review role. 3 years… more
    CareFirst (08/27/24)
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  • Associate Director of Corporate

    UT Health (Houston, TX)
    Associate Director of Corporate Engagement and Foundation Relations in Development **Location:** Texas Medical Center-Houston, Texas **Hot** **Category:** ... #: 240002CS UTHealth Houston's Office of Development is seeking an Associate Director of Corporate Engagement and Foundation Relations. This role offers… more
    UT Health (09/28/24)
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  • Organ Utilization Administrative…

    LifeCenter Northwest (Bellevue, WA)
    Utilization Administrative Coordinator is responsible for supporting the Organ Utilization Director and the department's Managers along with administrative ... + Calendar management and meeting support - Manage the calendar of the Director of Organ Utilization and scheduling for the leadership team, scheduling… more
    LifeCenter Northwest (09/07/24)
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  • Director of Clinical Informatics

    Peak Vista (Colorado Springs, CO)
    Director of Clinical Informatics Summary Title: Director of Clinical Informatics ID:1101-5055 Department Location:3205/3207 N. Academy, Colorado Springs, ... the Electronic Health Record (EHR), practice management application and associated clinical solutions. The Director will oversee the implementation, deployment,… more
    Peak Vista (11/02/24)
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  • Director of Clinical Informatics

    HCA Healthcare (Las Vegas, NV)
    …sites of care in 21 states and the United Kingdom. We are looking for a Director of Clinical Informatics for our Southern Hills Hospital and Medical Center team- ... years. Do you want to be an influencer in healthcare? **Apply for our Director of Clinical Informatics role today!** **Job Summary and Qualifications** + You… more
    HCA Healthcare (11/12/24)
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  • Medicare Grievances and Appeals Corporate

    Humana (Columbus, OH)
    **Become a part of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims and ... preservice appeals. The Corporate Medical Director works on problems of...+ Excellent communication skills + 5 years of established clinical experience + Knowledge of the managed care industry… more
    Humana (10/29/24)
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  • Director Clinical Quality Value…

    Penn State Health (Hershey, PA)
    …PDF for more detailed steps for assistance._ **Union:** Non Bargained **Position** Director Clinical Quality Value Analysis - Supply **Location** US:PA: Hershey ... to evaluate new product requests, identify and drive product standardization and appropriate utilization of clinical products to deliver optimal value and care.… more
    Penn State Health (10/05/24)
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  • Executive Clinical Director Quality…

    AdventHealth (Tampa, FL)
    …the general direction of the Chief Quality and Safety Officer, the Executive Clinical Director of Quality & Safety will provide project management, redesign ... care across the continuum (acute and ambulatory) for AdventHealth. The Executive Clinical Director Quality & Safety must lead/facilitate performance improvement… more
    AdventHealth (09/18/24)
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  • Professional Care Manager Utilization

    UPMC (Hanover, PA)
    …the clinical and financial plan for patients. Performs overall utilization management, resource management, discharge planning and post-acute care referrals and ... is hiring a Professional Care Manager to support the Utilization Review process! This is a full time, day...role in concurrent denial process. Works with Care Management Director , Physician Advisor, Attending Physicians and clinical more
    UPMC (11/06/24)
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  • Director -Nursing & Women's Oncology…

    Baptist Memorial (Memphis, TN)
    …risk management, utilization review, reimbursement, and oversight of all clinical patient care facilities with in Baptist Medical Group. Responsibilities * ... education + Employee referral program Job Summary: Position: 237 - Director -Nursing & Women's Oncology Services Facility: BMG- Corporate Department: MG… more
    Baptist Memorial (10/16/24)
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  • Clinical Director , Perioperative…

    Roper St. Francis (Charleston, SC)
    …Weekly Hours:** 40 **Work Shift:** Days (United States of America) The Clinical Director , Perioperative Services is responsible for providing leadership and ... St. Francis Eye Center locations. This role partners closely with the Director of Perioperative Services - Roper Downtown/Roper Berkeley to support in developing… more
    Roper St. Francis (08/28/24)
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  • Utilization Management Care Coordinator…

    Sharp HealthCare (San Diego, CA)
    **Facility:** Corporate Offices **City** San Diego **Department** **Job Status** Regular **Shift** Day **FTE** 1 **Shift Start Time** **Shift End Time** Other; ... UM Care Coordinator, under the direct supervision of the Supervisor, Utilization Management Care Coordinators, prepares referral requests for outpatient services,… more
    Sharp HealthCare (11/10/24)
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  • Senior Director Clinical Trials…

    e CancerCare (Fresno, CA)
    Purpose: The Director , Clinical Trials & Research, for CCARE Physicians, PC, is responsible and accountable for the daily operations and management of staff, of ... in the department. Promote clinical excellence through applied clinical knowledge, leadership, team recommendations and research utilization . Ensure… more
    e CancerCare (11/15/24)
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  • Medical Director , Behavioral Health (Part…

    Magellan Health Services (San Diego, CA)
    …supervision of the use of the medical necessity criteria. + Along with the Corporate Clinical team, implements clinical practice standards and policies ... clinical quality improvement activity (QIA) in collaboration with the clinical lead senior medical director , and quality improvement staff. May… more
    Magellan Health Services (10/27/24)
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  • Remote Child / Adolescent Behavioral Medical…

    Centene Corporation (Springfield, IL)
    …and utilization management programs in accordance with regulatory, state, corporate , and accreditation requirements. + Assists the Chief Medical Director ... Assists in the development and implementation of physician education with respect to clinical issues and policies. + Identifies utilization review studies and… more
    Centene Corporation (11/10/24)
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  • Associate Medical Director - UM PT

    Independent Health (Buffalo, NY)
    …benefits and commitment to diversity and inclusion. **Overview** The Associate Medical Director , Utilization Management is responsible for assisting the Medical ... Director in the oversight of Utilization Management (UM) programs and will support the development...The AMD will collaborate with internal teams to support corporate HEDIS initiatives with appropriate clinical program… more
    Independent Health (10/18/24)
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  • Medical Director - South Central

    Humana (Columbus, OH)
    …hospitals/ Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management. + Utilization management experience ... a Regional Vice President of Health Services, Lead, or Corporate Medical Director , depending on size of...size of region or line of business. The Medical Director conducts Utilization Management of the care… more
    Humana (11/08/24)
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  • Senior Medical Director , Behavioral Health…

    Magellan Health Services (Albuquerque, NM)
    …plans for individual members. + Evaluates the effectiveness and cost of care of clinical programs through review and analysis of utilization and financial data., ... the need for modifications and additions to medical policy. May participate on corporate medical policy and clinical guideline committees. May do background… more
    Magellan Health Services (10/02/24)
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  • Director , Case Management

    LifePoint Health (Rutherfordton, NC)
    …discharge. The Director participates regularly in RRHS, Service Area, or Corporate meetings pertinent to the accountable areas, and also participates in ... services to communities. Duke LifePoint combines Duke's unparalleled expertise in clinical excellence and quality care with LifePoint's extensive resources and… more
    LifePoint Health (10/19/24)
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