- CHRISTUS Health (Lake Charles, LA)
- …high-quality, cost-effective care to patients. Responsible in assisting the Director for analyzing, planning, implementing, evaluating, and communicating processes ... within the scope of labor laws. Discovers opportunities to improve resource utilization . Implements changes in role consistent with scope of practice. Anticipates… more
- Sally Beauty Holdings (Denton, TX)
- …will sell and consume and how much inventory is needed to support utilization from retail operations and sales activities. 25% Support Procurement Category Manager ... analytics, and vendor agreements. 5% Assist the Procurement Category Manager or Director with assigned category strategy support with applicable data and vendor… more
- AmerisourceBergen Drug Corporation (Conshohocken, PA)
- …and costs required to ensure support this effortWork with the Sr. Director of Secure Supply Chain in managing developing serialization requirements, pilots, ... local law.The company's continued success depends on the full and effective utilization of qualified individuals. Therefore, harassment is prohibited and all matters… more
- Point32Health (Canton, MA)
- …are at Point32Health, click here (https://youtu.be/S5I\_HgoecJQ) . **Job Summary** The Director , Utilization Management is responsible for directing, leading, ... modifying the business processes and operations for all levels of utilization management review (ie, Precertification and Intake Services, Inpatient & Outpatient)… more
- Commonwealth Care Alliance (Boston, MA)
- **Why This Role is Important to Us:** The Director of Utilization Management leads and manages all utilization management (UM) functions for physical health ... state and federal regulatory requirements and all applicable accreditation standards. The Director of Utilization Management is responsible for setting strategic… more
- Dignity Health (Bakersfield, CA)
- …or Arizona, with a clear and current CA RN license.** **Position Summary:** The Director of Utilization Management is the senior lead over the utilization ... review. The UM Director is also responsible for the oversight of utilization management auditing, both internal and external, for all DHMSO service areas, as… more
- CareFirst (Baltimore, MD)
- …location based on business needs and work activities/deliverables that week. The Director , Utilization Management provides strategic leadership of the ... is responsible for the design, assessment, implementation and outcomes of utilization management strategies using a multidisciplinary approach to enhance member… more
- Prime Healthcare (Ontario, CA)
- …Responsibilities The Corporate Director of Clinical ... 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 Healthcare Management… more
- Trinity Health (Boise, ID)
- …Description:** Saint Alphonsus is seeking a physician leader to become our Medical Director of Documentation and Utilization Excellence. This position will be ... and evaluated annually by the Saint Alphonsus Chief Clinical Officer. The Medical Director of Documentation and Utilization Excellence (MDDUE) is the lead… more
- Catholic Health Initiatives (Lexington, KY)
- …both inside our hospitals and out in the community. **Responsibilities** The Utilization Management (UM) Director is responsible for the market(s) development, ... implementation, evaluation and direction of the Utilization Management Program and staff in support of the...processes appeals and reconsiderations. In collaboration with the Division Director Care Coordination, the UM Director develops… more
- Dignity Health (Bakersfield, CA)
- …be expected to work within PST business hours.** **Position Summary:** The Medical Director of UM reports to the Chief Physician Executive (CPE) and is responsible ... to developing clinical guidelines, measuring adherence to guidelines, and communicating utilization and quality concerns on specific cases to the provider network.… more
- Fallon Health (Worcester, MA)
- …+ Member appeals review + Pharmacy issues and referral requests + Medical director on-call coverage + Support the benefits and technology review process + Provide ... licensable). Board certified in medical or surgical specialty. **Experience:** Utilization management; network management; medical policy and technology experience.… more
- UTMB Health (Galveston, TX)
- …of stay for all admissions. + Tracks and reports trends of inappropriate resource utilization to Director /Assistant Director of Utilization Management. + ... Utilization Review Case Mgr. - Galv. Campus Utilization Mgmt. (M- F / 8a- 5p) **Galveston, Texas, United States** Nursing & Care Management UTMB Health… more
- Hackensack Meridian Health (Belle Mead, NJ)
- …third party payers and communicate potential or identified concerns to the treatment team, Director of Utilization Management, and the Medical Director . + ... and serve as a leader of positive change. The Utilization Management Coordinator utilizes clinical knowledge and understanding of...ACCESS center staff and PFS department to ensure appropriate utilization of resources and benefits on a case by… more
- Carle (Urbana, IL)
- …team members and the medical staff. + Collaborates with the System Director Utilization Management and Clinical Denial Management. + Collaborates with ... Director of Regional Care Management East/South + Department:...of care + Effectively reduces hospital readmissions and inappropriate utilization of hospital resources. + Provides regular updates to… more
- LifeCenter Northwest (Bellevue, WA)
- … Utilization Administrative Coordinator is responsible for supporting the Organ Utilization Director and the department's Managers along with administrative ... management and meeting support - Manage the calendar of the Director of Organ Utilization and scheduling for the leadership team, scheduling meetings, booking… more
- CVS Health (San Juan, PR)
- …Account Management in support of Key Clients as assigned. The Medical Director transacts Utilization Management UM activities (prior authorization and appeals) ... Account Management in support of Key Clients as assigned. The Medical Director transacts Utilization Management UM activities (prior authorization and appeals)… more
- Humana (Columbus, OH)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an ... of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations… more
- Humana (Columbus, OH)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an ... of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations… more
- Humana (Columbus, OH)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an ... of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations… more
