- Merck & Co. (North Wales, PA)
- …key priorities for our Company is a significant focus-on Data and its utilization as a Strategic asset to drive insights-driven decisions. The opportunity to ... is to focus on driving these capabilities to increase utilization of data within the organization.How will you invent...not limited to Data Marketplace, Data Quality, Data Risk Management c) Value Realization with use of these Data… more
- Novo Nordisk Inc. (Boulder, CO)
- …change. Are you ready to make a difference? The Position The Associate Director , Process Chemistry will be responsible for the design, development and staffing of ... and scaling of small molecules, oligonucleotide intermediates and API's. The Associate Director is expected to implement novel strategies towards highly scalable and… more
- Merck & Co. (Minneapolis, MN)
- …the following designated customers as assigned by the HCS Regional Director :Integrated Delivery Network (IDN, including hospital outpatient and home-infusion if IDN ... on a regular basis (plays a significant role in ensuring that the Director of Commercial Operations, Customer Team Leader(s), and understand the (payer) customer's… more
- University of Maryland Medical System (Largo, MD)
- … utilization strategies which support clinical pathways, discharge planning and case management .Under the direction and supervision of the Nurse Manager., ... Description Reporting to a Nursing Manager- or other senior clinical leader (Nursing Director ), the Assistant Nurse Manager (ANM), is accountable for the delivery of… more
- Catholic Health Initiatives (Lexington, KY)
- …can happen both inside our hospitals and out in the community. **Responsibilities** The Utilization Management (UM) Director is responsible for the market(s) ... processes appeals and reconsiderations. In collaboration with the Division Director Care Coordination, the UM Director develops...advanced clinical degree. + Minimum 3 years of clinical case management ( Utilization Management… more
- Point32Health (Canton, MA)
- …we are at Point32Health, click here (https://youtu.be/S5I\_HgoecJQ) . **Job Summary** The Director , Utilization Management is responsible for directing, ... leadership. The Director oversees and leads medical management activities related to precertification utilization ...based behavioral health and / or case management leaders and programs. The Director assumes… 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 ... state and federal regulatory requirements and all applicable accreditation standards. The Director of Utilization Management is responsible for setting… more
- CareFirst (Baltimore, MD)
- …location based on business needs and work activities/deliverables that week. The Director , Utilization Management provides strategic leadership of the ... utilization management team and is responsible for the design, assessment,...of services and approved claims. + Oversees retrospective reviews, case appeals, billing coordination, and clinical support. + Ensure… more
- UTMB Health (Galveston, TX)
- …and reports trends of inappropriate resource utilization to Director /Assistant Director of Utilization Management . + Maintains a documentation system ... + Educates the Medical Staff and Nursing Staff on Utilization Management and provides specific information related to case types, including financial… more
- Prime Healthcare (Ontario, CA)
- …Responsibilities The Corporate Director of Clinical ... or another relevant field + A minimum of seven (7) years' experience in Clinical Utilization Review or Case Management with a large Health Plan +… more
- Trinity Health (Boise, ID)
- …of two years' experience in hospital based medicine with exposure to utilization management and documentation initiatives. 3. Demonstrated teamwork, performance ... is seeking a physician leader to become our Medical Director of Documentation and Utilization Excellence. This...MDDUE will work in a dyad partnership with the Director of Clinical Resource Management . This position… more
- Sharecare, Inc. (Racine, WI)
- …their expertise. **Essential Job Functions:** + Partners directly with the Program Director , physicians, Resource/ Utilization / Case Management , diabetes ... rounds with attending physicians/clinical staff who treat diabetes patients. + Facilitates case management of complex diabetes cases through Diabetes Inpatient… more
- Fallon Health (Worcester, MA)
- …Provide clinical support for prior authorization process + On-site, off-site and telephonic inpatient case management rounds + Outpatient case management ... MA (or licensable). Board certified in medical or surgical specialty. **Experience:** Utilization management ; network management ; medical policy and… more
- Brockton Hospital (Brockton, MA)
- PURPOSE OF POSITION: The Director of Case Management is responsible for planning, directing, and managing of the activities of the Case Management ... solves problems, referring exceptional issues to Vice President. The Director of Case Management is...resource utilization . Provides training to staff on case management methods and techniques. Establishes monitoring… more
- Sharecare, Inc. (Kingsport, TN)
- …Tri-Cities area. **Essential Job Functions:** + Partners directly with the Program Director , physicians, Resource/ Utilization / Case Management , diabetes ... needs of patients/families. + Works with interdisciplinary team to facilitate case management of complex diabetes patients. **Specific Skills/ Attributes:** +… more
- BronxCare Health System (Bronx, NY)
- …and implementation of educational programs for Denial Prevention and Management . Responsibilities - Establish and maintain positive relationships with patients, ... includes data collection, analysis, implementation of and compliance with risk management and claims activities, support of and participation in Continuous Quality… more
- Houston Methodist (Baytown, TX)
- …promoting the most cost-effective utilization of the hospital's resources. The Director Case Mgmt Social Svcs position deploys population-focused teams to ... At Houston Methodist, the Director Case Mgmt Social Svcs position...in the areas of care coordination, evidence- based practice, utilization management , and service excellence. Disseminates information… more
- HCA Healthcare (Nashville, TN)
- …**Introduction** Do you want to join an organization that invests in you as a Director of Clinical Case Management ? At HCA Healthcare, you come first. ... lives and you have the opportunity to make a difference. We are looking for a dedicated Director of Clinical Case Management like you to be a part of our… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Director of Case Management is responsible for the overall operation of the Case Management Department. This includes ... to patients. This involves the delivery of comprehensive front-line Case Management services, including utilization ... Management services, including utilization management , care facilitation and discharge planning. The Director… more
- LifePoint Health (Rutherfordton, NC)
- …resources and knowledge and experience operating community hospitals and healthcare organizations. The Director of Case Management is responsible for the ... candidates for employment: Minority/Female/Disabled/Protected Veteran* **Job:** ** Case Management /Social Services* **Organization:** ** **Title:** * Director , … more
