• Field Medical Director

    Evolent Health (Columbus, OH)
    …Join Evolent for the mission. Stay for the culture. **What You'll Be Doing:** As a Field Medical Director - Physical Health, you will be a key member of ... to jeans. **Collaboration Opportunities:** Evolent is looking for a Field Medical Director to be...members + Supports design and implementation of health plan medical policies, and appropriate Care Management and UM more
    Evolent Health (11/06/24)
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  • UM Coordinator - Utilization Review - F/T…

    Hackensack Meridian Health (Belle Mead, NJ)
    …concerns to the treatment team, Director of Utilization Management, and the Medical Director . + Review charts at identified review points and attend ... collecting data pertaining to clinical status and justifying the medical necessity for continued treatment in inpatient level of...+ RN, BSN, or Bachelors degree in a clinical field with a health care focus + Minimum five… more
    Hackensack Meridian Health (10/28/24)
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  • Director , Utilization Management

    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 ... federal regulatory requirements and all applicable accreditation standards. The Director of Utilization Management is responsible for setting strategic direction,… more
    Commonwealth Care Alliance (09/19/24)
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  • Medical Director ( Medical

    CVS Health (Springfield, IL)
    …support to Account Management in support of Key Clients as assigned. The Medical Director transacts Utilization Management UM activities (prior authorization ... Fortune 6 company, has an outstanding opportunity for a Medical Director ( Medical Affairs). This...review activities and other quality oversight processes for internal Director UM decisions. If specifically assigned to… more
    CVS Health (11/07/24)
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  • Market Director Utilization Management

    Catholic Health Initiatives (Lexington, KY)
    …necessity determinations; processes appeals and reconsiderations. In collaboration with the Division Director Care Coordination, the UM Director develops ... 5000 active employees 8 hospitals specialty clinics and a Medical Group with more than 200 locations across Central...and out in the community. **Responsibilities** The Utilization Management ( UM ) Director is responsible for the market(s)… more
    Catholic Health Initiatives (09/19/24)
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  • Physician-Scientist, Director Of Clinical…

    University of Maryland, Baltimore (Baltimore, MD)
    …physician-scientist with expertise in clinical trial design and execution to serve as Director of Clinical Trial Innovation.* The UM -IHC is a large-scale ... life and longevity of the citizens of Maryland. The UM -IHC, located in North Bethesda, MD, is a collaborative...of Maryland College Park, and the University of Maryland Medical System, funded with initial grants from the State… more
    University of Maryland, Baltimore (10/16/24)
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  • Director , Contracting & Strategic Sourcing

    University of Miami (Miami, FL)
    …for a Director , Contracting & Strategic Sourcing to work at the UHealth Medical Campus. Core Job Summary The Director , Contracting and Strategic Sourcing (H) ... Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . Director , Contracting & Strategic Sourcing The University of Miami/UHealth… more
    University of Miami (10/13/24)
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  • Director , Behavioral Health, Health Plans

    VNS Health (Manhattan, NY)
    …other evaluative measures to maintain high-quality care standards. + Plans leadership and medical director meetings as stipulated by the State BH contract ... company holidays + Health insurance plan for you and your loved ones, Medical , Dental, Vision, Life and Disability + Employer-matched retirement saving funds +… more
    VNS Health (09/04/24)
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  • Director , Clinical Performance…

    Healthfirst (NY)
    …and business leader coaching. Metric types include compliance activities, CM and UM activities, clinical status outcomes, medical cost trend implications for ... CM and UM , staffing/ attrition recommendations, medical cost savings initiatives and tracking, new program design...degree and/or BS, BA in a health care related field ** **Experience in medical care management, utilization… more
    Healthfirst (09/14/24)
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  • Market Clinical Director Population Health…

    AmeriHealth Caritas (Charleston, SC)
    **Market Clinical Director Population Health | South Carolina** Location: Charleston, SC Primary Job Function: Medical Management ID**: 37889 **Job Brief** Must ... SC State House in Columbia, SC** **Responsibilities:** The Market Clinical Director of Population Health is responsible for market-specific clinical operations,… more
    AmeriHealth Caritas (10/05/24)
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  • Director , Contact Center Quality…

    University of Miami (Medley, FL)
    …. The department of UHealthConnect has an exciting opportunity for a full-time Director , Contact Center Quality Management (QM) & Training. The Director , Contact ... experiences that drive brand loyalty and high customer satisfaction. The director creates and implements ongoing developmental programs that will ensure… more
    University of Miami (09/14/24)
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  • Associate Behavioral Health Director - WY…

    One Health (Sheridan, WY)
    …Behavioral Health Management Team! One Health is Seeking an Associate Behavioral Health Director for our Wyoming Region . The position is expected to work on-site ... supervision of the Executive Vice President, the Associate Behavioral Health Director (ABHD) provides clinical supervision and support to licensed Behavioral Health… more
    One Health (11/07/24)
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  • Director Managed Care Enrollment…

    Dignity Health (Bakersfield, CA)
    …dedicated to providing quality managed care administrative and clinical services to medical groups hospitals health plans and employers with a business objective to ... benefits they want from a variety of options including medical dental and vision plans for the employee and...**within California** **.** Working in a collaborative environment, the Director will be a hands-on leader to the Enrollment… more
    Dignity Health (10/16/24)
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  • Corporate Director of Clinical Utilization…

    Prime Healthcare (Ontario, CA)
    …Responsibilities The Corporate Director of Clinical Utilization ... Paid Time Off + 401K retirement plan + Outstanding Medical + Dental + Vision Coverage + Tuition Reimbursement...Bachelor's degree in Nursing, Healthcare Administration, or another relevant field + A minimum of seven (7) years' experience… more
    Prime Healthcare (08/29/24)
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  • Manager II Behavioral Health Services (Utilization…

    Elevance Health (FL)
    …analysis services. + Responsibilities include overseeing clinical rounds, coordinating with medical director to ensure program meets quality standards and ... Management for Behavior Analysis Services)** Responsible for Behavioral Health Utilization Management (BH UM ). Serves as a mentor to lower leveled managers and as a… more
    Elevance Health (11/02/24)
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  • Medical Oncology- Research Professor

    University of Miami (Miami, FL)
    …sarcoma global oncology initiatives. The incumbent in this position will work closely with Director , Sarcoma Med Research Program and will be a key member of bone ... Professor may lecture or conduct demonstrations and teach across UM schools. The Professor will partner and collaborate with...contribute towards the making of scientific advances in the field of work. + Demonstrates ability to teach in… more
    University of Miami (10/06/24)
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  • Utilization Review Coord

    Covenant Health Inc. (Louisville, TN)
    …treatment and authorizes sessions per guidelines. + Works collaboratively with Medical Director and accesses consultation and involvement whenever appropriate ... Pay Period, Day Shift Peninsula Overview: Peninsula, a division of Parkwest Medical Center (http://www.treatedwell.com/) , has set a new standard for effective,… more
    Covenant Health Inc. (11/05/24)
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  • Sr. Manager, Programs

    University of Miami (Miami, FL)
    …as necessary. CORE QUALIFICATIONS Education: Bachelor's Degree in relevant field Certification and Licensing: Not Applicable Experience: Minimum 5 years ... both online and residential, reports directly to the Associate Dean and inaugural director of online MPH, and offers administrative support for the design and… more
    University of Miami (10/30/24)
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  • Medicine, Myeloma - Professor

    University of Miami (Miami, FL)
    …The incumbent in this position will work closely with the Chief of Myeloma and Director of the SCCC Myeloma Institute and will be a key member of myeloma-focused ... research. Also, together with the Chief of Myeloma and Director of the SCCC Myeloma Institute, the position will...larger grants (such as PO1, SPORE and SCOR) within UM and in collaboration with other institutions with the… more
    University of Miami (10/08/24)
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  • Therapist

    University of Miami (Miami, FL)
    …training packets containing appropriate measures/forms + Other duties as assigned by the UM PCIT Director and team leaders + Assist with manuscript preparation ... child maltreatment. + Scores program metric measures + Enters UM PCIT related data into appropriate databases/systems (eg, REDCap,...but not required. ​ + Bachelor's degree in relevant field + Certification in relevant specialty or field more
    University of Miami (10/25/24)
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