- Ascension Health (Nashville, TN)
- …Saint Thomas hospitals throughout the TN market . We're looking for an experienced Director of Utilization Management to join our team! In this pivotal ... **Details** + **Department:** Utilization Management + **Schedule:** Monday -...root-cause analysis to enhance our processes. You'll collaborate with Market Care Management , Finance, CDI, and Physician… 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,...the candidate's work experience, education/training, internal peer equity, and market and business consideration. It is not typical for… more
- ERP International (Nellis AFB, NV)
- …No Call, No Weekends, No Holidays! **Job Specific Position Duties:** * Provides Utilization Management activities and functions by using MTF specific Quality ... disciplines to include discharge planning and referrals for case management . * Utilization management duties...appropriate health plan. Collaborates, coordinates with TOPA and Referral Management Director when needed in accordance with… more
- LA Care Health Plan (Los Angeles, CA)
- Supervisor, Utilization Management RN Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full ... safety net required to achieve that purpose. Job Summary The Supervisor of Utilization Management (UM) RN is responsible for executing the day-to-day operations… more
- LA Care Health Plan (Los Angeles, CA)
- …observation) admission in the acute setting. Works with UM leadership, including the Utilization Management Medical Director , on requests where determination ... Utilization Management Admissions Liaison RN II...data presented and established criteria/guidelines, escalating to the medical director if needed. Triages and assesses members for admission… more
- Elevance Health (FL)
- **JR133557 Manager II Behavioral Health Services ( Utilization Management for Behavior Analysis Services)** Responsible for Behavioral Health Utilization ... lower cost of care. + Candidate will be responsible for the oversight of the utilization management team. + Responsible for a team of clinicians who conduct… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position ... support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and approves… more
- Katmai (Usaf Academy, CO)
- …(BSN) is required. + Minimum of two (2) years of prior experience in Utilization Management . + Must possess a current, active, full, and unrestricted Registered ... background checks. **DESIRED QUALIFICATIONS &** **SKILLS** + Certification by a Utilization Management -specific program such as Certified Professional in… more
- The Hartford (King Of Prussia, PA)
- … will provide direct underwriting leadership, sales leadership, and agency management for the Middle Market Underwriting Center (MMUC). Responsibilities ... Promotes utilization of services: Claims and Risk Engineering Middle Market Underwriting Operations + Inspires team to achieve operating plan objectives through… more
- Jacobs (Sacramento, CA)
- As a Market Growth Director ( Market GD) you report to your assigned Executive Director of Sales (EDS). You are responsible for the development of a ... strategy to include input and create alignment with the Lead Account Strategist (LAS), the Director of Operations (DO) aligned to your market , and Market … more
- ChenMed (Largo, FL)
- …expanding and we need great people to join our team. The Associate Market Clinical Director will directly supervise, performance manage and train Clinical ... workplace concerns. + Reviews/approves center-level referrals and provides back-up for market referral and delegated utilization authorizations. Other duties as… more
- J&J Family of Companies (Horsham, PA)
- Product Director (Senior Manager), Market Development, Multiple Myeloma Marketing - 2406221519W **Description** Johnson & Johnson is currently recruiting for a ... Product Director , Market Development, Multiple Myeloma Marketing located...+ Partner with analytics and operations teams to track utilization and impact of market development initiatives… more
- HCA Healthcare (Charleston, SC)
- …purpose and integrity. We care like family! Jump-start your career as a(an) Market Director Clinical Professional Development today with Trident Medical Center. ... Eligibility for benefits may vary by location._** Come join our team as a(an) Market Director Clinical Professional Development. We care for our community! Just… more
- AbbVie (Mettawa, IL)
- …Commercial and Medicare FFS aspects of the Medical Benefit and associated utilization management and reimbursement dynamics. Preferred Qualifications: + Previous ... @abbvie on Twitter, Facebook, Instagram, YouTube and LinkedIn. Job Description The Associate Director , US Market Access Marketing, Oncology supports US Market… more
- Huron Consulting Group (Chicago, IL)
- …They provide client engagement delivery oversight, team leadership and program management . Throughout the process, they construct enduring relationships that benefit ... leadership instill passion and followership in clients, juniors and management . If you're defined by ongoing progress-if you can...clients achieve their full potential. Rewarding and boundless a Director role at Huron will ignite your future in… more
- Huron Consulting Group (Chicago, IL)
- …Their talents and leadership instill passion and followership in clients, juniors, and management . So if you're defined by ongoing progress-if you can lead teams, ... guidance to pursuit team in coordination with lead Workday Managing Director ** **Coordinate and update industry specific practices on specific opportunities,… more
- LifePoint Health (Johnstown, PA)
- …**Case Management /Social Services* **Organization:** ** **Title:** * Market Director Case Managemen* **Location:** *Pennsylvania-Johnstown* **Requisition ... Position Summary: Provide Case Management leadership and management for hospitals within a market of... program.Ensure staff competencies in all areas of care management to include utilization review, transition/discharge planning,… more
- CVS Health (Albany, NY)
- …ensuring timely and consistent responses to members and providers. As a Medical Director you will focus primarily on overseeing utilization review / quality ... ability to obtain a NJ License. In the Medical Director role you will provide oversight for medical policy...of clinical / medical programs and expand Aetna's medical management programs to address member needs across the continuum… more
- Virginia Mason Franciscan Health (Tacoma, WA)
- …strategic leadership partnership with an administrative dyad partner, the market leader's responsibilities also focus on leading/facilitating anesthesia and ... variability in anesthesia and perioperative medicine services/resources, maximizing effective utilization of resources and enhancing overall patient outcomes/service satisfaction.… 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 ... community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement...with prior experience participating in teams focusing on quality management , utilization management , case … more