- CHRISTUS Health (Tenneryville, TX)
- …and teams; identifying and addressing staff training and development needs * Medical staff, department heads, and administrators in matters related to nursing ... to set a baseline for comparison . Discovers opportunities to improve resource utilization . Implements changes in role consistent with scope of practice .… more
- Christus Health (Jasper, TX)
- …teams; identifying and addressing staff training and development needs * Apprising medical staff, department heads, and administrators in matters related to nursing ... to set a baseline for comparison * Discovers opportunities to improve resource utilization * Implements changes in role consistent with scope of practice *… more
- CHRISTUS Health (Tyler, TX)
- …of teams; identifying and addressing staff training and development needs Apprising medical staff, department heads, and administrators in matters related to nursing ... to set a baseline for comparison Discovers opportunities to improve resource utilization Implements changes in role consistent with scope of practice Anticipates and… more
- Henry Ford Health System (Detroit, MI)
- The Medical Director of Utilization Review is responsible for the medical oversight of activities related to appropriateness of Henry Ford Hospital (HFH) ... utilization of hospital resources, and continued stays of inpatients. The Medical Director of utilization review will ensure the most efficient use of… more
- Trinity Health (Boise, ID)
- …**Job Description:** Saint Alphonsus is seeking a physician leader to become our Medical Director of Documentation and Utilization Excellence. This position ... and evaluated annually by the Saint Alphonsus Chief Clinical Officer. The Medical Director of Documentation and Utilization Excellence (MDDUE) is the lead… more
- AnMed Health (Anderson, SC)
- The Utilization Review Medical Director supports operations and direction of the Care Coordination, Clinical Documentation, and Utilization Management ... programs at AnMed. The Medical Director ensures the program and associated physicians work collaboratively with and provide consultation to the leadership and… more
- UCLA Health (Los Angeles, CA)
- …that clear, timely communication is provided to all stakeholders. + Working closely with medical director , utilization management and quality review team to ... Description As the Utilization Management & Quality Review Specialist, you will...issue cases, ensuring compliance with regulatory requirements for both utilization management and quality assurance processes + Ensuring that… more
- HonorHealth (Mesa, AZ)
- …other hospitals, health plans and vendors, as required. Works closely with the Medical Director , Utilization Management, Nursing, the Chief Medical ... and the AVP to optimize the Medical Director role internally and externally. Responsible for restructuring and...contacts to assure quality service is provided. Partners with medical staff to assure proper utilization of… more
- Independent Health (Buffalo, NY)
- …perks, 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 and maintenance of these programs, with focus… more
- CVS Health (Sacramento, CA)
- …support to Account Management in support of Key Clients as assigned. The Medical Director transacts Utilization Management UM activities (prior authorization ... to Account Management in support of Key Clients as assigned. The Medical Director transacts Utilization Management UM activities (prior authorization and… 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 ... caring community and help us put health first** The Medical Director actively uses their medical...insurance, other healthcare providers, clinical group practice management. + Utilization management experience in a medical management… more
- Humana (Columbus, OH)
- …quality management or utilization management. **Additional Information** Reports to a Lead Medical Director . The Medical Director conducts ... caring community and help us put health first** The Medical Director relies on medical ...other healthcare providers, clinical group practice management. + Prefer Medical Oncology or Surgery specialties + Utilization … 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 ... caring community and help us put health first** The Medical Director actively uses their medical...insurance, other healthcare providers, clinical group practice management. + Utilization management experience in a medical management… more
- Martin's Point Health Care (Portland, ME)
- …including applicable managed care experience with progressively increasing responsibilities in medical director capacities, including utilization management ... to Work" since 2015. Position Summary The Health Plan Medical Director provides leadership for the clinical...and executes on all aspects of the health plan's medical policy, clinical utilization management programs and… more
- CVS Health (Oklahoma City, OK)
- …regional role that primarily supports the Aetna Better Health Plan of Oklahoma. This UM ( Utilization Management) Medical Director will be a "Work from Home" ... health care more personal, convenient and affordable. **Position Summary:** Ready to take your Medical Director skills to the next level with a Fortune 6… more
- St. Luke's University Health Network (Allentown, PA)
- …incorrect registrations and/or physician queries + Serves as liaison between Physician Advisor/ Medical Director , Finance, Utilization Review Department and ... lost with feedback to respective departments + Conduct concurrent review with utilization review department for post op surgical cases with potential status issues,… more
- InnovaCare (San Juan, PR)
- …process as required to meet member's needs.15. Performs authorizations determined by Medical Director , coordination, and utilization of the cases ... Participates in round clinics discussion with Multidisciplinary team such as program medical director as well as other disciplines, documenting all… 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
- Ascension Health (Nashville, TN)
- …Ascension 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 - Friday. 40...optimize patient care, and partner with the National Senior Director of UM to align on organizational goals. Ready… more
- Molina Healthcare (CA)
- …from authorization requests or for additional information as requested by the Medical Director . + ** Utilization Management experience-Health plan or ... Experience** 3+ years' experience in an administrative support role in healthcare, Medical Assistant preferred. To all current Molina employees: If you are… more
