- 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 ...scheduling, reviews, feedback 11. Peer-to-peer cases a. Work with system UM medical director to ... of hospital resources, and continued stays of inpatients. The Medical Director of utilization review...Utilization Management Conditions of Participation (COP) 14. Attend system IPAS monthly meetings 15. Attending Length of Stay… 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...and Executive staff, strategic metrics short and long range Utilization goals in line with Honorhealth system … 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 ... **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement… more
- Humana (Columbus, OH)
- …quality management or utilization management. **Additional Information** Reports to a Lead Medical Director . The Medical Director conducts ... a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews preauthorization requests… 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 ... **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement… more
- Martin's Point Health Care (Portland, ME)
- …"Great Place to Work" since 2015. Position Summary The Health Plan Medical Director provides leadership for the clinical care systems that improve the health ... including applicable managed care experience with progressively increasing responsibilities in medical director capacities, including utilization management… 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 ... feedback to respective departments + Conduct concurrent review with utilization review department for post op surgical cases with...medical terminology required. Previous experience with EPIC patient medical record system and 3M encoding … 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
- 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 ... Develop systems and processes for prospective, concurrent and retrospective utilization review for allself-funded and fully insured clients to implement and… 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
- Ascension Health (Tulsa, OK)
- …+ Develop systems and processes for prospective, concurrent and retrospective utilization review for all self-funded and fully insured clients to implement and ... **Details** + **Department:** Utilization Management + **Schedule:** FT, Monday-Friday, 8am-5pm +...**Schedule:** FT, Monday-Friday, 8am-5pm + **Hospital:** Ascension St. John Medical Center + **Location:** Tulsa, OK **Benefits** Paid time… more
- City of New York (New York, NY)
- …court proceedings for guardianship and other legal interventions. - Consult with the Medical Director regarding utilization off MHL Section 9.37 authority. ... Visiting Psychiatric Services Unit, who will: Under the supervision of the Medical Director , with latitude for independent judgement and initiative, the… more
- Mount Sinai Health System (New York, NY)
- … System :** Mount Sinai Health System is one of the largest academic medical systems in the New York metro area, with more than 43,000 employees working ... **Job Description** The Utilization Review Manager for the Selikoff Centers for...+ Other related duties as assigned by the program medical director , manager, and administrator. **About Us**… more
- Mount Sinai Health System (New York, NY)
- … System :** Mount Sinai Health System is one of the largest academic medical systems in the New York metro area, with more than 43,000 employees working ... Sinai Health System . + Responsible for the development of complex utilization management strategies and drug utilization review programs to enhance formulary… more
- ERP International (Nellis AFB, NV)
- …employing team building concepts in both multi -and inter-disciplinary setting to maintain medical and utilization management goals. Must be able to provide oral ... and present medical care practices for patterns; trends incidents of under-or over- utilization of resources incidental to providing medical care. * Acts as… more
- Covenant Health Inc. (Louisville, TN)
- …treatment and authorizes sessions per guidelines. + Works collaboratively with Medical Director and accesses consultation and involvement whenever appropriate ... targets. + Provides medical /psychiatric leadership/consultation to Provider Relations, Medical Utilization Management, and Quality Management Staff in… more
