- University of Maryland Medical System (Largo, MD)
- …in Largo in the heart of Prince George's County, our new state-of-the-art regional medical center ( UM Capital Region Medical Center) will provide improved ... to the Patient and Family Experience Manager and Corporate Director , the Communication Supervisor plays a crucial role in...safe and timely execution of overhead paging throughout all UM Capital's locations. In addition to supervisory duties, this… more
- University of Maryland Medical System (Largo, MD)
- …in Largo in the heart of Prince George's County, our new state-of-the-art regional medical center ( UM Capital Region Medical Center) will provide improved ... 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
- City and County of San Francisco (San Francisco, CA)
- …specifically in the Mental Health Service Center + Supervises medical staff, including UM Medical Director , OCC Nurse Practitioner, and the medical ... health services, including psychiatric services. The Behavioral Health Services (BHS) Deputy Medical Director of Managed Care provides effective leadership and… more
- Nuvance Health (Norwalk, CT)
- …cost-effective utilization of Hospital Resources and optimize financial performance. Collaborates with UM Medical Director and Vice President of Medicine. ... in Connecticut, and Northern Dutchess Hospital, Putnam Hospital Center and Vassar Brothers Medical Center in New York - plus multiple primary and specialty care… more
- Point32Health (MA)
- …as well as any partner entities at the direction of Behavioral Health Medical Director Team Leader for Utilization Management ( UM ) and/or the Medical ... initial reviews and appeals. They will work closely with colleagues in UM and Medical Management, and with other departments as needed, including but not limited… more
- Dignity Health (Bakersfield, CA)
- …week, and will be expected to work within PST business hours.** **Position Summary:** The Medical Director of UM reports to the Chief Physician Executive ... oversight to medical physician reviewers and network medical directors who support UM reviews, ensuring consistency, quality and compliance in UM… more
- University of Maryland, Baltimore (Baltimore, MD)
- The University of Maryland School of Medicine is seeking a Chair and Medical Director of Critical Care for the UM Capital Region Health Medical Center ... Associates, PA They will work closely and in collaboration with the Trauma Medical Director , Chief of Cardiac Surgery, Surgery, Medicine, Neurocritical Care. The… more
- ManpowerGroup (Columbia, SC)
- …back up review determinations. Identifies and makes referrals to appropriate staff ( Medical Director , Case Manager, Preventive Services, Subrogation, Quality of ... **Title:** **Managed Care Coordinator UM II** **Location: Columbia SC (Onsite)** **Duration: 3...Remote after training **Job Responsibilities:** + Reviews and evaluates medical or behavioral eligibility regarding benefits and clinical criteria… more
- Kepro (AR)
- … UM contract for Arkansas Medicaid. Job Responsibilities: + Collaborate with Medical Director and other Dental Physician Reviewers on case consultations as ... public sector. Acentra is looking for an Oral Surgeon ( UM Reviewer) to join our growing team. Job Summary:...+ Develop and complete an annual review of clinical medical necessity criteria. + Travel in-state as needed for… more
- 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 ... or team meetings, collecting data pertaining to clinical status and justifying the medical necessity for continued treatment in inpatient level of care. Referral of… more
- Dignity Health (Bakersfield, CA)
- …Director of Utilization Management ( UM ) ensuring partnership with the Managed Care Medical Director of UM for the implementation and compliance to all ... of Utilization Management ( UM ) ensuring partnership with the Managed Care Medical Director of UM for the medical necessity reviews, denials… more
- University of Miami (Miami, FL)
- …Director , HR Communications. This position is located in the UM Medical Campus, Health District. SUMMARY The Director , HR Communications (H) provides ... Miami offers competitive salaries and a comprehensive benefits package including medical , dental, tuition remission and more. UHealth-University of Miami Health… more
- CVS Health (San Juan, PR)
- …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
- 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
- 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
- Dignity Health (Bakersfield, CA)
- …preservice utilization review, concurrent inpatient review, and retro claim review. The UM Director is also responsible for the oversight of utilization ... providing quality managed care administrative and clinical services to medical groups hospitals health plans and employers with a...for bringing on new lines of business into the UM workflow. The Director is responsible for… more
- Magellan Health Services (Honolulu, HI)
- …quality improvement activity (QIA) in collaboration with the clinical lead senior medical director , and quality improvement staff. May participate in various ... day to day physician oversight to an assigned interdisciplinary UM team, including regular involvement in the case management...committees or project teams as directed by the senior medical director or vice-president. + Supports senior… more
- CVS Health (Little Rock, AR)
- …license without encumbrances in one (1) of those five (5) states. + In the Medical Director role you will provide oversight for medical policy ... consistent responses to members and providers. + As a Medical Director you will focus primarily on...States Market (Georgia, Louisiana, Alabama, Mississippi, or Arkansas). Previous UM experience with a Health Plan / Payor. Previous… more
- 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
- Magellan Health Services (Albuquerque, NM)
- The Children in State Custody (CISC) Director has expansive knowledge and experience of the child welfare system. Is a subject matter expert in resources available ... care coordination needs. Qualifications : Preferred RN Maintains accountability for medical management functions to achieve the business and clinical outcomes for… more
