- Harbor Health Services, Inc. (Mattapan, MA)
- …MA and cares for more than 580 participants. We are currently seeking a Director of Utilization Management & Quality Programs. Harbor Health offers an excellent, ... Senior Director of Health Plan Operations, the Director of Utilization Management and Quality Programs...to the quality and appropriateness of care within a managed care environment. Additionally, the Director of… more
- Molina Healthcare (Houston, TX)
- …to learn new programs. Preferred Qualifications * Experience with utilization/quality program management . * Managed care experience. * Peer review experience. * ... oversight and clinical leadership for health plan and/or market specific utilization management and care management behavioral health programs and chemical… more
- Christus Health (Canton, TX)
- …data processing and space planning. * Works in conjunction with Regional Director and corporate Marketing Department in practice development. * Ensures ... areas and ensures compliance with regulations and standards. * Helps fiscal management and other administrative staff in implementing cost effective policies and… more
- Dignity Health (Bakersfield, CA)
- …patient monitoring, and CRM. - Provide backup support to the Medical Director of Utilization Management in medical review activities, peer-to-peer consultations, ... primarily in the Bakersfield/Central CA region.** **Position Summary:** The Medical Director of Physician Engagement is responsible for developing and driving… more
- Huron Consulting Group (Chicago, IL)
- …of collaboration, Huron offers a rewarding path forward. As the Healthcare Consulting Senior Director - Managed Care & Payment Strategy, you will: + Lead complex ... the expert you are now and create your future. At Huron, a Senior Director leads with expertise and collaboration, partnering with Huron and client leaders to create… more
- Dignity Health (Bakersfield, CA)
- … managed care populations. This leader will have direct oversight of the Medical Director of Utilization Management (UM) and the Medical Director of ... Clinical Oversight functions. + Oversee and manage the medical director capacity to support Managed Care Services... Care COO to ensure contract compliance and successful management of the managed care population. +… more
- KBF (CA)
- …NC** **.** As the external client facing Controller at KBF within the Managed Accounting Services practice you will be responsible for assisting clients ... a variety of industries. This position will be a management level role with the expectation that client service...service is critical. The role will report to a Director of Managed Accounting Service and be… more
- Humana (Raleigh, NC)
- …Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in ... a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance. + Experience with national guidelines… more
- Catholic Health Initiatives (Omaha, NE)
- …development and management of patient-centered quality initiatives with CVSL Executive Managed Market Director ; and, in conjunction with the SSVP of the ... national best practices. + Works (in partnership with Executive Managed Market Director and CHI Health leadership)...the Chief Medical Officer (or designee) to evaluate the practice patterns of members where there is a reasonable… more
- Morehouse School Of Medicine (Atlanta, GA)
- Sr. Director / Director , Department Administrator Bookmark this Posting Print Preview | Apply for this Job Please see Special Instructions for more details. ... a fulfilling career at MSM ! Posting Number NONAC3668 Job Title Sr. Director / Director , Department Administrator Position Title Sr. Director / Director ,… more
- CVS Health (Columbus, OH)
- …statutes and regulations pertaining to both pharmacy practice laws and Managed Medicaid/PBM regulations. The Pharmacy Director stays updated on changing ... the health plan and external partners for the state Managed Medicaid pharmacy benefit. The Pharmacy Director ...competitive advantage for the health plan. + **Pharmacy Benefit Management :** The Pharmacy Director is responsible for… more
- University Of Vermont (Burlington, VT)
- …without notice. Advertising Copy The University of Vermont ( UVM ) Libraries seeks a director of Collection Management Services ( CMS ). This position reports to ... and metadata, collection development and analysis, and acquisitions and electronic resources management . The director of CMS works closely with other library… more
- Ventura County (Ventura, CA)
- …communicates matters of VCHCP medical policy with the Health Care Agency Director and Insurance Administrator, Utilization Management staff and Quality Assurance ... Medical Director , Ventura County Health Care Plan Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/4924113)...Health and Safety code for VCHCP, a Department of Managed Health Care (DMHC) licensed Commercial HMO. This position… more
- Duquesne Light Company (Pittsburgh, PA)
- …innovation and outcomes. We want you to join our team! **Job Title:** Director , Project Management Office (PMO) **Position Summary:** The Director ... Program Excellence (CIPE). As a key member of the management team, the Director influences high-impact decisions,...activities within the sub function or major business area managed . Key member of the management team… more
- CommonSpirit Health (Santa Cruz, CA)
- …Responsibilities** This position will support the Central Coast market. The Market Director , Facility Management provides oversight and leadership to Market, and ... objectives, attaining high customer satisfaction, and meeting CommonSpirit Health's Facilities Management 's mission. The Market Director , Facility Management … more
- Baylor Scott & White Health (Dallas, TX)
- **JOB SUMMARY** Director , Comprehensive Care Management (CCM) is a System Director responsible for planning, developing, and implementing the comprehensive ... of Baylor Scott and White Health (BSWH), which may include case management , social services, coordination of patient care, patient access, utilization management… more
- Humana (Indianapolis, IN)
- …Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in ... a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance. + Experience with national guidelines… more
- CommonSpirit Health (Phoenix, AZ)
- …operational performance of IT systems and applications that support population health management , managed care operations, and end-user support services within a ... **Job Summary and Responsibilities** The System Director of IT Population Health Services Organization (PHSO)...accurate and timely reporting of key population health and managed care metrics. Project & Vendor Management … more
- Humana (Baton Rouge, LA)
- …Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in ... management review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance. + Experience with...size of region or line of business. The Medical Director conducts Utilization Management of the care… more
- Guthrie (Sayre, PA)
- …+ The director must have a clear understanding of multiple managed care contracts, multiple specialty insurance and billing practices, and exercise professional ... Summary In partnership with Guthrie's leadership team, PFS Director SBO is responsible for developing and executing the strategic vision for The Guthrie Clinic's… more
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