- CVS Health (Sacramento, CA)
- …in inter-rater review activities and other quality oversight processes for internal Director UM decisions. If specifically assigned to one business segment ... in inter-rater review activities and other quality oversight processes for internal Director UM decisions. If specifically assigned to one business segment… more
- Molina Healthcare (Tampa, FL)
- …**Job Summary** Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an ... integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and… more
- Ascension Health (Nashville, TN)
- …in utilization management to optimize patient care, and partner with the National Senior Director of UM to align on organizational goals. Ready to lead and ... TN market. Must be located within TN market. We're looking for an experienced Director of Utilization Management to join our team! In this pivotal role, you'll lead… more
- Integra Partners (Troy, MI)
- …call center and other internal & external sources + Other duties as assigned by UM Director + Strong organizational skills, ability to adapt quickly to change ... The UM Coordinator assists and supports the clinical team ( UM Nurses/Medical Director ) with administrative and non-clinical tasks related to processing… 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 (UMCRH), ... PA They will work closely and in collaboration with the Trauma Medical Director , Chief of Cardiac Surgery, Surgery, Medicine, Neurocritical Care. The Chair will be… more
- CVS Health (Baton Rouge, LA)
- …regional role that primarily supports the Aetna Better Health Plan of Louisiana. This UM (Utilization Management) Medical Director will be a "Work from Home" ... Oklahoma. Support for other regions may occasionally be required. The UM Medical Director will ensure timely and consistent responses to members and providers… more
- Point32Health (MA)
- …as well as any partner entities at the direction of Behavioral Health Lead Medical Director for Utilization Management ( UM ) and/or the Medical Director of ... and appeals. They will work closely with colleagues in UM and Medical Management, and with other departments as...legacy Tufts Health Plan or Harvard Pilgrim Health Care UM Policy and Procedure Manual. + Render medical necessity… more
- Nuvance Health (Norwalk, CT)
- …utilization of Hospital Resources and optimize financial performance. Collaborates with UM Medical Director and Vice President of Medicine. Develops ... utilization management and high-risk case management. Works collaboratively with the Director of transitions to ensure optimum utilization of Social Work Skills.… more
- LA Care Health Plan (Los Angeles, CA)
- …cost cases and reports are maintained and referred to the Physician Advisor/ UM Director . Document in platform/system of record. Utilize designated software ... and implement a successful discharge plan. Works with the UM Manager and Physician Advisor on case reviews for...or HMO setting . Preferred: Managed Care experience performing UM and CM at a medical group or management… more
- University of Miami (Coral Gables, FL)
- …concerns and/or issues as soon as they arise; this includes involving the Director , Business Operations Manager, and/or UM HR as required. + Supervises ... a member of the Lowe's leadership team, the Assistant Director for Learning, Engagement, & Technology (ADLET) directs one...other departmental units, both at the Lowe and across UM 's three campuses, to further the museum's mission, advance… more
- Apex Health Solutions (Houston, TX)
- Summary: The UM Reviewer serves as a contact and resource person to Health Solutions' members for the utilization review (UR) of healthcare services. The UM ... pending cases for a review determination with Health Solutions Medical Director , coordinate pre-authorization activities with affiliated health plans and interface… more
- Sharp HealthCare (San Diego, CA)
- …or services, readmissions to acute or visit to the Emergency Department.Informs Director , QI/ UM of any quality issues.Attends hospitalists rounds, as required, ... for medical necessity are issued under the direction of the Medical Director or designee.Assists with transfers, when necessary. + Demonstrates knowledge of… more
- Prime Healthcare (Ontario, CA)
- …Responsibilities The Corporate Director of Clinical Utilization ... 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 Inc… 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 ... improving the quality of life and longevity of the citizens of Maryland. The UM -IHC, located in North Bethesda, MD, is a collaborative effort of the University of… more
- University of Miami (Miami, FL)
- …a liaison between the Director of Program (Admin), Program Director (s), administrative leadership, UM /JMH Graduate Medical Education (GME) administration, ... Functions The Senior Residency Coordinator provides comprehensive administrative support to the Director of Programs (Admin) and Program Director (s) in the… more
- University of Michigan (Dearborn, MI)
- Director of Alumni Engagement Apply Now **How to Apply** A cover letter is required for consideration for this position and should be attached as the first page of ... to this position. **Job Summary** **Join Our Team as Director of Alumni Engagement** Are you ready to lead...a vibrant community of engaged alumni who actively support UM -Dearborn with their time, talent, and treasure. As a… more
- Sharp HealthCare (San Diego, CA)
- …and employer business practices. **What You Will Do** This Senior Medical Director position provides critical management and oversight for Sharp Health Plan's (SHP) ... practice of medicine. + 5 years' experience as an HMO Health Plan Medical Director . + California Physicians and Surgeons License - Medical Board of CA -REQUIRED… more
- University of Maryland, Baltimore (Baltimore, MD)
- …Center (UMGCCC), located in Baltimore, MD are recruiting for a*full-time Medical Director of the University of Maryland St. Joseph Cancer Institute, located in ... Towson, MD.* *_Administrative duties and responsibilities of the Medical Director role will include, but not limited to the following:_* * In conjunction with the… more
- University of Miami (Coral Gables, FL)
- …. General Description (Purpose and Function): The Director of Engagement Communications is responsible for developing ... media into the overall Office of Engagement business strategy. In addition, the Director will lead the Engagement team with traditional and online marketing and… more
- Magellan Health Services (San Diego, CA)
- …of care. Provides day to day physician oversight to an assigned interdisciplinary UM team, including regular involvement in the case management of at-risk cases and ... care at the most cost-effective setting. Evaluates the effectiveness of UM practices and criteria. Actively monitors for over- and under-utilization. Assumes… more
Related Job Searches:
Director,
Managing Medical Director UM,
Medical Director UM Utilization,
Senior Medical Director UM,
UM Medical Director