- CHRISTUS Health (Tyler, TX)
- …to set a baseline for comparison Discovers opportunities to improve resource utilization Implements changes in role consistent with scope of practice Anticipates and ... plans for admission/discharge/transfer needs to facilitate patient flow Resolves conflicts in a wide variety of situations, such as workload allocation, schedule overlap etc. Adjusts management and personal style to fit the needs of different people and… more
- CHRISTUS Health (Tenneryville, TX)
- …to set a baseline for comparison . Discovers opportunities to improve resource utilization . Implements changes in role consistent with scope of practice . ... Anticipates and plans for admission/discharge/transfer needs to facilitate patient flow . Resolves conflicts in a wide variety of situations, such as workload allocation, schedule overlap etc. . Adjusts management and personal style to fit the needs of… more
- CHRISTUS Health (Irving, TX)
- …nursing initiatives for the CHRISTUS Health System. Works with the Program Director and clinical leaders to lead the implementation of clinical strategies, policies, ... education and competency, physician collaboration, integration, outcomes, and resource utilization with the goal of increasing service line growth, efficiency,… more
- CHRISTUS Health (Tenneryville, TX)
- …high-quality, cost-effective care to patients. Responsible in assisting the Director for analyzing, planning, implementing, evaluating, and communicating processes ... within the scope of labor laws. Discovers opportunities to improve resource utilization . Implements changes in role consistent with scope of practice. Anticipates… more
- WellSpan Health (York, PA)
- Director - Utilization and Denials Management Location: WellSpan Health, York, PA Schedule: Full Time General Summary Supervises and oversees the operations of the ... Co-chair's System Utilization Management Committee. + Works closely with Medical Director to identify trends in payor denials and appeals. + Serves as point… 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 ... state and federal regulatory requirements and all applicable accreditation standards. The Director of Utilization Management is responsible for setting strategic… 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) ... of hospital resources, and continued stays of inpatients. The Medical Director of utilization review will ensure the most efficient use of the institution's… 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
- 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
- Trinity Health (Boise, ID)
- …Description:** Saint Alphonsus is seeking a physician leader to become our Medical Director of Documentation and Utilization Excellence. This position will be ... and evaluated annually by the Saint Alphonsus Chief Clinical Officer. The Medical Director of Documentation and Utilization Excellence (MDDUE) is the lead… more
- Catholic Health Initiatives (Lexington, KY)
- …both inside our hospitals and out in the community. **Responsibilities** The Utilization Management (UM) Director is responsible for the market(s) development, ... implementation, evaluation and direction of the Utilization Management Program and staff in support of the...processes appeals and reconsiderations. In collaboration with the Division Director Care Coordination, the UM Director develops… more
- AnMed Health (Anderson, SC)
- The Utilization Review Medical Director supports operations and direction of the Care Coordination, Clinical Documentation, and Utilization Management ... consultation to the leadership and staff who perform the functions of Utilization Management (UM), Case Management (CM), Transition Planning/ Discharge Planning, and… more
- UCLA Health (Los Angeles, CA)
- …timely communication is provided to all stakeholders. + Working closely with medical director , utilization management and quality review team to ensure that all ... 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
- Hackensack Meridian Health (Belle Mead, NJ)
- …third party payers and communicate potential or identified concerns to the treatment team, Director of Utilization Management, and the Medical Director . + ... and serve as a leader of positive change. The Utilization Management Coordinator utilizes clinical knowledge and understanding of...ACCESS center staff and PFS department to ensure appropriate utilization of resources and benefits on a case by… more
- Providence (Mission Hills, CA)
- …program in the Southern California Region. The Manager assists the Regional Director of Utilization Management, Appeals & Clinical Training through the ... **Description** The Manager of Utilization Management provides a key role in leading,...direction for and leadership to a large team of Utilization Management RNs in the care of patients by… more
- AdventHealth (Maitland, FL)
- …Medical Director is responsible for providing physician review of utilization , claims management, and quality assurance related to inpatient care, outpatient ... by the Division CFO/SrVP, Vice President of Revenue Cycle Operations and/or Director , Utilization Review Management..Reviews data and trends to identify… more
- SUNY Upstate Medical University (Syracuse, NY)
- …This Utilization Review Denials Review Unit (DRU) 3 Team Lead will assist the Director of Utilization Review and the Associate Director of Utilization ... Review with daily staff mentoring, leadership and resource provision. This position will have supervisory oversight of the DRU level I & II nurses and provides feedback/mentorship to UR CR I as to review, payor and regulatory questions. This UR DRU 3 Team… more
- Sacramento Behavioral Healthcare Hospital (Santa Rosa, CA)
- POSITION TITLE: Utilization Review Clinician REPORTS TO (TITLE): Director of Utilization Review DESCRIPTION OF POSITION: Work as member of multi-disciplinary ... third party payers. + Recordkeeping: Maintains appropriate records of the Utilization Review Department. + Training: Provide staff in-service training and education.… more
- Independent Health (Buffalo, NY)
- …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...focus on clinical accuracy and appropriateness. The Associate Medical Director (AMD) will assist the Medical Director … more
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