- Luminis Health (Lanham, MD)
- …Job Code: 000747 FLSA Status: Non - Exempt Reports To : Clinical Director - Nursing Position Objective The Clinical Supervisor directly supervises staff and is ... and developmentally experience/opportunities. . Demonstrates the ability to optimize utilization of staff, matching staff talents and proficiencies to organizational… more
- Luminis Health (Lanham, MD)
- …Job Code: 000747 FLSA Status: Non - Exempt Reports To : Clinical Director - Nursing Position Objective The Clinical Supervisor directly supervises staff and is ... coaching and developmentally experience/opportunities. .Demonstrates the ability to optimize utilization of staff, matching staff talents and proficiencies to… more
- Unknown (Philadelphia, PA)
- …education, healthcare management, or business, with a Master's degree and campus director /president experience highly preferred. A minimum of 5 years in a leadership ... services business, with a focus on marketing, service quality, and asset utilization , is essential. The role also requires the ability to analyze operational… more
- Alameda Health System (Oakland, CA)
- Director , Utilization Management + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day + Nursing + Req #:40826-30155 + ... plans **Role Overview:** Alameda Health System is hiring! The Director of Utilization Management holds a critical...Health System is hiring! The Director of Utilization Management holds a critical role encompassing operational oversight,… more
- Wellpath (Cleveland, OH)
- …education, and point of care support. **How you make a difference** The Medical Director of Utilization Management leads and oversees utilization review, ... efforts to ensure quality patient care and the appropriate utilization of medical services. The Medical Director of Utilization Management serves as a key… more
- UNC Health Care (Morrisville, NC)
- …well-being of the unique communities we serve. **Summary** : The **Executive System Director of Utilization Management (UM)** is a strategic and operational ... leader responsible for designing, implementing, and standardizing utilization management functions across a large healthcare system, including a complex academic… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …protected characteristic. Blue Cross and Blue Shield of Minnesota Position Title: Senior Director of Health Services - Utilization Management Location: Hybrid | ... join us. The Impact You Will Have The Senior Director of Health Services, Utilization Management is responsible for the design, strategic planning, evolution,… more
- Fallon Health (Worcester, MA)
- … Director to identify and prioritize the cost of care opportunities related to Utilization Management. + Works with VP/ Medical Director to set agenda related ... of purpose:** With the general direction from the VP Sr. Medical Director Clinical Management and SVP/Chief Medical Officer will provide strategic leadership and… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The **Program Director (Licensed)** is responsible for leading and sustaining a Utilization Management Initiative supporting ACO and ... **Experience Requirements** + 7+ years of experience in care management, utilization management, population health, or value-based care. + Demonstrated experience… more
- Centene Corporation (Richmond, VA)
- …a fresh perspective on workplace flexibility. **Position Purpose:** Directs the utilization management team to ensure the appropriate application of policy ... and processes to help support best member outcomes. Oversees and manages Utilization Operations specific to the daily operations of Utilization Management… more
- Insight Global (New York, NY)
- …turn-around times for clinical reviews. * Collaborate with other departments on Utilization Management Operations. * Lead key projects and drive initiatives to ... medicine is required. * 3+ years of clinical practice * 2+ years of utilization review experience in a managed care plan (health care industry) referred Experience… more
- Healthfirst (NY)
- …to maintain and improve department performance + Collect, analyze, and report on utilization trends, patterns, and impacts to identify areas for improvement + Lead ... Clinical Eligibility, Behavioral Health, and Appeals and Grievances teams to align utilization decisions + Partner with technology and data teams to refine data… more
- Integra Partners (Troy, MI)
- …operational needs require. The Senior MD provides clinical oversight to the Utilization Review Medical Director (s), ensures consistent application of criteria, ... Integra's clinical position to internal and external stakeholders. The Senior Utilization Review Medical Director 's responsibilities include but are not… more
- Integra Partners (Troy, MI)
- The Utilization Review Medical Director is responsible for conducting clinical reviews of Durable Medical Equipment (DME) and related requests to support ... and are committed to consistency, compliance, and evidence-based decision making. The Utilization Review Medical Director 's responsibilities include but are not… more
- Elevance Health (Indianapolis, IN)
- ** Utilization Management Medical Director - Indiana Medicaid** **Location:** This role enables associates to work virtually full-time, with the exception of ... by law. Alternate locations may be considered. The **Medical Director ** is responsible for reviewing cases for IN Medicaid...state or territory of the United States when conducting utilization review or an appeals consideration and cannot be… more
- LifeCenter Northwest (Bellevue, WA)
- …response to case activity or operational needs. + Collaborate with the Director , Organ Utilization , to manage departmental budgets and identify cost-management ... proficiency and participate in on-call schedule as directed by the Director , Organ Utilization , available for consultation outside of regular working hours as… more
- Huron Consulting Group (Chicago, IL)
- …agencies, and hospital contractual payor agreements. This position reports to the Director of Utilization Management and works with hospital leadership to ... review staff and function for the system, reporting to the Director of Utilization Management within Revenue Cycle. Assists with leading recruiting, orienting,… more
- Houston Behavioral Healthcare Hospital (Houston, TX)
- …currently has an opening for Part-time Utilization Management Coordinator. The Utilization Management Coordinator will report to the Director of ... Utilization Review and will be responsible to provide quality case management services to all patients and their families, to serve as a member of interdisciplinary team supporting the organization's treatment program and philosophy, and assure the… more
- UPMC (Pittsburgh, PA)
- …Health Plan is seeking a licensed MD or DO for a fully remote Medical Director , Utilization Management role. The Medical Director , Utilization Management ... UPMC Health Plan members. They will oversee adherence to quality and utilization standards through committee delegations and further establish an effective working… more
- Prime Healthcare (Inglewood, CA)
- …full-time or part-time. Responsibilities We are seeking a strategic and compassionate Director of Case Management to lead our dynamic Case Management Team consisting ... and Clinical Coordinators. This leader will oversee all facets of utilization management, discharge planning, and care coordination to ensure patients receive… more
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