• Market Director of Utilization

    Ascension Health (Nashville, TN)
    …the 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, ... **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
    Ascension Health (01/24/25)
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  • Corporate Director of Clinical…

    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
    Prime Healthcare (11/28/24)
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  • Medical Director : Documentation…

    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
    Trinity Health (01/12/25)
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  • Medical Director - Utilization

    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
    AnMed Health (01/21/25)
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  • Director of Case Management…

    Scottish Rite for Children (Dallas, TX)
    …priority! We're committed to giving children back their childhood! Job Posting Title: Director of Case Management and Utilization Management Location: Dallas - ... Monday - Friday 8:00am to 4:30pm Job Description: Duties/Responsibilities: + Utilization Management supporting medical necessity and denial prevention + Transition… more
    Scottish Rite for Children (11/11/24)
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  • Utilization Review Clinician (Non-Remote)…

    Sacramento Behavioral Healthcare Hospital (Santa Rosa, CA)
    …TITLE: Utilization Review Clinician PAY RANGE: $31.00-$49.24 PER HOUR REPORTS TO: Director of Utilization Review DESCRIPTION OF POSITION: Work as member of ... and optimize reimbursement for external reviewers/third party payers. The Utilization Review Clinician maintains knowledge of, participates in further training… more
    Sacramento Behavioral Healthcare Hospital (12/10/24)
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  • Utilization Review Coordinator

    Desert Parkway Behavioral Healthcare Hospital (Las Vegas, NV)
    …to ensure that all days are authorized and identify denied days, coordinate with Director of Utilization Review and add to Denial Tracker when appropriate. ... the insurance authorizations. Daily Discharges At the direction of the UR Director , retrieves required documentation from the patient's medical record per EMR for… more
    Desert Parkway Behavioral Healthcare Hospital (12/18/24)
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  • Medical Director - Medical Affairs…

    CVS Health (Sacramento, CA)
    …Account Management in support of Key Clients as assigned. The Medical Director transacts Utilization Management UM activities (prior authorization and appeals) ... Account Management in support of Key Clients as assigned. The Medical Director transacts Utilization Management UM activities (prior authorization and appeals)… more
    CVS Health (01/04/25)
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  • Director of Case Management…

    Prime Healthcare (Inglewood, CA)
    …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/189094/ director -of-case-management utilization ... Privacy Notice for California Applicants: https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf Responsibilities The Director of Case Management is responsible for the… more
    Prime Healthcare (01/18/25)
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  • Medical Director - Gulf South

    Humana (Columbus, OH)
    Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an ... a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The Medical Director more
    Humana (12/03/24)
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  • Medical Director - South Central

    Humana (Columbus, OH)
    Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an ... of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations… more
    Humana (01/22/25)
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  • Medical Director - Mid West Region

    Humana (Columbus, OH)
    Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an ... of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations… more
    Humana (10/29/24)
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  • Medical Director - Health Plan

    Martin's Point Health Care (Portland, ME)
    …managed care experience with progressively increasing responsibilities in medical director capacities, including utilization management and medical policy ... a "Great Place to Work" since 2015. Position Summary The Health Plan Medical Director provides leadership for the clinical care systems that improve the health of… more
    Martin's Point Health Care (12/19/24)
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  • Medical Director , Ventura County Health…

    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/4527347) Apply  Medical Director , Ventura… more
    Ventura County (11/14/24)
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  • Director Case Management

    HCA Healthcare (Marion, NC)
    …and external agencies to ensure continuity of care and optimal clinical resource utilization . The Director has oversight for all aspects of daily hospital ... join an organization that invests in you as a(an) Director Case Management? At Mission Hospital McDowell, you come...make a difference. We are looking for a dedicated Director Case Management like you to be a part… more
    HCA Healthcare (01/22/25)
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  • Director Case Management

    HCA Healthcare (Kansas City, MO)
    …and external agencies to ensure continuity of care and optimal clinical resource utilization . The Director has oversight for all aspects of daily hospital ... Introduction Do you have the career opportunities as a(an) Director Case Management you want with your current employer?...of colleagues. Do you want to work as a(an) Director Case Management where your passion for creating positive… more
    HCA Healthcare (01/08/25)
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  • Director Case Management

    HCA Healthcare (Gainesville, FL)
    …and external agencies to ensure continuity of care and optimal clinical resource utilization . The Director has oversight for all aspects of daily hospital ... diversity and inclusion thrive? Submit your application for our Director Case Management opening with HCA Florida North Florida...benefits may vary by location._** We are seeking a(an) Director Case Management for our team to ensure that… more
    HCA Healthcare (01/08/25)
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  • Director Case Management

    HCA Healthcare (Anchorage, AK)
    …and external agencies to ensure continuity of care and optimal clinical resource utilization . The Director has oversight for all aspects of daily hospital ... over 156,000 hours volunteering in our communities. As a(an) Director Case Management with Alaska Regional Hospital you can...in our organization. We are looking for an enthusiastic Director Case Management to help us reach our goals.… more
    HCA Healthcare (12/10/24)
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  • Director of Payment Innovations

    Community Health Systems (Franklin, TN)
    …performance to improve quality of patient care and reduce unnecessary post-acute care utilization . The Director will be able to consider financial and quality ... **Summary:** The Director , Payment Innovation has responsibility for supporting the...Strategy and Business Development, Legal, and Compliance **.** The Director will also be prepared to manage ongoing Medicare… more
    Community Health Systems (01/22/25)
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  • Director Case Management

    HCA Healthcare (Bradenton, FL)
    …and external agencies to ensure continuity of care and optimal clinical resource utilization . The Director has oversight for all aspects of daily hospital ... is incentive eligible. **Introduction** Do you have the career opportunities as a(an) Director Case Management you want in your current role? We invest in what… more
    HCA Healthcare (12/10/24)
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