- Alameda Health System (Oakland, CA)
- …Generous paid time off plans Role Overview: Alameda Health System is hiring! The Director of Utilization Management holds a critical role encompassing ... hoc duties as needed. In essence, they orchestrate efficient utilization management to deliver high-quality patient care....in the classification. Lead and manage a team of utilization review professionals providing guidance, training, and… more
- AmeriHealth Caritas (Newtown Square, PA)
- Role Overview Under the direction of a supervisor, the Utilization Management Reviewer evaluates medical necessity for inpatient and outpatient services, ... making determinations based on clinical criteria. Using professional judgment, the Utilization Management Reviewer assesses the appropriateness of services,… more
- AmeriHealth Caritas (Newtown Square, PA)
- …Under the direction of a supervisor, the Clinical Care Reviewer - Utilization Management evaluates medical necessity for inpatient and outpatient services, ... policies. When necessary, cases are escalated to the Medical Director for further review . The reviewer independently...case management of all transplant members. Conduct utilization management reviews for all transplant services… more
- AmeriHealth Caritas (Newtown Square, PA)
- …with providers and appropriate others to facilitate and coordinate the Utilization Management process(es) activities. Utilize technology and resources (systems, ... CHC process for requesting additional information. Refers cases to the Plan Medical Director for medical necessity review when medical information provided does… more
- Saint Francis Health System (Tulsa, OK)
- …participates in the Patient Care Committee for patient care reviews, and in Utilization Review Staff Committee, providing data and contributing to improvement of ... support to the hospital and treatment team throughout the review of patients, their placement in various levels of...nor does it prohibit the assignment of additional duties. Utilization Management - Laureate Campus Location Tulsa,… more
- Tris Pharma (Monmouth Junction, NJ)
- …execution of contracting, pricing governance, government compliance, and vendor management . The Director orchestrates complex cross-functional workflows, manages ... have an opening in our Monmouth Junction, NJ facility for a Director , Market Access, OperationsThis position is responsible for managing the operational… more
- CVS Health (Columbus, OH)
- …health plan. This includes benefit set-up, claims processing, contractual oversight, formulary management and updates, medication utilization review , prior ... safety. This may involve medication therapy management (MTM), disease management initiatives, drug utilization review , and medication adherence… more
- Concentrix (Raleigh, NC)
- Home (https://jobs.concentrix.com/) "Job Details Director , Account Management Account Management (https://jobs.concentrix.com/job-search/?category=Account ... Location United States Of America Language English Apply Now (https://cnx.wd1.myworkdayjobs.com/external_global/job/USA-Work-at-Home/ Director --Account-Management_R1676422-1/apply?1=1) Summary Director , Account Management ,… more
- Select Medical (Tucson, AZ)
- …Hospital - Tucson In partnership with Select Medical $10,000 Sign-On Bonus Position: Director of Quality Management Location: 355 North Wilmot Road, Tucson, AZ ... action documentation related to the hospital's CQI program. Performs basic chart review activities with appropriate staff for outcome utilization , infection… more
- Select Medical (Hummelstown, PA)
- …Rehabilitation Hospital A joint venture with Select Medical & Penn State Health Director of Quality Management (DQM) Bonus incentives Extensive onboarding and ... action documentation related to the hospital's CQI program. Performs basic chart review activities with appropriate staff for outcome utilization , infection… more
- Cardinal Health (Tewksbury, MA)
- …as an objective tool to work with specific Medical Staff Departments or Utilization Management Teams to improve medication utilization Ensures clinically ... the Health System Director of Pharmacy (HSD), Director of Pharmacy Operations and Account Management ,...initiatives, updates to the Policy and Procedure manual, annual review of order sets and protocols, black box warning,… more
- Humana (Phoenix, AZ)
- … management Utilization management experience in a medical management review organization such as Medicare Advantage, managed Medicaid, or Commercial ... community and help us put health first The Medical Director relies on broad clinical expertise to review...with prior experience participating in teams focusing on quality management , utilization management , or similar… more
- Carnegie Mellon University (Pittsburgh, PA)
- …Provide analytical support and financial insight for audits, facilities projects, space utilization , grants management , and special projects. Coordinate with the ... areas to investigate and solve real-world problems. We are seeking a Director of Accounting Operations. This position provides strategic and operational leadership… more
- University of Pennsylvania (Philadelphia, PA)
- …guidelines. In collaboration with the Medical Director and Associate Medical Director develop, review , and revise patient care policies and procedures. ... and wellness programs and resources, and much more. Posted Job Title Assistant Medical Director , Gender & Sexual Health Job Profile Title Director C, Healthcare… more
- Oracle (Columbus, OH)
- …power and cooling in the data center. Critical responsibilities include change management , incident & event support, space utilization , efficiency upgrades, and ... Job Description The Data Center Facility Engineering Director individual will lead an organization of Data Center Facility Engineers and Technicians, responsible for… more
- ENFRA (Charlotte, NC)
- …director /job?mode=apply&apply=yes&in_iframe=1&hashed=-1834357758) Job Locations US-NC-Charlotte ID 2025-8511 Category Construction Management Position ... just values-they are the pillars of our continued success. Overview The Director of Construction will be responsible, in collaboration with regional leadership, for… more
- Encore (Kansas City, MO)
- …Venue Sales Leadership on sales strategies Creates and participate in business review presentations. Financial Management & Reporting Drive Results by managing ... Position Overview The Director , Event Technology II (DET II) is responsible...financial goals for the location(s) by effectively directing the management of labor, equipment sub-rentals and other costs. Train… more
- The Cigna Group (St. Louis, MO)
- JOB SUMMARY The Director Health Systems Sales will lead a Sales Manager and a team of Account Managers and Business Development Managers responsible for the ... a strategic growth priority for Evernorth Health Services (HSS). This Sales Director will be instrumental in expanding our Health System Offering, driving… more
- Battelle Memorial Institute (Columbus, OH)
- …and welcome all qualified individuals to apply. Job Summary The Sr. Director , Procurement is responsible for directing the procurement and subcontracts functions for ... objectives within contractual agreements, required laws, and regulations. The Sr. Director role will be developing and implementing procurement strategies; managing… more
- Cardinal Health (Columbus, OH)
- …healthcare services and products company headquartered in Dublin, OH. The National Director of Sales, Market Access serves as the dynamic commercial leader for ... Managers. The leader is uniquely responsible for balancing traditional people management with direct, hands-on support for the team's critical frontline efforts,… more
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