- University of Maryland Medical System (Largo, MD)
- …in Largo in the heart of Prince George's County, our new state-of-the-art regional medical center ( UM Capital Region Medical Center) will provide improved ... Description Reporting to a Nursing Manager- or other senior clinical leader (Nursing Director ), the Assistant Nurse Manager (ANM), is accountable for the delivery of… more
- ManpowerGroup (Columbia, SC)
- …back up review determinations. Identifies and makes referrals to appropriate staff ( Medical Director , Case Manager, Preventive Services, Subrogation, Quality of ... **Title:** **Managed Care Coordinator UM II** **Location: Columbia SC (Onsite)** **Duration: 3...Remote after training **Job Responsibilities:** + Reviews and evaluates medical or behavioral eligibility regarding benefits and clinical criteria… more
- Commonwealth Care Alliance (Boston, MA)
- …and performance monitoring and + Leads the Utilization Management team in managing and continuously improving UM program design, policies, procedures, workflows, ... **Why This Role is Important to Us:** The Director of Utilization Management leads and manages all...of Utilization Management leads and manages all utilization management ( UM ) functions for physical health services and long term… more
- Magellan Health Services (Albuquerque, NM)
- The Children in State Custody (CISC) Director has expansive knowledge and experience of the child welfare system. Is a subject matter expert in resources available ... care coordination needs. Qualifications : Preferred RN Maintains accountability for medical management functions to achieve the business and clinical outcomes for… more
- Evolent Health (Columbus, OH)
- …mission. Stay for the culture. **What You'll Be Doing:** As a Behavioral Health Field Medical Director will be a key member of the utilization management team. ... Opportunities:** Evolent Health is looking for a Behavioral Health Medical Director to be a member of...members + Supports design and implementation of health plan medical policies, and appropriate Care Management and UM… more
- University of Miami (Miami, FL)
- …for a Director , Contracting & Strategic Sourcing to work at the UHealth Medical Campus. Core Job Summary The Director , Contracting and Strategic Sourcing (H) ... Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . Director , Contracting & Strategic Sourcing The University of Miami/UHealth… more
- Healthfirst (NY)
- …and business leader coaching. Metric types include compliance activities, CM and UM activities, clinical status outcomes, medical cost trend implications for ... CM and UM , staffing/ attrition recommendations, medical cost savings initiatives and tracking, new program design staffing models, and more** **.** **Design and… more
- University of Maryland, Baltimore (Baltimore, MD)
- …52 start-up companies*.* In the latest /US News & World Report/ ranking of the Best Medical Schools, published in 2021, the UM School of Medicine is ranked *#9* ... Division of General Obstetrics and Gynecology is seeking a Generalist Division Director who will lead the clinical, administrative, educational, and research goals… more
- Evolent Health (Columbus, OH)
- …a growth mindset as we solve complex business problems. **Collaboration Opportunities** The Director , Client Analyst role will be serving as a strategic advisor to ... + Leading a team of stateside and global analytical resources. This includes managing team capacity, mentoring junior team members, and guiding the team toward… more
- CVS Health (Hartford, CT)
- …and exciting ways every day. Aetna is recruiting for an Executive Director , Medicaid Provider Experience Standardization who is responsible for ensuring the ... PCPs are terminated. + Reviewing active prior authorizations and informing the UM /CM departments prior to the completion of the termination to ensure continuity… more
- Dignity Health (Bakersfield, CA)
- …Director of Utilization Management ( UM ) ensuring partnership with the Managed Care Medical Director of UM for the implementation and compliance to all ... ( UM ) ensuring partnership with the Managed Care Medical Director of UM for...and managed care service areas. This includes the planning, managing , analysis and communication in regards to the entire… more
- Huron Consulting Group (Chicago, IL)
- …internal processes and deliver better consumer outcomes. Health systems, hospitals and medical clinics are under immense pressure to improve clinical outcomes and ... utilization of healthcare services by reviewing patient cases for medical necessity, appropriateness, and efficiency of Munson Healthcare's services. This… more
- University of Miami (Miami, FL)
- …inquiries. Prepares, maintains, and reports on program effectiveness. Assists with managing program budget by monitoring expenditures. Stays abreast of market trends ... both online and residential, reports directly to the Associate Dean and inaugural director of online MPH, and offers administrative support for the design and… more
- ChenMed (Philadelphia, PA)
- …for the foundational business unit of our care model - the center. The Senior Medical Director (SMD) will partner with the Center Director /Center Executive ... The SMD is an earned title where the Center Medical Director completes all necessary primary care...Center Manager/Center General Manager to co-lead center stand-ups. + Managing , mentoring and coaching PCPs in his/her assigned center… more
- Penn Medicine (Hamilton, NJ)
- …leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across ... your life's work? Summary: + Under supervision from the Director of outpatient services and other clinical directors, provides...for assigned program(s). + Oversee and assist staff in managing clinical crises and transfer to inpatient units. +… more
- University of Michigan (Ann Arbor, MI)
- …care complexes in the world and has been the site of many groundbreaking medical and technological advancements since the opening of the U-M Medical School ... victor for the greater good. **What Benefits can you Look Forward to?** + Excellent medical , dental and vision coverage effective on your very first day + 2:1 Match… more
- University of Michigan (Ann Arbor, MI)
- …with information of a highly sensitive and confidential nature, managing calendars, scheduling meetings, answering phones, maintaining electronic and conventional ... . **Supervision Received** This position reports to the Associate Director , Department of Care Management, with additional matrix supervision received… more
- Immigration and Customs Enforcement (IN)
- …and medical payment authorization requests (MedPAR) process for off-site medical services, supports related UM processes, supports related management of ... Operations (ERO), ICE Health Service Corps (IHSC), Office of Deputy Assistant Director for Healthcare Compliance (HCC), Health Plan Management Unit (HPMU). This is… more
- NFTA (Buffalo, NY)
- …claims. An employee in this class is responsible for developing, managing , and revising operational procedures, interpreting, and applying laws and regulations ... making claims management decisions subject to final review and approval by the Director of Risk Management and/or Office of General Counsel. ESSENTIAL FUNCTIONS: The… more
- ManpowerGroup (Columbia, SC)
- …up review determinations. + Identifies and makes referrals to appropriate staff ( Medical Director , Case Manager, Preventive Services, Subrogation, Quality of ... clients. **Note:-** + Must Have Behavioral Health Experience + Previous Utilization Management ( UM ) or Case Management (CM) experience + Training will be onsite &… more
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