• Director , Trial Attorney BI/ UM

    USAA (New Orleans, LA)
    …Come be a part of what makes us so special! **The Opportunity** As a dedicated Director , Trial Attorney (BI/ UM ) you will lead a team of Legal Assistants and ... staff counsel office. + Experience acting as the attorney in charge when managing trial attorney is not present. + Experience mentoring and developing trial… more
    USAA (10/31/24)
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  • Managed Care Coordinator UM II

    ManpowerGroup (Columbia, SC)
    …review determinations. + Identify and make referrals to appropriate staff (eg, Medical Director , Case Manager, Preventive Services, etc.). + Participate in ... + **Title:** Managed Care Coordinator UM II + **Location:** Initial on-site work required...extension) **Role Overview** This role involves reviewing and evaluating medical or behavioural eligibility for benefits and clinical criteria… more
    ManpowerGroup (10/30/24)
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  • Director , Utilization Management

    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
    Commonwealth Care Alliance (09/19/24)
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  • Clinical Director - Early Childhood Support…

    Magellan Health Services (Hodge, LA)
    The ECSS Clinical Director will have oversight and monitoring of ECSS site-developed assessments and Plans of Care to ensure the highest level of standards of care ... in Louisiana, candidates must reside in Louisiana. Maintains accountability for medical management functions to achieve the business and clinical outcomes for… more
    Magellan Health Services (10/24/24)
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  • Executive Medical Director Revenue…

    AdventHealth (Maitland, FL)
    …Site position** **The role you'll contribute:** As the physician advisor, the Executive Medical Director of Revenue Cycle educates, informs, and advises members ... related to denial prevention measures for our contracted managed care payers. The Medical Director is responsible for providing physician review of utilization,… more
    AdventHealth (11/04/24)
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  • Ambulatory HIV Medical Director

    University of Maryland, Baltimore (Baltimore, MD)
    …School of Medicine are seeking applicants for a full-time (1.0 FTE)*Ambulatory HIV Medical Director position*. The expected faculty rank for this position will ... **School of Medicine - Clinical Departments* **Title:** *Ambulatory HIV Medical Director (3-309-1236)* **Location:** *null* **Requisition ID:** *240001HU* more
    University of Maryland, Baltimore (10/10/24)
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  • Medical Director - Behavioral Health…

    CVS Health (Baton Rouge, LA)
    …Better Health of Louisiana is seeking a dedicated and experienced Behavioral Health Medical Director . The ideal candidate will be a board-certified psychiatrist ... in a medical specialty. The Behavioral Health Medical Director will ensure timely medical...At least three (3) years of training in a medical specialty. * Experience in managing behavioral… more
    CVS Health (09/10/24)
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  • Director , Contracting & Strategic Sourcing

    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
    University of Miami (10/13/24)
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  • Director , Clinical Performance…

    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
    Healthfirst (09/14/24)
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  • OBGYN Generalist Division Director

    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
    University of Maryland, Baltimore (08/15/24)
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  • Director Managed Care Enrollment…

    Dignity Health (Bakersfield, CA)
    …dedicated to providing quality managed care administrative and clinical services to medical groups hospitals health plans and employers with a business objective to ... benefits they want from a variety of options including medical dental and vision plans for the employee and...**within California** **.** Working in a collaborative environment, the Director will be a hands-on leader to the Enrollment… more
    Dignity Health (10/16/24)
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  • Manager II Behavioral Health

    Elevance Health (Atlanta, GA)
    …II Behavioral Health Services** is responsible for Behavioral Health Utilization Management (BH UM ), or Behavioral Health Case Management (BH CM) or a combination of ... make an impact:** + Serves as a resource for medical management programs. + Identifies and recommends revisions to...of care initiatives. + May attend meetings to review UM and/or CM process and discusses facility issues. +… more
    Elevance Health (11/08/24)
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  • Manager II Behavioral Health Services (Utilization…

    Elevance Health (FL)
    …analysis services. + Responsibilities include overseeing clinical rounds, coordinating with medical director to ensure program meets quality standards and ... Management for Behavior Analysis Services)** Responsible for Behavioral Health Utilization Management (BH UM ). Serves as a mentor to lower leveled managers and as a… more
    Elevance Health (11/02/24)
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  • Manager of Case Management and Social Work

    Houston Methodist (Baytown, TX)
    …assurance and quality improvement processes related to admission, concurrent and retrospective UM and medical claims programs. Collaborates with medical ... other areas according to department specifications. + Manages utilization management ( UM ) programs including Medical Claims Review, Precertification and… more
    Houston Methodist (10/05/24)
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  • Sr. Manager, Programs

    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
    University of Miami (10/30/24)
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  • Academic Program Specialist

    University of Michigan (Ann Arbor, MI)
    …and the Office/Program leadership, as well as other relevant units and offices on the UM campus, such as Rackham and the Medical School. Our office operates in ... of Research is looking for a highly qualified individual to assist in managing our PhD, dual degree PhD/DDS, and DSPP graduate programs. The selected candidate… more
    University of Michigan (10/26/24)
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  • Nurse Educator

    University of Miami (Miami, FL)
    …sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The University of Miami/UHealth Medical Training Lab is currently seeking a ... practices within a specialized area of nursing. The incumbent collaborates with medical practitioners to incorporate nursing processes into the plan of care for… more
    University of Miami (10/25/24)
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  • Senior Manager, Medical Policy

    Healthfirst (NY)
    …and medical departments + Conducts ad hoc medical condition research per Medical Director and/or UM Clinical Director requests + Collaborates ... **Duties/Responsibilities:** + Develops, reviews, and updates medical policies and clinical guidelines to ensure they are evidence-based and aligned with best… more
    Healthfirst (10/31/24)
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  • Pharmacy Technician Supervisor

    University of Michigan (Ann Arbor, MI)
    …successful completion and submission of the following: + Completed application via the UM Careers website + Letter of Intent or Cover Letter + Updated curriculum ... 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… more
    University of Michigan (10/25/24)
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  • Primary Care Physician

    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
    ChenMed (09/28/24)
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