- Alameda Health System (Oakland, CA)
- …time off plans Role Overview: Alameda Health System is hiring! The Director of Utilization Management holds a critical role encompassing operational oversight, ... strategic planning, compliance, and collaboration. Their responsibilities span from managing admissions to ensuring clean claims, identifying trends, and optimizing… more
- Centene Corporation (Jefferson City, MO)
- …hearings, STARS metrics + Previous experience with ensuring high quality medical director training to review Medicare UM and appeals, Clinical review quality ... for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …you see is right for you, we encourage you to apply! Job Description: The Medical Director participates in the broad array of activities of the Medical ... reviews and may require peer-to-peer discussions with providers regarding UM case review determinations. + Provides clinical expertise on...and medical criteria. + Assists with training medical director colleagues and nursing staff ,… more
- Fallon Health (Worcester, MA)
- …of care opportunities related to Utilization Management. + Works with VP/ Medical Director to set agenda related to UM and represent the plan at clinical ... purpose:** With the general direction from the VP Sr. Medical Director Clinical Management and SVP/Chief ... necessities and criteria for coverage. + Oversight of UM by delegated organizations and ensure regulatory and accreditation… more
- Alameda Health System (Oakland, CA)
- Director , Utilization Management + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day + Nursing + Req #:40826-30155 + FTE:1 + ... time off plans **Role Overview:** Alameda Health System is hiring! The Director of Utilization Management holds a critical role encompassing operational oversight,… more
- University of Michigan (Ann Arbor, MI)
- …Chief Nursing Officer (ACNO) for Primary Care and Post Acute + Partners with the Medical Director for Care Management + Work closely with Finance and Revenue ... SENIOR DIRECTOR (Care Management and Social Work) Apply Now...a senior leader, this individual partners with executive leadership, medical staff, and other healthcare teams to align departmental… more
- University of Michigan (Ann Arbor, MI)
- Director (Cell and Gene Therapy Program) Apply Now **Job Summary** The Director of the Cell and Gene Therapy Program holds enterprise-wide accountability for the ... This role provides visionary leadership in planning, organizing, and managing multidisciplinary workgroups to deliver innovative, high-quality care. At the… more
- Sharp HealthCare (San Diego, CA)
- …operational planning consistent with existing policies and/or principles. Responsible for managing medical management activities to include tracking, trending ... and analyzing UM data. Works in collaboration with regional ...of the manager of in-patient care management and the Director of Utilization Management. **Required Qualifications** + 3 Years… more
- Point32Health (Canton, MA)
- …new programs + Performs other roles/duties and projects as assigned by the Pharmacy UM Supervisor or Director **Qualifications** **- what you need to perform the ... . **Job Summary** Under the direction of the Pharmacy Utilization Management ( UM ) Supervisor, the Per Diem Clinical Pharmacist is responsible for reviewing,… more
- Point32Health (MA)
- …+ Performs other roles/duties and projects as assigned by the Pharmacy UM Supervisor or Director **Salary Range** $107,921.67 -$161,882.51 **Compensation & ... . **Job Summary** Under the direction of the Pharmacy Utilization Management ( UM ) Supervisor, the Clinical Pharmacist is responsible for reviewing, processing and … more
- UTMB Health (Webster, TX)
- …or hospital transfers. If unsuccessful, elevates to department leadership and Senior Medical Director . Discharge Planning + Demonstrates skill in educating ... of enhancing quality clinical outcomes, promoting timely access to medical care, and managing care cost and...achieve target. + Presents LOS variances for review to Director and Inpatient Medical Director .… more
- University of Michigan (Ann Arbor, MI)
- …Medicine is seeking a dynamic and experienced leader for the **Administrative Director ** position. This individual will serve as a trusted advisor, providing ... intersection of health system strategy, operations, and transformation, the Director will drive alignment, accountability, and execution of enterprise priorities.… 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 ... **What Benefits can you Look Forward to?** + Excellent medical , dental and vision coverage effective on your very...Directors, RAHS APP Manager, RAHS Operations Manager, and RAHS Director to ensure compliance with standards of care, policies,… 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)
- …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 ... **What Benefits can you Look Forward to?** + Excellent medical , dental and vision coverage effective on your very...+ Knowledge of the FDA Food Code and experience managing kitchen operations using safe food handling sanitation and… more
- CDPHP (Latham, NY)
- …Social Work, Behavioral Health, Respiratory Therapy, Registered Dietitian, Registered Nurse, Medical Director , Pharmacist, Geriatrics, etc.) to ensure continuity ... policy and leadership, current NYS DOH, CMS regulations and standards if managing members of Medicare programs, and other regulatory requirements as applicable. +… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …Social Work, Behavioral Health, Respiratory Therapy, Registered Dietitian, Registered Nurse, Medical Director , Pharmacist, Geriatrics, etc.) to ensure continuity ... policy and leadership, current NYS DOH, CMS regulations and standards if managing members of Medicare programs, and other regulatory requirements as applicable. +… more
- Corewell Health (Royal Oak, MI)
- …status and level of care. Uses defined resources to guide decisions, including Medical Director Care Management, Physician Advisors, and management staff. 5. ... hospital outpatient, observation or inpatient services. 4. May review cases for medical necessity, uses InterQual and/or other UR/ UM Committee-approved … 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
