- Catholic Health Initiatives (Lexington, KY)
- …the community. **Responsibilities** The Utilization Management (UM) Director is responsible for the market (s) development, implementation, evaluation and ... processes appeals and reconsiderations. In collaboration with the Division Director Care Coordination, the UM Director develops... programs to meet the Care Coordination goals and market utilization management goals while… more
- Ascension Health (Nashville, TN)
- …Saint Thomas hospitals throughout the TN market . We're looking for an experienced Director of Utilization Management to join our team! In this pivotal ... **Details** + **Department:** Utilization Management + **Schedule:** Monday -...root-cause analysis to enhance our processes. You'll collaborate with Market Care Management , Finance, CDI, and Physician… more
- CareFirst (Baltimore, MD)
- …location based on business needs and work activities/deliverables that week. The Director , Utilization Management provides strategic leadership of the ... utilization management team and is responsible for the design, assessment,...the candidate's work experience, education/training, internal peer equity, and market and business consideration. It is not typical for… more
- ERP International (Nellis AFB, NV)
- …No Call, No Weekends, No Holidays! **Job Specific Position Duties:** * Provides Utilization Management activities and functions by using MTF specific Quality ... disciplines to include discharge planning and referrals for case management . * Utilization management duties...appropriate health plan. Collaborates, coordinates with TOPA and Referral Management Director when needed in accordance with… more
- LA Care Health Plan (Los Angeles, CA)
- Supervisor, Utilization Management RN Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full ... safety net required to achieve that purpose. Job Summary The Supervisor of Utilization Management (UM) RN is responsible for executing the day-to-day operations… more
- LA Care Health Plan (Los Angeles, CA)
- …observation) admission in the acute setting. Works with UM leadership, including the Utilization Management Medical Director , on requests where determination ... Utilization Management Admissions Liaison RN II...data presented and established criteria/guidelines, escalating to the medical director if needed. Triages and assesses members for admission… more
- Elevance Health (FL)
- **JR133557 Manager II Behavioral Health Services ( Utilization Management for Behavior Analysis Services)** Responsible for Behavioral Health Utilization ... lower cost of care. + Candidate will be responsible for the oversight of the utilization management team. + Responsible for a team of clinicians who conduct… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position ... support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and approves… more
- Katmai (Usaf Academy, CO)
- …(BSN) is required. + Minimum of two (2) years of prior experience in Utilization Management . + Must possess a current, active, full, and unrestricted Registered ... background checks. **DESIRED QUALIFICATIONS &** **SKILLS** + Certification by a Utilization Management -specific program such as Certified Professional in… more
- The Hartford (King Of Prussia, PA)
- … will provide direct underwriting leadership, sales leadership, and agency management for the Middle Market Underwriting Center (MMUC). Responsibilities ... Promotes utilization of services: Claims and Risk Engineering Middle Market Underwriting Operations + Inspires team to achieve operating plan objectives through… more
- Jacobs (Sacramento, CA)
- As a Market Growth Director ( Market GD) you report to your assigned Executive Director of Sales (EDS). You are responsible for the development of a ... strategy to include input and create alignment with the Lead Account Strategist (LAS), the Director of Operations (DO) aligned to your market , and Market … more
- ChenMed (St. Louis, MO)
- …expanding and we need great people to join our team. The Associate Market Clinical Director will directly supervise, performance manage and train Clinical ... workplace concerns. + Reviews/approves center-level referrals and provides back-up for market referral and delegated utilization authorizations. Other duties as… more
- J&J Family of Companies (Horsham, PA)
- Product Director (Senior Manager), Market Development, Multiple Myeloma Marketing - 2406221519W **Description** Johnson & Johnson is currently recruiting for a ... Product Director , Market Development, Multiple Myeloma Marketing located...+ Partner with analytics and operations teams to track utilization and impact of market development initiatives… more
- HCA Healthcare (Charleston, SC)
- …purpose and integrity. We care like family! Jump-start your career as a(an) Market Director Clinical Professional Development today with Trident Medical Center. ... Eligibility for benefits may vary by location._** Come join our team as a(an) Market Director Clinical Professional Development. We care for our community! Just… more
- AbbVie (Mettawa, IL)
- …Commercial and Medicare FFS aspects of the Medical Benefit and associated utilization management and reimbursement dynamics. Preferred Qualifications: + Previous ... @abbvie on Twitter, Facebook, Instagram, YouTube and LinkedIn. Job Description The Associate Director , US Market Access Marketing, Oncology supports US Market… more
- Huron Consulting Group (Chicago, IL)
- …They provide client engagement delivery oversight, team leadership and program management . Throughout the process, they construct enduring relationships that benefit ... leadership instill passion and followership in clients, juniors and management . If you're defined by ongoing progress-if you can...clients achieve their full potential. Rewarding and boundless a Director role at Huron will ignite your future in… more
- Huron Consulting Group (Chicago, IL)
- …Their talents and leadership instill passion and followership in clients, juniors, and management . So if you're defined by ongoing progress-if you can lead teams, ... guidance to pursuit team in coordination with lead Workday Managing Director ** **Coordinate and update industry specific practices on specific opportunities,… more
- LifePoint Health (Johnstown, PA)
- …**Case Management /Social Services* **Organization:** ** **Title:** * Market Director Case Managemen* **Location:** *Pennsylvania-Johnstown* **Requisition ... Position Summary: Provide Case Management leadership and management for hospitals within a market of... program.Ensure staff competencies in all areas of care management to include utilization review, transition/discharge planning,… more
- CVS Health (Albany, NY)
- …ensuring timely and consistent responses to members and providers. As a Medical Director you will focus primarily on overseeing utilization review / quality ... ability to obtain a NJ License. In the Medical Director role you will provide oversight for medical policy...of clinical / medical programs and expand Aetna's medical management programs to address member needs across the continuum… more
- Virginia Mason Franciscan Health (Tacoma, WA)
- …strategic leadership partnership with an administrative dyad partner, the market leader's responsibilities also focus on leading/facilitating anesthesia and ... variability in anesthesia and perioperative medicine services/resources, maximizing effective utilization of resources and enhancing overall patient outcomes/service satisfaction.… more