- Pathways Vermont (Burlington, VT)
- …House Program Manager Supervisor: Alternative Mental Health Services Director Location: Burlington, Vermont Responsibilities:Oversight of Service ProvisionEnsure ... Lead Work in partnership with the APRN and contracted psychiatrist to oversee medical and psychiatric services for residentsSupport the APRN in their role of… more
- SunCrest Home Health - Manchester PD (Manchester, TN)
- …care (SOC) visits. Coordinates determination of patient home health benefits, medical necessity, and ongoing insurance approvals. Ensures patient needs are ... all aspects of care with all disciplines, physicians, durable medical equipment providers, caregivers/family members, transferring facilities, and any other… more
- Brookdale Home Health St. Louis (Creve Coeur, MO)
- …care (SOC) visits.Coordinates determination of patient home health benefits, medical necessity, and ongoing insurance approvals.Ensures patient needs are continually ... all aspects of care with all disciplines, physicians, durable medical equipment providers, caregivers/family members, transferring facilities, and any other… more
- Mederi Caretenders (Inverness, FL)
- …care (SOC) visits. Coordinates determination of patient home health benefits, medical necessity, and ongoing insurance approvals. Ensures patient needs are ... all aspects of care with all disciplines, physicians, durable medical equipment providers, caregivers/family members, transferring facilities, and any other… more
- Assured Home Health (Portland, OR)
- …the appropriate plan of care. Ensures patients meet home health eligibility and medical necessity guidelines as defined by payer source. The Registered Nurse in Home ... nursing evaluation visit, ensures patients meet home health eligibility and medical necessity guidelines as defined by payer source, accurately determines primary… more
- Saint Francis Health System (Tulsa, OK)
- …psychosocial factors. Documents steps of the nursing process. Utilizes proper medical terminology. Addresses problems and progress toward goals. Facilitates patient ... discharge through timely, appropriate referrals and utilization of patient education resources, suitable to patient age and cultural/psychosocial factors.… more
- Saint Francis Health System (Tulsa, OK)
- …psychosocial factors. Documents steps of the nursing process. Utilizes proper medical terminology. Addresses problems and progress toward goals. Facilitates patient ... discharge through timely, appropriate referrals and utilization of patient education resources, suitable to patient age and cultural/psychosocial factors.… more
- Trinity Health (Boise, ID)
- …**Job Description:** Saint Alphonsus is seeking a physician leader to become our Medical Director of Documentation and Utilization Excellence. This position ... and evaluated annually by the Saint Alphonsus Chief Clinical Officer. The Medical Director of Documentation and Utilization Excellence (MDDUE) is the lead… more
- Geisinger (Harrisburg, PA)
- …use of technology where possible to improve quality and enhance efficiency. The Medical Director will direct providers, faculty, residents and other clinicians, ... execution of a strategic plan for the provision of Utilization Management services across the organization, fostering a spirit...of medical necessity justification with health plan medical director staff. Job Duties + Provides… more
- CVS Health (Springfield, IL)
- …clinical support to Account Management in support of Key Clients as assigned.The Medical Director transacts Utilization Management UM activities (prior ... to Account Management in support of Key Clients as assigned.The Medical Director transacts Utilization Management UM activities (prior authorization and… more
- Humana (Columbus, OH)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members ... caring community and help us put health first** The Medical Director relies on medical ...insurance, other healthcare providers, clinical group practice management. + Utilization management experience in a medical management… more
- Humana (Columbus, OH)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members ... caring community and help us put health first** The Medical Director relies on medical ...insurance, other healthcare providers, clinical group practice management. + Utilization management experience in a medical management… more
- Humana (Columbus, OH)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members ... caring community and help us put health first** The Medical Director actively uses their medical...insurance, other healthcare providers, clinical group practice management. + Utilization management experience in a medical management… more
- AmeriHealth Caritas (Newark, DE)
- …policy and practice initiatives in collaboration with the Corporate Medical Director (s), Senior Medical Directors, Utilization Management and the CMO. ... preferred. + 5+ years of clinical practice. + Experience in Utilization Management as a Medical Director within a managed care organization desired. +… more
- AmeriHealth Caritas (Orlando, FL)
- …policy and practice initiatives in collaboration with the Corporate Medical Director (s), Senior Medical Directors, Utilization Management and the Vice ... ** Medical Director , UM Review, Family Medicine**...** Medical Director , UM Review, Family Medicine** Location: Orlando, FL...to practice in any state licensed in as a medical director . Additional state licensure required in… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Medical Director oversees all activities of utilization review, care management and quality to determine the ... needs of members. We are looking for an experienced Medical Director in the greater Baltimore /...post-acute care, and appeals. + Oversees all activities of utilization review, care management and quality to determine the… more
- YesCare Corp (Hanover, MD)
- …Shares information gathered at the quarterly area multidisciplinary CQI Committee meetings with the Utilization Management Medical Director to be used at the ... Nurse in Maryland. + Current Basic Life Support/CPR Certification at the Medical Professional Level with AED Training. American Heart Association is the preferred… more
- InnovaCare (San Juan, PR)
- …process as required to meet member's needs.15. Performs authorizations determined by Medical Director , coordination, and utilization of the cases ... Participates in round clinics discussion with Multidisciplinary team such as program medical director as well as other disciplines, documenting all… more
- St. Luke's University Health Network (Allentown, PA)
- …incorrect registrations and/or physician queries + Serves as liaison between Physician Advisor/ Medical Director , Finance, Utilization Review Department and ... lost with feedback to respective departments + Conduct concurrent review with utilization review department for post op surgical cases with potential status issues,… more
- CVS Health (Springfield, IL)
- …to cover urgent cases; and can be done from your laptop. Fundamental Components: * Utilization management - The medical director will perform concurrent and ... services to its membership. Aetna is looking for a Medical Director to be part of a...and/or Medicaid) Experience with managed care (Medicare and Medicaid) utilization review preferred MD or DO; Board certification in… more
Related Job Searches:
Associate Medical Director Utilization,
Director,
Medical,
Medical Director,
Medical Director UM Utilization,
Medical Director Utilization Management,
Medical Director Utilization Physician,
Medical Director Utilization Review,
System Medical Director Utilization,
Utilization