• Alameda Health System (Oakland, CA)
    …each individual in the classification. Lead and manage a team of utilization review professionals providing guidance, training, and performance evaluations. ... utilization reviews and determine program improvements. Develop and implement utilization review policies and procedures in accordance with industry… more
    job goal (12/08/25)
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  • Catholic Health System (Buffalo, NY)
    …Erie. This Physician shall be Board Certified/Eligible in Hematology and Medical Oncology and will provide both inpatient and outpatient services to Catholic ... Health System Hospitals across Western New York. Trinity Medical , WNY, is the multispecialty physician group...Holistic development of patient treatment plans, readily available for review in the EHR. 12. Utilization of… more
    job goal (12/11/25)
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  • Defense Health Agency (San Antonio, TX)
    Utilization Management and Quality Assurance processes. Attends Continuing Medical Education (CME) Courses and maintains specialty specific CME sufficient to ... Overview Physician (Internal Medicine) Joint Base San Antonio Time...and perks to include competitive compensation packages, paid-time off, medical benefits, student loan repayments, and retirement package with… more
    job goal (12/11/25)
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  • Monogram Health (Jacksonville, FL)
    …suite of technology-enabled clinical services, including case and disease management, utilization management and review , and medication therapy management ... Monogram Health is seeking a full-time physician , specialized in palliative care, to join the...be integrated into their local market with the pod Medical Director and primarily renders care in the home… more
    job goal (12/11/25)
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  • Vista Community Clinic (Vista, CA)
    …of clinic protocols and procedures to ensure quality medical care Participate in utilization and peer review programs which evaluates the quality of the ... technicians and other staff. Participate in quality assurance, quality improvement and utilization review Provide in-service training to clinic staff to increase… more
    job goal (12/12/25)
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  • Alameda Health System (Oakland, CA)
    …for patients, improve the quality of patient care and maximize the efficient utilization of physician and hospital resources. Report to departmental leadership ... Emergency Medicine Physician + Oakland, CA + Highland General Hospital...for Alameda Health System, under employment from Alameda Health Medical Group. Services will be on-site at Highland Hospital.… more
    DirectEmployers Association (10/29/25)
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  • HCA Healthcare - Chief Medical Officer (San Antonio, TX)
    …Serves as a consultant to hospital Medical Staff Services regarding physician credentialing, utilization , and quality profiling. Serves as a member of ... a data-driven environment of quality and cost improvement and develops systems to review utilization of resources and objectively measure outcomes of care in… more
    job goal (12/12/25)
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  • Buckeye Community Health Plan (Thornville, OH)
    … management, cost containment, and medical quality improvement activities. Performs medical review activities pertaining to utilization review , ... utilization review studies and evaluates adverse trends in utilization of medical services, unusual provider practice patterns, and adequacy of… more
    job goal (12/12/25)
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  • Trinity Health (Syracuse, NY)
    …with the administrative team to oversee department activities. Manage cost management, utilization review , quality assurance, and medical protocol ... St. Josephs Health is seeking a fellowship-trained, board-certified Medical Director of OB/GYN for a 0.1 FTE...foster an environment of excellence in patient care and physician collaboration. This role offers the opportunity to work… more
    job goal (12/12/25)
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  • BoldAge PACE (Oceanport, NJ)
    … management, quality management, performance improvement, pharmacy and therapeutics, peer review , credentialing, and physician leadership matters. Minimum of 3 ... Professional Growth Access to training and career development. Competitive Compensation: Medical /Dental Flex Time Off 401K with Match Life Insurance Tuition… more
    job goal (12/12/25)
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  • Monogram Health (Fort Myers, FL)
    …Medicaid populations Experience with NCQA, HEDIS, Medicaid, Medicare, quality improvement, medical utilization management, and risk adjustment Current state ... Utilize IT and data tools to report, monitor, and improve quality and utilization Assist Practice Medical Executives to conduct retrospective reviews of… more
    job goal (12/12/25)
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  • Fresenius Medical Care (Atlanta, GA)
    …Manages staff scheduling and payroll. PHYSICIANS: Facilitates the application process for physician privileges and compliance with Fresenius Medical Care ... Medical Staff By-Laws. Responsible for strong physician relationships and ensures regular and effective communication. Participates in Governing Body, an… more
    job goal (12/12/25)
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  • Premera Blue Cross (Mountlake Terrace, WA)
    …appropriate procedure and diagnosis codes, and support business decisions regarding utilization management activities and guidelines. + Support medical policy ... by identifying and updating appropriate procedure and diagnosis codes for company medical policies and UM ( Utilization Management) guidelines that reflect … more
    DirectEmployers Association (11/21/25)
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  • Fresenius Medical Care (Fayetteville, NC)
    …involves staff in problem solving. PHYSICIANS: Facilitates the application process for physician privileges and compliance with FMS Medical Staff By-Laws. ... communicated to and implemented by the facility staff. Maintains integrity of medical records and other FMS administrative and operational records. Complies with all… more
    job goal (12/10/25)
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  • Stanford Health Care (Palo Alto, CA)
    …provides clinical direction and education, works closely with operational and physician leaders, and has oversight of hiring, termination, and professional growth ... Nurse Specialist (CNS), Certified Registered Nurse Anesthetist (CRNA), or the Physician Assistant (PA) Job Description approved by the Interdisciplinary Practice… more
    DirectEmployers Association (11/13/25)
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  • Yale New Haven Health (Danbury, CT)
    …A Charge Nurse. Meets Performance Expectations For Customer Service, Teamwork, Resource Utilization , And Staff And Self Development As Outlined In Performance ... Review . Performs Other Duties As Assigned Or Directed To...Trached Patient Demonstrates Skill And Understanding In Assisting The Physician And Caring For The Patient During Special Neuro… more
    job goal (12/10/25)
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  • BroadPath Healthcare Solutions (Tucson, AZ)
    …results-driven **UM RN Appeals Coordinator.** This role collaborates with clinical review staff, medical directors/ physician reviewers, network physicians, ... to enhance understanding of criteria application, benefit use, and the appeal, External Medical Review (EMR), and Fair Hearing processes + Coordinate: Ensures… more
    DirectEmployers Association (11/13/25)
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  • Yale New Haven Health (Fairfield, CT)
    …A Charge Nurse. Meets Performance Expectations For Customer Service, Teamwork, Resource Utilization , And Staff And Self Development As Outlined In Performance ... Review . Performs Other Duties As Assigned Or Directed To...Trached Patient Demonstrates Skill And Understanding In Assisting The Physician And Caring For The Patient During Special Neuro… more
    job goal (12/10/25)
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  • Unknown (Houston, TX)
    …site. Listen to deliberations and provide verbal feedback as necessary. Visually review all documents pertaining to committee functions. II. Patient Care Provide ... Represent MD Anderson at community events, educational forums, and among referring physician groups across the region. Practice clinical medicine in an exemplary… more
    job goal (12/11/25)
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  • Stanford Health Care (Palo Alto, CA)
    …Provides clinical direction and education, works closely with operational and physician leaders, and has oversight of hiring, termination, and professional growth ... Nurse Specialist (CNS), Certified Registered Nurse Anesthetist (CRNA), or the Physician Assistant (PA) Job Description approved by the Interdisciplinary Practice… more
    DirectEmployers Association (11/04/25)
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