- Immigration and Customs Enforcement (IN)
- …Assistant Director for Healthcare Compliance, Office of Health Plan Management. The Senior Utilization Review Consultant will report directly to the IHSC ... position Responsibilities DUTIES AND RESPONSIBILITIES: Serves in the capacity of Senior Utilization Review Consultant and subject matter expert in program… more
- Office of Personnel Management (Washington, DC)
- Summary The Director , Small and Disadvantaged Business Utilization (SDBU) promotes opportunities for small, minority, disadvantaged, and women-owned businesses ... owned and disabled veteran businesses in Agency programs. Responsibilities The Director SDBU ensures that small businesses participate equitably in OPM programs… more
- Geisinger (Harrisburg, PA)
- …educational programs across the department. Responsible for management of the Utilization Review policy and observation management performance including outcomes ... Establishes and leads execution of a strategic plan for the provision of Utilization Management services across the organization, fostering a spirit of innovation in… more
- Ascension Health (Baltimore, MD)
- …initiatives. + Develops systems and processes for prospective, concurrent and retrospective utilization review for all self-funded and fully insured clients to ... CM as appropriate * Performs other duties as assigned Utilization Management: + Ensures integration of utilization ...of care, including more than 140 hospitals and 40 senior living communities in 19 states. Our Mission, Vision… more
- UPMC (Moosic, PA)
- We have an exciting opportunity for a full-time Senior Medical Director to join our leadership team with UPMC Community Care! As Senior Medical Director , ... invite you to learn more and apply today! The Senior Medical Director provides guidance for clinical...the Quality Management Programming designing and evaluating protocols. + Review the medical aspects of cost and utilization… more
- Boehringer Ingelheim (Ridgefield, CT)
- **Description** The Sr. AD Scientific Affairs Medical Information and Medical Review is responsible for developing, maintaining and continuously improving Medical ... Information (MI) assets and for review and approval of medical and promotional materials as...timely development of scientific content for internal and external utilization based on customer needs and aligned with global… more
- VIP Care (Tampa, FL)
- …help improve utilization and provide better health for patients. The Senior Medical Director would also leverage their entrepreneurial and innovative ... Summary/Objective: The Senior Medical Director is responsible for...ongoing improvements in MHT to lead to improvements in utilization + Direct the integration of the Pharmacy team… more
- Magellan Health Services (Albuquerque, NM)
- …to an assigned interdisciplinary UM team. + Responsible for the quality of utilization review determinations, including appeals. + Reviews cases, makes medical ... implements and manages programs to support this vision. The Senior Medical Director ensures the delivery of...effectiveness and cost of care of clinical programs through review and analysis of utilization and financial… more
- LA Care Health Plan (Los Angeles, CA)
- …required to achieve that purpose. Job Summary Under the general direction of the Director of Utilization Management (UM) the Program Manager II is responsible ... Utilization Management Program Manager II Job Category: Clinical...Expected to serve as a strategic thought partner with director and senior management leadership team members… more
- Huron Consulting Group (Chicago, IL)
- …on established criteria and guidelines. + Maintain accurate and detailed records of review decisions and interactions in the utilization management system. + ... the expert you are now and create your future. **Qualifications** The Utilization Management Specialist is responsible for ensuring the appropriate utilization … more
- McLaren Health Care (Indianapolis, IN)
- …for utilization management functions. This includes but is not limited to review and authorization of services, utilization of medical policy, utilization ... We are looking for a Utilization Management, RN - IN to join us...and under and overuse of services. Collaborates with Medical Director and senior management on complex cases… more
- CVS Health (Hartford, CT)
- …more personal, convenient and affordable. Job Purpose and Summary: The LTSS/SAI National Senior Medical Director , reporting to a Regional CMO of Medicaid, will ... quality and financial goals across Medicaid* Responds to LTSS RFP sections and review LTSS portions of state contracts.* Works with trainers to develop and provide… more
- ChenMed (Louisville, KY)
- …leader for the foundational business unit of our care model - the center. The Senior Medical Director (SMD) will partner with the Center Director /Center ... all internal physician training and have attained partnership. + Must complete full medical director training prior to promotion to Senior Medical Director ,… more
- HCA Healthcare (Nashville, TN)
- …Do you want to join an organization that invests in you as a Senior Director Clinical Resource Management? At HealthTrust, you come first. HCA Healthcare ... and you have the opportunity to make a difference. We are looking for a dedicated Senior Director Clinical Resource Management like you to be a part of our team.… more
- Elderwood (Buffalo, NY)
- …players - but also for our valued employees. Elderwood Administrative Services is seeking a Senior Director of Purchasing. Position Overview: + The Senior ... is located at 500 Seneca Street, Suite 100, Buffalo, NY 14204. Responsibilities Senior Director of Purchasing + Directs enterprise-wide purchasing / supply chain… more
- Comunilife (Bronx, NY)
- …assessment review for each client, submitting report and recommendations to utilization review committee. + Responsible for maintaining contact with other ... Senior Program Director -El Rios Job Details...services + Design and implement a comprehensive program evaluation. Evaluate/ review employees' annual job performance. + Prepare any and… more
- CVS Health (Columbus, OH)
- …of patients with severe, complex, and/or treatment resistant illnesses through peer review and educational interventions.* Work with medical director teams ... health outcomes.* Leverage extensive knowledge of health care delivery system, utilization management, reimbursement methods and treatment protocols for DSNP/MMP and… more
- University of Delaware (Newark, DE)
- Senior Associate Athletic Director , Governance & Compliance Job no: 501024 College / VP Area:Athletics & Recreation Svcs Work type: Staff Location: Newark ... Time Pay Grade: 33E Context of the Job: The Senior Associate Athletic Director (AD) for Governance...college athletics. + Responsible for leading the department-wide strategic utilization of ARMS. This includes but is not limited… more
- Southern Glazer's Wine and Spirits (Miramar, FL)
- …to fill your glass with opportunity, come join our FAMILY. **Overview** The Senior Director Workplace Strategy will lead the delivery of Southern Glazer's ... partners with the overall strategy regarding the real estate portfolio. The Sr Director of Real estate will develop processes that align the wok environment and… more
- Acacia Network (Bronx, NY)
- …Degree preferred) + Minimum of 2 years of case management and/or utilization review experience + Strong problem-solving and advanced analytical skills ... Acacia Network Inc. Utilization Manager Bronx, : 5/30/2024 Job Description Job...identifying and referring requests for services to the Medical Director when guidelines are not met and reviewing residential… more
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