- AmeriHealth Caritas (Orlando, FL)
- ** Medical Director , UM Review,...policy and practice initiatives in collaboration with the Corporate Medical Director (s), Senior Medical ... to practice in any state licensed in as a medical director . Additional state licensure required in...within 3 months of employment. 5+ yrs clinical practice. UM /Care Coordination exp. preferred. Your career starts now. We… more
- Humana (Frankfort, KY)
- …a part of our caring community and help us put health first** The Director of Utilization Management ( UM ) Cost of Care Strategy provides data-based strategic ... for business segments or the company at large. The Director of Utilization Management ( UM ) Cost of...day-to-day leadership to drive progress and alignment + Solicit senior leader alignment on key decisions through executive-level presentations… more
- CVS Health (Springfield, IL)
- …you'll perform a share of special clinical investigations and research as requested by the Senior Medical Director , Medical Affairs. These projects can ... Account Management in support of Key Clients as assigned.The Medical Director transacts Utilization Management UM...special clinical investigations and research as requested by the Senior Medical Director , Medical… more
- ChenMed (Louisville, KY)
- …P&L leader for the foundational business unit of our care model - the center. The Senior Medical Director (SMD) will partner with the Center Director ... conjunction with the transitional care team; hospital, SNF, post-acute, UM , and home-based services for the division. + Assists... director training prior to promotion to Senior Medical Director , as part… more
- CVS Health (Columbus, OH)
- …resistant illnesses through peer review and educational interventions.* Work with medical director teams focusing on inpatient care management, clinical ... * Outward facing position to interact and collaborate with medical / physical professional associates, the local provider community,...* Be able to effectively communicate these finding to Senior Management and staff at all levels.* Develop and… more
- Magellan Health Services (Albuquerque, NM)
- …Medicare and Commercial) and implements and manages programs to support this vision. The Senior Medical Director ensures the delivery of appropriate health ... quality assurance and continuous quality improvement (CQI) processes. General Job Information Title Senior Medical Director , Behavioral Health - New Mexico… more
- Magellan Health Services (Dallas, TX)
- …clinical quality improvement activity (QIA) in collaboration with the clinical lead senior medical director , and quality improvement staff. May ... day to day physician oversight to an assigned interdisciplinary UM team, including regular involvement in the case management...various committees or project teams as directed by the senior medical director or vice-president.… more
- University of Maryland, Baltimore (Baltimore, MD)
- …physician-scientist with expertise in clinical trial design and execution to serve as Director of Clinical Trial Innovation.* The UM -IHC is a large-scale ... life and longevity of the citizens of Maryland. The UM -IHC, located in North Bethesda, MD, is a collaborative...of Maryland College Park, and the University of Maryland Medical System, funded with initial grants from the State… more
- AdventHealth (Maitland, FL)
- …Site position** **The role you'll contribute:** As the physician advisor, the Executive Medical Director of Revenue Cycle educates, informs, and advises members ... related to denial prevention measures for our contracted managed care payers. The Medical Director is responsible for providing physician review of utilization,… more
- University of Michigan (Ann Arbor, MI)
- …the unit Medical Director partner. Work closely with the Medical Director and area Nursing Services Senior Director to create and support an ... CLINICAL NURSING DIRECTOR : Postpartum Breastfeeding Lactation Program (Von Voigtlander Women's...priorities and institutional program development. + Work closely with medical staff and other disciplines for the successful implementation… more
- University of Miami (Coral Gables, FL)
- …law school stakeholders, including members of decanal advisory and oversight committees, UM senior administrators, trustees, donors, and other stakeholders. Bar ... the Dean of the School of Law. RESPONSIBILITIES: The Director will lead the program, and will work closely...one of the nation's top research universities and academic medical centers in the nation. The University comprises 12… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- … leaders for decision making + Apply their clinical knowledge when assessing/auditing medical records and UM letters against medical necessity criteria ... + Accurately plan and scope projects; keep project leads, senior consultants, and Director informed of key...skills and understanding of CMS Part C guidance including UM operational procedures, and CMS guidance including coverage and… more
- University of Michigan (Ann Arbor, MI)
- …society. **Responsibilities + Provide administrative and calendar management support to the Senior Associate Chair for Research; Executive Director , Pain & ... Administrative Assistant Senior Healthcare Apply Now **How to Apply** A...with writing a variety of correspondence including faculty and medical school recommendation letters and tracking due dates. +… more
- University of Miami (Coral Gables, FL)
- …related experience. Bachelor's degree preferred. Position requires significant experience with UM purchasing systems. The Senior Program Coordinator should have ... of Student Affairs, has a great opportunity for a Senior Program Coordinator to work at the Coral Gables...budget of the Student Bar Association, and assist the Director of Programs in managing the budget for the… more
- The Cigna Group (Bloomfield, CT)
- …partners with Coverage Policy Unit (CPU) medical policy team, manager, CPU Medical Director , clinical subject matter experts, and external vendors to meet ... Participates in National Clinical Updates and Pearls (CUPS) Calls, with UM RNs and Medical Directors, responding to questions and providing clarification on new… more
- Highmark Health (Columbus, OH)
- …in the capacity as a clinical pharmacist the incumbent may also review UM requests; provide consultation into the case and disease management identification process, ... and consult with the Organization's Associate Medical Directors and Medical Directors when appropriate,...+ Manage individual projects for timely review with the Director , Clinical Pharmacy. + Participate in Medicare Stars performance… 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 ... leading and managing a portfolio of strategic and transformational UM programs and projects that are generally complex and...Expected to serve as a strategic thought partner with director and senior management leadership team members… more
- Huron Consulting Group (Chicago, IL)
- …internal processes and deliver better consumer outcomes. Health systems, hospitals and medical clinics are under immense pressure to improve clinical outcomes and ... utilization of healthcare services by reviewing patient cases for medical necessity, appropriateness, and efficiency of Munson Healthcare's services. This… more
- University of Maryland, Baltimore (Baltimore, MD)
- … level Neonatologist to join UM -SJMC as the level III NICU Medical Director . This position requires someone with strong clinical, operational, and leadership ... * Medical Director , Level III Neonatal Intensive Care Unit* *University of Maryland St Joseph's Medical Center ( UM -SJMC) * *I. GENERAL SUMMARY* The… more
- University of Miami (Miami, FL)
- …is currently seeking a full time Sr. Manager, Programs. The Senior Manager, Programs oversees the day-to-day administrative management of assigned program(s) ... to the University faculty and staff and other key stakeholders. Furthermore, the Senior Manager, Programs serves as the liaison to leadership, faculty, students, and… more
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