- CVS Health (Baton Rouge, LA)
- …Michigan, Kansas and Oklahoma. Support for other regions may occasionally be required. The UM Medical Director will ensure timely and consistent responses to ... that primarily supports the Aetna Better Health Plan of Louisiana. This UM (Utilization Management) Medical Director will be a "Work from Home" position… more
- Nuvance Health (Norwalk, CT)
- …cost-effective utilization of Hospital Resources and optimize financial performance. Collaborates with UM Medical Director and Vice President of Medicine. ... in Connecticut, and Northern Dutchess Hospital, Putnam Hospital Center and Vassar Brothers Medical Center in New York - plus multiple primary and specialty care… more
- Integra Partners (Troy, MI)
- The UM Coordinator assists and supports the clinical team ( UM Nurses/ Medical Director ) with administrative and non-clinical tasks related to processing ... with authorization requests + Contact requesting providers to obtain medical records or other necessary documentation related to specific...& external sources + Other duties as assigned by UM Director + Strong organizational skills, ability… more
- Point32Health (MA)
- …products, as well as any partner entities at the direction of Behavioral Health Lead Medical Director for Utilization Management ( UM ) and/or the Medical ... initial reviews and appeals. They will work closely with colleagues in UM and Medical Management, and with other departments as needed, including but not limited… more
- Apex Health Solutions (Houston, TX)
- …coordinate pending cases for a review determination with Health Solutions Medical Director , coordinate pre-authorization activities with affiliated health plans ... Summary: The UM Reviewer serves as a contact and resource...questionable admissions, and prolonged lengths of stays to the Medical Director for determination. Collect accurate data… more
- University of Maryland, Baltimore (Baltimore, MD)
- The University of Maryland School of Medicine is seeking a Chair and Medical Director of Critical Care for the UM Capital Region Health Medical Center ... Associates, PA They will work closely and in collaboration with the Trauma Medical Director , Chief of Cardiac Surgery, Surgery, Medicine, Neurocritical Care. The… more
- CVS Health (Sacramento, CA)
- …support to Account Management in support of Key Clients as assigned. The Medical Director transacts Utilization Management UM activities (prior authorization ... to Account Management in support of Key Clients as assigned. The Medical Director transacts Utilization Management UM activities (prior authorization and… more
- Sharp HealthCare (San Diego, CA)
- …the position, and employer business practices. **What You Will Do** This Senior Medical Director position provides critical management and oversight for Sharp ... + 5 years' experience as an HMO Health Plan Medical Director . + California Physicians and Surgeons...+ Achieves and maintains benchmarked utilization and cost management ( UM ) goals and clinical quality improvement (QI) objectives, in… more
- Magellan Health Services (San Diego, CA)
- …quality improvement activity (QIA) in collaboration with the clinical lead senior medical director , and quality improvement staff. May participate in various ... day to day physician oversight to an assigned interdisciplinary UM team, including regular involvement in the case management...committees or project teams as directed by the senior medical director or vice-president. + Supports senior… more
- Kepro (Indianapolis, IN)
- …solutions in the public sector. Acentra is looking for a Part-Time Behavioral Health Medical Director to join our growing team. Job Summary: The Part-Time ... Behavioral Health Medical Director shall provide the clinical and...if MD or DO. + Experience in Utilization Management ( UM ) with knowledge of Medicaid and Medicare programs. +… 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
- Point32Health (MA)
- …are at Point32Health, click here (https://youtu.be/S5I\_HgoecJQ) . **Job Summary** The Medical Director , Clinical reviews will primarily perform utilization ... as any partner entities at the direction of the Medical Director for Utilization Management. These functions...will work closely with staff from all partners of UM (Utilization Management), Medical Management Departments on… more
- University of Maryland, Baltimore (Baltimore, MD)
- …Comprehensive Cancer Center (UMGCCC), located in Baltimore, MD are recruiting for a*full-time Medical Director of the University of Maryland St. Joseph Cancer ... Institute, located in Towson, MD.* *_Administrative duties and responsibilities of the Medical Director role will include, but not limited to the following:_* *… more
- CVS Health (Tallahassee, FL)
- …our members' health care and social determinant needs. The Case Management (CM) Medical Director will participate in designing, developing and deploying our ... reside in Florida and and must have a Florida medical license or be willing to obtain one. **Primary...programs and/or improvements to effectively manage trends. *Participate in UM activities as needed by the market including but… more
- CVS Health (Columbus, OH)
- …have Internal Medicine or Internal Medicine/Pediatrics (Med/Peds) Board Certification. In the Medical Director role, you will provide oversight for medical ... and consistent responses to members and providers. As a Medical Director you will focus primarily on...UM (Utilization Management) experience *Active and current state medical license in CA without encumbrances and willing to… more
- CVS Health (Harrisburg, PA)
- …preferably resides in PA/DE/WV and have a PA/WV/DE License without encumbrances. In the Medical Director role you will provide oversight for medical policy ... and consistent responses to members and providers. As a Medical Director you will focus primarily on...license in either PA/WV/DE state without encumbrances * Previous UM experience with a Health Plan/Payor. **Education:** MD or… more
- CVS Health (Baton Rouge, LA)
- …Better Health of Louisiana is seeking a dedicated and experienced Behavioral Health Medical Director . The ideal candidate will be a board-certified psychiatrist ... in a medical specialty. The Behavioral Health Medical Director will ensure timely medical...manage after-hours consultations when needed. **Preferred Qualifications** + Previous UM Experience with a Health Plan or Health /… more
- Magellan Health Services (Albuquerque, NM)
- …Commercial) and implements and manages programs to support this vision. The Senior Medical Director ensures the delivery of appropriate health care by overseeing ... staff and physician advisors. Ensures adequate physician resources. Develops and manages medical director and physician advisor budgets, travel budgets, and… more
- University of Maryland, Baltimore (Baltimore, MD)
- …School of Medicine are seeking applicants for a full-time (1.0 FTE)*Ambulatory HIV Medical Director position*. The expected faculty rank for this position will ... **School of Medicine - Clinical Departments* **Title:** *Ambulatory HIV Medical Director (3-309-1236)* **Location:** *null* **Requisition ID:** *240001HU* more
- CVS Health (Richmond, VA)
- …health care more personal, convenient and affordable. **Position Summary:** Ready to take your Medical Director skills to the next level with a Fortune 6 ... Northeast Region, particularly Aetna Better Health of Virginia. This Medical Director will be a "Work from...Medicine, Family Medicine, Emergency Medicine Specialty Preferred. - Prior UM experience working at Health Plan / Insurer or… more
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