- 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
- CVS Health (Sacramento, CA)
- …will participate in inter-rater review activities and other quality oversight processes for internal Director UM decisions. If specifically assigned to one ... Management in support of Key Clients as assigned. The Medical Director transacts Utilization Management UM...inter-rater review activities and other quality oversight processes for internal Director UM decisions. If… 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 ... Officer. **Required Qualifications** + Doctor of Medicine (MD) - Internal Medicine or Family Practice + **OR** Doctor of...+ 5 years' experience as an HMO Health Plan Medical Director . + California Physicians and Surgeons… more
- 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 ... supports the Aetna Better Health Plan of Louisiana. This UM (Utilization Management) Medical Director ...experience - Board certification in Internal Medicine/Pediatrics, Internal Medicine, or Family Medicine - Prior UM… 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
- 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 ... in Towson, MD.* *_Administrative duties and responsibilities of the Medical Director role will include, but not...be board certified or board-eligible by the ABIM in Internal Medicine and Hematology and/or Medical Oncology… 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)
- …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 (Austin, TX)
- …a Texas License without encumbrances or willing to obtain a Texas License. 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...Reside in the Central Time Zone **Preferred Qualifications:** Previous UM experience with a Health Plan / Payor. Board… 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 ... Better Health Plans of the Northeast Region, particularly Aetna Better Health of Virginia. This Medical Director will be a "Work from Home" position and part of… more
- VNS Health (Manhattan, NY)
- …other evaluative measures to maintain high-quality care standards. + Plans leadership and medical director meetings as stipulated by the State BH contract ... company holidays + Health insurance plan for you and your loved ones, Medical , Dental, Vision, Life and Disability + Employer-matched retirement saving funds +… more
- Healthfirst (NY)
- …and business leader coaching. Metric types include compliance activities, CM and UM activities, clinical status outcomes, medical cost trend implications for ... CM and UM , staffing/ attrition recommendations, medical cost savings initiatives and tracking, new program design staffing models, and more** **.** **Design and… more
- University of Michigan (Ann Arbor, MI)
- CLINICAL NURSING DIRECTOR (CS Mott Children's Hospital: 8W Brandon Newborn Intensive Care Unit) Apply Now **Job Summary** The Clinical Nursing Director (CND) ... state's leading referral centers for premature newborns and infants with complex medical problems such as congenital heart disease, complex surgical problems, or… more
- CenterLight Health System (NY)
- …initial responsibility for the management of internal providers. Collaborates with the Medical Director / Chief Medical Officer on managing the ... orders. + Provide clinical input, when necessary, with internal or external stakeholders. + Work with all providers,...basis and as deemed necessary. + Collaborate with the medical director on rolling out the foundational… more
- Dignity Health (Bakersfield, CA)
- …dedicated to providing quality managed care administrative and clinical services to medical groups hospitals health plans and employers with a business objective to ... benefits they want from a variety of options including medical dental and vision plans for the employee and...is work from home** **within California.** **Position Summary:** The Director of Provider Relations is a business-minded leader who… more
- University of Maryland, Baltimore (Baltimore, MD)
- *University of Maryland, Baltimore (UMB) is currently seeking a Director of Clinical Research Operations & Compliance to join the Department of Radiation ... country to have a Master Research Agreement with Varian Medical Systems, the market leader in the development of...mission is to facilitate and provide services to: * UM Faculty Researchers: Assisting with study start-up and administration.… more
- Catholic Health Services (Melville, NY)
- …Minimum Qualifications: 1. Minimum Education/Training Required: Graduate of an accredited medical school. Completion of specialty residency (ie, Internal ... the monthly Physician Advisor meeting. Attends hospital Utilization Management ( UM ) committees. Supervises the Facility Physician Advisors. Observes Catholic Health… more
- Independent Health (Buffalo, NY)
- …work through the process of obtaining approval for any changes from the Medical Director and governing committee(s) then overseeing the implementation throughout ... will be responsible for identifying recommended changes to the UM Medical Management program and seeking approval...support HCS team with regards to implementation and communication ( internal and external) of new medical management… more