- Boston Medical Center (Boston, MA)
- …SUMMARY:The Senior Director, Payer Strategy and Contracting works with the hospital management team, physician leadership and representatives from all health ... physician and hospital issues related to cost and utilization , quality and safety as well as strategy. Serves...management skills, the ability to set strategy and lead a team in a fast paced environment.Equal Opportunity… more
- Boston Medical Center (Boston, MA)
- …The Senior Director , Payer Strategy and Contracting works with the hospital management team, physician leadership and representatives from all health plans ... physician and hospital issues related to cost and utilization , quality and safety as well as strategy. Serves...management skills, the ability to set strategy and lead a team in a fast paced environment Equal… more
- Boston Medical Center (Boston, MA)
- …SUMMARY:The Senior Director, Payer Strategy and Contracting works with the hospital management team, physician leadership, and representatives from all health ... care plans) to represent physician and hospital issues related to cost and utilization , quality and safety as well as strategy. Serves as the Senior Director of… more
- Tufts Medical Center (Boston, MA)
- …flexible with work assignments. Excellent communication and presentation skills. Excellent physician relationship management skills. Job Profile Summary This ... development. Job Overview This position is accountable for service line management , leading strategic, financial, and operational aspects of the Service Lines.… more
- Tufts Medical Center (Boston, MA)
- …be flexible with work assignments.Excellent communication and presentation skills.Excellent physician relationship management skills.Job Profile SummaryThis role ... and program development.Job OverviewThis position is accountable for service line management , leading strategic, financial, and operational aspects of the Service… more
- Tufts Medical Center (Boston, MA)
- …operations and remove operational barriers. You'll be responsible for operational management , budget and financial management , quality assurance and compliance, ... the Department, excellence in patient access and care, and effective financial management .Job OverviewThis position is accountable for service line management ,… more
- Stanford Children's Health | Lucile Packard Children's… (Palo Alto, CA)
- …chiefs, APP Leadership, and Nursing leadership, create an outpatient delivery system and lead operations to support the physician practice and to support other ... clinics including the personnel, quality/regulatory, patient experience, and budgetary management of multiple sites/clinics(s), program(s) and/or project(s) that cross… more
- Lucile Packard Children's Hospital (Palo Alto, CA)
- …including the personnel, quality/regulatory, patient experience, and budgetary management of multiple sites/clinics(s), program(s) and/or project(s) that cross ... outpatient delivery system and leads operations to support the physician practice and to support other services that are...LPCH. Manages the practice and coaching of lean daily management (Leader Standard Work and A-3 problem solving). Develops… more
- Mass. Black Women Attorneys (Boston, MA)
- …and quality services are delivered. This individual will also supervise all non- physician staff on the unit, with clinical leadership support, advocating for their ... promoting patient centered care, diversity, equity and inclusion among staff and clients. Management of all programming during operating hours of the unit including… more
- Huron (Chicago, IL)
- …clinical outcomes, create a more consumer-centric healthcare experience, and drive physician , patient and employee engagement across the enterprise.Join our team as ... knowledge reflects in the projects they manage, and the teams they lead . As change leaders, our Managers build long-standing partnerships with clients, while… more
- UC Health (Cincinnati, OH)
- UC Health is hiring a Utilization Management and Physician Advisor Vice President. The Vice President (VP) will collaborate with cross-functional teams to ... operate the Physician Advisor Program, lead the system-wide CDI... the system-wide CDI initiative, and work to augment utilization management . This position reports directly to… more
- Trinity Health (Maywood, IL)
- …our small but mighty team to guide and manage Utilization Review and Management for the Loyola Physician Partners LPP) Health Plan, a delegated entity for ... preauthorization requests utilizing defined criteria. Collects, analyzes and communicates relevant utilization management information to insurers and third party… more
- Point32Health (Canton, MA)
- …at Point32Health, click here (https://youtu.be/S5I\_HgoecJQ) . **Job Summary** The Director, Utilization Management is responsible for directing, leading, and ... modifying the business processes and operations for all levels of utilization management review (ie, Precertification and Intake Services, Inpatient &… more
- Trinity Health (Boise, ID)
- …of two years' experience in hospital based medicine with exposure to utilization management and documentation initiatives. 3. Demonstrated teamwork, performance ... the Saint Alphonsus Chief Clinical Officer. The Medical Director of Documentation and Utilization Excellence (MDDUE) is the lead provider for coordination and… more
- Huron Consulting Group (Chicago, IL)
- …standards. + Participate in quality assurance activities to improve utilization management processes and patient care outcomes. + Lead UM Denials Team ... you are now and create your future. **Qualifications** The Utilization Management Specialist is responsible for ensuring...daily Staff Huddles for operations and priorities review. + Lead Patient Care Management Escalation Huddles to… more
- The Cigna Group (Franklin, TN)
- The Chief Medical Officer (CMO) Utilization Management will develop and manage efforts to improve and maintain cost and utilization trends. Responsible for ... departments of insurance, and similar accreditors/regulators for the performance of all utilization management (UM) programs across the enterprise. The CMO is… more
- Dignity Health (Bakersfield, CA)
- …practice, capitation, HMO regulations, managed healthcare systems, quality improvement, medical utilization management , risk management , risk adjustment, ... **Preferred Qualifications:** - Minimum of 10 years+ of clinical experience in a Utilization Management setting preferred - Board Certified in Internal Medicine… more
- Dignity Health (Bakersfield, CA)
- …Arizona, with a clear and current CA RN license.** **Position Summary:** The Director of Utilization Management is the senior lead over the utilization ... retro claim review. The UM Director is also responsible for the oversight of utilization management auditing, both internal and external, for all DHMSO service… more
- HCA Healthcare (Campbell, CA)
- …purpose and integrity. We care like family! Jump-start your career as a(an) Utilization Management RN today with HCA Healthcare. **Benefits** HCA Healthcare, ... vary by location._** Come join our team as a(an) Utilization Management RN. We care for our...experts in hospitalist integration, and graduate medical education. We lead more than 1,300 physician practices and… more
- Trinity Health (Silver Spring, MD)
- …acute healthcare setting required. + Extensive knowledge of payer mechanisms and clinical utilization management is required **Preferred:** + At least 5-7 years ... - 4:30pm + Reporting to the Director of Care Management + The RN Manager is responsible and accountable...RN Case Managers for in inpatient care coordination and utilization review. Oversees interactions of staff with outside activities… more
