- University of Maryland Medical System (Charles County, MD)
- Company Description Experience the highest level of appreciation at UM Baltimore Washington Medical Center - named Top Workplace in the Baltimore area by The ... is one of three ANCC Pathway to Excellence(R) designated hospitals in Maryland. UM BWMC features one of the state's busiest emergency departments, as well as… more
- CVS Health (Washington, DC)
- …in inter-rater review activities and other quality oversight processes for internal Director UM decisions. If specifically assigned to one business segment ... in inter-rater review activities and other quality oversight processes for internal Director UM decisions. If specifically assigned to one business segment… more
- Evolent Health (Washington, DC)
- …value proposition and outcomes that effectively support these programs. + Collaborates with UM Director and Quality Management to develop, implement and maintain ... department. The UM Lead, in collaboration with the UM Manager and Director , ensures compliance with all regulatory standards that include state, federal,… more
- Evolent Health (Washington, DC)
- …for the mission. Stay for the culture. **What You'll Be Doing:** **Senior Director , Partner Operations** The Senior Director , Partner Operations serves as ... the go-to expert on client priorities. **Collaboration Opportunities** The Senior Director , Partner Operations role also collaborates with internal teams as… more
- Evolent Health (Washington, DC)
- …Stay for the culture. **What You'll Be Doing:** As a Behavioral Health Field Medical Director will be a key member of the utilization management team. We can offer ... Evolent Health is looking for a Behavioral Health Medical Director to be a member of the Evolent clinical...health plan medical policies, and appropriate Care Management and UM goals and objectives + Population health - collaborative… more
- Evolent Health (Washington, DC)
- …a growth mindset as we solve complex business problems. **Collaboration Opportunities** The Director , Client Analyst role will be serving as a strategic advisor to ... medical, pharmacy and ancillary claims data, membership data, clinical operational data ( UM & CM), or other healthcare data- **Required.** + Familiarity with Power… more
- Prime Therapeutics (Washington, DC)
- …Prime's functional areas: Clinical Program Management, Utilization Management ( UM ), Formulary, GuidedHealth, Pharmaceutical Trade Relations, Pharmacy Audit, Provider ... and process support for Prime National and Client Utilization Management ( UM ) programs, review of regulatory requirements and adherence for processes related… more
- Somatus (Mclean, VA)
- …provides support to the local market teams but reports centrally to the Director of Audit and Risk. This individual will monitor the effectiveness and outcomes ... policies of Somatus + Assist Directors of Quality and UM on quality and utilization audits as assigned, including...as assigned, including targeted audits as requested by the Director . + Analyze and interpret data to makes recommendations… more