- Henry Ford Health System (Detroit, MI)
- The Medical Director of Utilization Review is responsible for the medical oversight of activities related to appropriateness of Henry Ford Hospital ... of hospital resources, and continued stays of inpatients. The Medical Director of utilization review will ensure the most efficient use of the… more
- Behavioral Center of Michigan (Warren, MI)
- Under general supervision, the Utilization Review Coordinator provides professional assessment, planning, coordination, implementation and reporting of complex ... and supports the operations of Samaritan Behavioral Center. The Utilization Review Coordinator reviews the patient's chart...all tasks requested by the UR Manager, CEO or Medical Director to meet the needs of… more
- Molina Healthcare (Detroit, MI)
- …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... + 3+ years relevant experience, including: + 2 years previous experience as a Medical Director in a clinical practice. + Current clinical knowledge. + Experience… more
- Corewell Health (Royal Oak, MI)
- …leader to further advance the clinical, educational and research missions as the Medical Director of the Mickey Shapiro 2 East Cardiovascular Intensive Care ... plan for CV Surgery and Advanced Heart Failure. The Medical Director partners with faculty from Cardiac...of federal and state laws and regulations relating to utilization management operations + Ability to cultivate a service-oriented… more
- Sunrise Senior Living (Troy, MI)
- …a big breath of fresh air."_** **_- Sunrise Leader_** The Executive Director is responsible for overall leadership, management, and success of their community. ... & services to seniors better than anyone. The Executive Director is expected to create, in alignment with our...achieving customer engagement. + Leads the development and regular review of the engagement improvement plan. + Effectively resolves… more
- Tenet Healthcare (Detroit, MI)
- …and that transition planning assessments are completed timely. (30% daily, essential) Utilization Management Monitors the review process to ensure staff follow ... using the data to address opportunities for improvement Coordinates clinical care ( medical necessity, appropriateness of care and resource utilization for… more
- Corewell Health (Farmington Hills, MI)
- …patients. + Identifies patients that need care management services (ie utilization review ; care coordination; and/or discharge/transition planning). + ... status and level of care. Uses defined resources to guide decisions, including Medical Director Care Management, Physician Advisors, and management staff. +… more
- Henry Ford Health System (Troy, MI)
- …contracting and operational issues with payers, including billing, claim underpayments, utilization review , credentialing, notification of site closures or new ... GENERAL SUMMARY: Reporting to the Director - Managed Care Contracting, this position is...for managing the payor contracting functions for the hospitals, medical centers, urgent care centers, and employed physicians of… more
- AECOM (Detroit, MI)
- …in order to be able to identify support personnel and facilitate the quality review process for any regional project. In the event quality issues are identified, ... and implementation of solutions with the support of the Director of Project Delivery. + Ability to mentor junior...major pursuits by actively participating in the development and review of Project Plans and incorporation of other project… more
- HUB International (Troy, MI)
- …opportunity! **Benefits you may enjoy working at HUB International Midwest-East:** + Medical , Dental, and Vision (PPO, HMO, and HSA) + Comprehensive Wellness Program ... claims, risk control, accounting/billing, and others to ensure successful utilization in HUB's MI and IN operations. + Identify...per standards. + Collaborate with Team Leaders and the Director of Human Resources to drive cultural alignment in… more