- Fallon Health (Worcester, MA)
- …appeals review + Member appeals review + Pharmacy issues and referral requests + Medical director on-call coverage + Support the benefits and technology review ... license to practice medicine in MA (or licensable). Board certified in medical or surgical specialty. **Experience:** Utilization management; network management;… more
- Elevance Health (Houston, TX)
- ** Medical Director Associate - Oral Health ( Utilization Mgmt.)** This is an Individual Contributor Role. Location: **This position will work a Hybrid ... **Monday through Friday, 40 hrs a week** . The ** Medical Director Associate - Oral...state or territory of the United States when conducting utilization review or an appeals consideration and cannot be… more
- CareFirst (Baltimore, MD)
- …location based on business needs and work activities/deliverables that week. The Director , Utilization Management provides strategic leadership of the ... is responsible for the design, assessment, implementation and outcomes of utilization management strategies using a multidisciplinary approach to enhance member… more
- Humana (Frankfort, KY)
- …a part of our caring community and help us put health first** The Director of Utilization Management (UM) Cost of Care Strategy provides data-based strategic ... and strategic planning support for business segments or the company at large. The Director of Utilization Management (UM) Cost of Care Strategy requires an… more
- University of Colorado (Aurora, CO)
- Clinical Pathology Medical Director ; Assistant Professor to Associate Professor - 33849 Faculty **Description** **University of Colorado Anschutz Medical ... Campus** **Department: Pathology** **Job Title:** **Clinical Pathology Medical Director ; Assistant Professor to Associate Professor** **Open Rank - Assistant… more
- CareOregon (Portland, OR)
- …CareOregon is a federal contractor and must comply with all federal laws. Job Title Associate Medical Director - Maternal, Child, and Youth Department ... Exempt Requisition # 24391 Direct Reports N/A Manager Title Medical Director , CPCCO Pay & Benefits Estimated...to address member needs. + Implement, direct, and oversee utilization , case, disease, and/or quality management programs. + Develop… more
- Lancaster General Health (Lancaster, PA)
- **Summary** **Job Description** **POSITION SUMMARY:** The Associate Medical Director , Hospitalist Services is responsible for assisting the Medical ... of the LGHP Hospitalists practice. The Associate director will report to LGHP Medical ...provided by the Hospitalists, quality improvement, education of staff, medical and utilization review and feedback, and… more
- LA Care Health Plan (Los Angeles, CA)
- Supervisor, Utilization Management RN Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time ... safety net required to achieve that purpose. Job Summary The Supervisor of Utilization Management (UM) RN is responsible for executing the day-to-day operations of… more
- Beth Israel Lahey Health (Burlington, MA)
- …healthcare services. Leverage health informatics and data analytics across campuses The Director will oversee the integration and utilization of health ... taking a job, you're making a difference in people's lives.** The Institute Director will develop the strategic plan, research priorities, and recruit and build a… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full ... the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II will facilitate, coordinate, and approve medically… more
- Dartmouth Health (Lebanon, NH)
- Overview Associate Medical Director - Cheshire Hospital Medicine Physician Advisor The Cheshire Medical Center’s Department of Hospital Medicine is a ... Management, Care Management, and Clinical Documentation. The PA supports Utilization Management by performing concurrent, evidence-based second-level medical … more
- Tiburcio Vasquez Health Center (Hayward, CA)
- Under the direct supervision of the Chief Medical Officer (CMO), the Associate Medical Director , Family Medicine is responsible for the day-to-day ... discretion of the Chief Medical Officer, the Associate Medical Director may represent...and provides consultation within scope of responsibility. + Monitor utilization of services. + Performs other related duties as… more
- Johns Hopkins University (Baltimore, MD)
- …members for involvement in the medical leave of absence process. The Senior Associate Director of Clinical Services will actively lead and contribute to data ... (SHWB-MHS) at Johns Hopkins University seeks an energetic, organized, and motivated **_Senior Associate Director of Clinical Services_** to work in a dynamic and… more
- Henry Ford Health System (Detroit, MI)
- …Detroit, Michigan is seeking an Infectious Diseases physician to serve as the System Associate Medical Director of Epidemiology and Infection Prevention and ... and helping to develop and implement institutional policies and quality improvement initiatives. The Associate Medical Director will be a faculty member of… more
- Evolent Health (Columbus, OH)
- …to work collaboratively with other Client Service Leaders including our Client Service Associate Director and Director may also be available. **What ... mission. Stay for the culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management** at Evolent will serve as a point of contact for… more
- Horizon Services, Inc. (Hayward, CA)
- JOB TITLE: Associate Director of Outpatient & Prevention Program Operations LOCATION: Project Eden Who are we? Horizon Services, Inc. (HSI) is a nonprofit ... where our collective experiences enrich each other's growth. The Associate Director of Outpatient & Prevention Programs...other HSI subject matter experts such as Clinical & Medical specialists, and expanding services to serve new market… more
- Mitsubishi Chemical Group (Jersey City, NJ)
- …researching on real-world evidence, and creating hope for all facing illness. The Associate Director , Project Management is an integral member of the Product ... Integrated Development Strategy. As a senior, highly experienced team member, the Associate Director , Project Management is responsible for monitoring the… more
- University of Colorado (Boulder, CO)
- **Senior Associate Director ** **Requisition Number:** 58964 **Location:** Boulder Colorado **Employment Type:** University Staff **Schedule:** Full Time ... Life** at CU Boulder encourages applications for a **Senior Associate Director ** ! This role is a...recruitment and retention of a diverse staff, including the utilization of equity-minded searchers. + Facilitate all norming conversations,… more
- Rochester Institute of Technology (Rochester, NY)
- **9090BR** **Position Title:** Associate Director Clinical Services **Organization:** Counseling and Psychological Services **Job Responsibilities:** Direct ... data; CCAPS; appointment wait time; Clinical Load Index; student utilization ; and other clinical trends. + In collaboration with...(CaPS) is seeking to fill an opening for the Associate Director of Clinical Services. This is… more
- Acacia Network (Bronx, NY)
- …care plan (interdisciplinary) team, identifying and referring requests for services to the Medical Director when guidelines are not met and reviewing residential ... Acacia Network Inc. Utilization Manager Bronx, : 5/30/2024 Job Description Job...from third party payers at pre-admission through discharge, ongoing medical necessity reviews and interdisciplinary team support with respect… more