- Alameda Health System (Oakland, CA)
- …Generous paid time off plans Role Overview: Alameda Health System is hiring! The Director of Utilization Management holds a critical role encompassing ... adapting to ad hoc duties as needed. In essence, they orchestrate efficient utilization management to deliver high-quality patient care. DUTIES & ESSENTIAL JOB… more
- Harbor Health Services, Inc. (Mattapan, MA)
- …Brockton, MA and cares for more than 580 participants. We are currently seeking a Director of Utilization Management & Quality Programs. Harbor Health offers ... Reporting to the Senior Director of Health Plan Operations, the Director of Utilization Management and Quality Programs is responsible for the day-to-day… more
- Buckeye Community Health Plan (Thornville, OH)
- …functions for the business unit. Provides medical leadership of all for utilization management , cost containment, and medical quality improvement activities. ... Provides medical expertise in the operation of approved quality improvement and utilization management programs in accordance with regulatory, state, corporate,… more
- Conifer Revenue Cycle Solutions (Detroit, MI)
- …process quality and accuracy adherence to process standards Relative cost management metrics goals expense, cost, and margin control monthly, quarterly, and ... annual financial goal management ESSENTIAL DUTIES AND RESPONSIBILITIES Include the following. Others...of hospital budgets and ensures and manages human resource utilization at all levels. Analyzes monthly P & L's… more
- Christus Health (La Luz, NM)
- Description Summary: The Director Information Services will assist with creating business strategies and proposing implementation methods for content within the ... designated programs. The Director will drive continual process improvement in the delivery...of healthcare operations, proven communication, problem-solving, critical thinking, and management skills to guide design, development, and deployment of… more
- One Medical (San Mateo, CA)
- …care services, on-site labs, and programs for preventive care, chronic care management , common illnesses and mental health concerns have been delighting people for ... that make One Medical unique. As an Office Medical Director , you'll have the chance to lead your local...priorities. You will be able to continually develop your management and leadership skills as you learn about our… more
- Christus Health (Irving, TX)
- …the competitive landscape, and the diverse needs that each market has. The director will work externally to explore best practices and identify new technologies with ... such as remote patient monitoring. This position will partner with Information Management and regional hospital and provider leadership to coordinate strategies for… more
- Christus Health (San Antonio, TX)
- Description Summary: Under the direction of the Manager, Director , or other senior personnel, the Project Manager determines user demands, establishes work ... and workload planning. Maintains project issues and reports to Information System management and local steering teams on the progress of critical path items.… more
- Fresenius Medical Care (Fayetteville, NC)
- …Develops action plans for unexcused and missed treatments in collaboration with the Director . Plans, coordinates and acts as the liaison for patient care as per ... the disease management agreement, including initial and ongoing validation of member...with the established personnel policies, and confers with the Director and Human Resources regarding the nature of the… more
- Fresenius Medical Care (Hayward, WI)
- …a Clinical Manager, you may advance your career into an Area Team Lead or Director of Operations role. Our culture: We believe our employees are our most important ... Classification of Disease (ICD) coding. Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review.… more
- Alameda Health System (Oakland, CA)
- Director , Utilization Management + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day + Nursing + Req ... off plans **Role Overview:** Alameda Health System is hiring! The Director of Utilization Management holds a critical role encompassing operational… more
- UPMC (Pittsburgh, PA)
- …UMPC Health Plan is seeking a licensed MD or DO for a fully remote Medical Director , Utilization Management role. The Medical Director , Utilization ... full remote role._ Responsibilities: + Actively participates in the daily utilization management and quality improvement review processes, including concurrent,… more
- UNC Health Care (Morrisville, NC)
- …and well-being of the unique communities we serve. **Summary** : The **Executive System Director of Utilization Management (UM)** is a strategic and ... operational leader responsible for designing, implementing, and standardizing utilization management functions across a large healthcare system, including a… more
- Fallon Health (Worcester, MA)
- … to identify and prioritize the cost of care opportunities related to Utilization Management . + Works with VP/ Medical Director to set agenda related to UM ... strategic leadership and oversight responsibility for the clinical and operational utilization management activities for all inpatient and outpatient care,… more
- Healthfirst (NY)
- …maintain and improve department performance** + **Collect, analyze, and report on utilization trends, patterns, and impacts to identify areas for improvement** + ... closely with other Operations leaders including but not limited to Care Management , Clinical Eligibility, Behavioral Health, and Appeals and Grievances teams to… more
- Elevance Health (Indianapolis, IN)
- ** Utilization Management Medical Director - Indiana Medicaid** **Location:** This role enables associates to work virtually full-time, with the exception of ... Internal Medicine, and Family Medicine specialties preferred. + 3-5 years of Utilization Management experience preferred. + Indiana license or the ability… more
- Wellpath (Lemoyne, PA)
- …education, and point of care support. **How you make a difference** The Medical Director of Utilization Management leads and oversees utilization ... care and the appropriate utilization of medical services. The Medical Director of Utilization Management serves as a key liaison with external partners… more
- Huron Consulting Group (Chicago, IL)
- …regulatory agencies, and hospital contractual payor agreements. This position reports to the Director of Utilization Management and works with hospital ... review staff and function for the system, reporting to the Director of Utilization Management within Revenue Cycle. Assists with leading recruiting,… more
- Prime Healthcare (Inglewood, CA)
- …Workers, and Clinical Coordinators. This leader will oversee all facets of utilization management , discharge planning, and care coordination to ensure patients ... ie full-time or part-time. Responsibilities We are seeking a strategic and compassionate Director of Case Management to lead our dynamic Case Management… more
- Humana (Raleigh, NC)
- …a Lead Medical Director , depending on the line of business. The Medical Director conducts Utilization Management or clinical validation of the care ... community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement...with prior experience participating in teams focusing on quality management , utilization management , case … more
