- Trinity Health (Boise, ID)
- …Saint Alphonsus is seeking a physician leader to become our Medical Director of Documentation and Utilization Excellence. This position will be ... annually by the Saint Alphonsus Chief Clinical Officer. The Medical Director of Documentation and Utilization Excellence (MDDUE) is the lead provider for… more
- Intermountain Health (Las Vegas, NV)
- …utilization management, care management, claims, network management, and finance. As the Medical Director for Utilization Management, you are responsible, ... in partnership with MG Clinical Leadership, for the appropriate utilization of medical services within established guidelines and for assuring that quality … more
- AnMed Health (Anderson, SC)
- The Utilization Review Medical Director supports operations and direction of the Care Coordination, Clinical Documentation , and Utilization ... Management programs at AnMed. The Medical Director ensures the program and associated physicians work collaboratively with and provide consultation to the… more
- Ochsner Health (New Orleans, LA)
- …and comply with Federal and State regulations/quality initiatives. Reports to the System Medical Director of Utilization . This job description is a ... & support education needs of the medical staff with regard to documentation , placement and utilization of resources _Other duties as assigned_ +… more
- Independent Health (Buffalo, NY)
- …to determine medical necessity, and when necessary, will consult with the Associate Medical Director and/or Medical Director for all requests that ... Collaborative and Accountable. **Essential Accountabilities** Provide High Quality, Professional Utilization Management Services: ( Medical necessity review for… more
- Equinox, Inc (Albany, NY)
- …including admissions, discharges, and residential waitlist updates. Use the Evolv Medical Record System to track client documentation , including entering ... Intake & Utilization Coordinator - Adult Residential Services Albany, NY...clients. This position requires ensuring clients have the correct documentation to secure active housing waitlist status, maintaining accurate… more
- US Tech Solutions (Columbia, SC)
- …back up review determinations. Identifies and makes referrals to appropriate staff ( Medical Director , Case Manager, Preventive Services, Subrogation, Quality of ... accurate documentation of clinical information to support and determine medical necessity criteria and contract benefits. Collaborates with Care Management and… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …Conducts comprehensive reviews and documentation of findings for submission to the medical director for final determination, as required by law. + Provides ... and cost of medications for our members through the medical management of drugs across our pharmacy and ...Managed care experience is strongly preferred, especially experience in utilization management. In lieu of managed care experience, proven… more
- Amity Foundation (Tucson, AZ)
- …under pressure generated by association with substance abuse students. Title: Utilization Review Specialist Reports To: Dragonfly Program Director Job ... building. Remembrance, Resolution, Reconciliation, Restoration, Renewal Job Summary: As the Utilization Review Specialist, you will contribute to the organization by… more
- R1 RCM (Salt Lake City, UT)
- …operating costs and enhancing the patient experience. As our Business Development Director at R1RCM, you will be responsible for selling Clinical Documentation ... day in this role you will:** + **** The Director will be responsible for pursuing, developing, and sustaining...have significant knowledge and experience in selling within the Utilization Management/ Utilization review as well as RCM… more
- Katmai (Usaf Academy, CO)
- …+ Review precertification requests for medical necessity, referring to the Medical Director those that require additional expertise. + Review clinical ... for assuring the receipt of high quality, cost efficient medical outcomes for those enrollees identified as having the...Minimum of two (2) years of prior experience in Utilization Management. + Must possess a current, active, full,… more
- Rush University Medical Center (Chicago, IL)
- …origin, disability, veteran status, and other legally protected characteristics. **Position** Director - Advanced Practice Providers - Rush Medical Group ... Office of Advanced Practice **Work Type:** Full Time **General Summary:** The Director of Advanced Practice Providers (APP) Services supports the Office of Advanced… more
- Community Health Systems (Naples, FL)
- …of the UR Director /Manager the UR Nurse reviews all admissions for medical necessity, correct orders based on medical condition (inpt vs OBS). Facilitates ... improvement of the UR KPI's. Ensures proper and accurate medical record documentation . **Essential Functions** + Reviews...part of the application or hiring process, contact the director of Human Resources at the facility to which… more
- Evolent (Santa Fe, NM)
- …non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional ... per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management process,… more
- Humana (Nashville, TN)
- …to the Lead Medical Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of the care received by members ... caring community and help us put health first** The Medical Director relies on medical ...insurance, other healthcare providers, clinical group practice management. + Utilization management experience in a medical management… more
- Magellan Health Services (Albuquerque, NM)
- …Commercial) and implements and manages programs to support this vision. The Senior Medical Director ensures the delivery of appropriate health care by overseeing ... staff and physician advisors. Ensures adequate physician resources. Develops and manages medical director and physician advisor budgets, travel budgets, and… more
- Humana (Lansing, MI)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members ... caring community and help us put health first** The Medical Director relies on medical ...insurance, other healthcare providers, clinical group practice management. + Utilization management experience in a medical management… more
- Evolent (Atlanta, GA)
- …per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management process, ... culture. **What You'll Be Doing:** As a Cardiology, Field Medical Director you will be a key...National Committee for Quality Assurance (NCQA) guidelines. + Ensures documentation of all communications with medical office… more
- CVS Health (Aurora, CO)
- …with heart, each and every day. **Company:** Oak Street Health **Title:** Senior Medical Director **Location:** Various Oak Street Health is a rapidly growing, ... it should be. For more information, visit www.oakstreethealth.com. **Role Description:** The Senior Medical Director will join Oak Street Health at a critical… more
- The County of Los Angeles (Los Angeles, CA)
- NURSING DIRECTOR , ADMINISTRATION ( Director , Workforce Management and Operations) Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/3110377) ... Apply NURSING DIRECTOR , ADMINISTRATION ( Director , Workforce Management and Operations)...hospitals are training sites for physicians completing their Graduate Medical Education in nearly every medical specialty… more