- Humana (Salt Lake City, UT)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members ... **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement… more
- Humana (Salt Lake City, UT)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an… more
- Conviva (Salt Lake City, UT)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Physician Leadership in Population Health Strategy at Primary Care Organization. The Medical Director conducts Utilization Management of the care received by… more
- Humana (Salt Lake City, UT)
- … management or utilization management . **Additional Information** Reports to a Lead Medical Director . The Medical Director conducts Utilization ... a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews preauthorization requests… more
- Merck (Salt Lake City, UT)
- **Job Description** **Role Summary** The Regional Medical Scientific Director is a credentialed (ie, PhD, PharmD, DNP, MD) therapeutic and disease expert who ... SLs, including questions about Company products. The work of an Regional Medical Scientific Director is aligned to: Scientific Exchange, Research, Scientific… more
- Molina Healthcare (Provo, UT)
- …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... claims and appeals and resolves grievances related to medical quality of care. + Attends or chairs committees...experience, including: + 2 years previous experience as a Medical Director in a clinical practice. +… more
- Humana (Salt Lake City, UT)
- …help us put health first** The Corporate Medical Director relies on medical background and reviews health claims . The Corporate Medical Director ... of diverse scope and complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions about the… more
- Apartment Management Consultants, LLC (Salt Lake City, UT)
- We are currently seeking a Director of Risk Management ! The Head of Risk Management will develop, execute, and administer the insurance and risk strategy for ... of AMC. Responsibilities include: + Lead the design, implementation, and ongoing management of the company's new Master Insurance Program, ensuring consistency of… more
- University of Utah Health (Salt Lake City, UT)
- …the University of Utah Hospitals and Clinics. This roleensures seamless management of patient billing, insurance verification, claims processing, collections, ... Administration, or related area or equivalency. + Six years of progressive management experience, preferably within an academic medical center or complex… more
- Baylor Scott & White Health (Salt Lake City, UT)
- … claims data to uncover trends and assist in managing and understanding incurred medical and pharmacy cost. - The Director will design, develop, and support ... **Position Overview:** Reporting to the VP, Value-based Care Analytics, he Director of Healthcare Economics and Trend Analytics will support the Baylor Scott & White… more
- Takeda Pharmaceuticals (Salt Lake City, UT)
- …to bring life-changing therapies to patients worldwide. Join Takeda as Associate Director , Global Labeling Lead where you will be responsible for the development ... guidance. **How you will contribute:** With guidance from leadership: Management of Labeling Cross-Functional Teams + Independently leads Labeling cross-functional… more
- Christian Center of Park City (Park City, UT)
- …Department : Counseling and Wellness Center Reports to: Counseling Programs Assistant- Director Pay Range: $23-$27/h Schedule: Mon-Fri 9a-5p (29 hours/week) Location: ... clients. This role manages relationships with billing service providers, coordinates claims and reimbursements, and ensures compliance with billing standards. The… more
- University of Utah Health (Salt Lake City, UT)
- … departmental goals. + Internal resources include but not limited to: case management medical director , nursing staff, social services, compliance, risk ... It utilizes skills and knowledge as a subject matter expert to guide case management and facility staff to improve patient care within these populations and to… more
- CVS Health (Salt Lake City, UT)
- …and arranges for health care service delivery under the direction of nurse or medical director in the most appropriate setting at the most appropriate expense ... communication, both internally and externally to enhance effectiveness of medical management services (eg, health care providers,...- May assist in the research and resolution of claims payment issues. - Supports the administration of the… more
- Evolent (Salt Lake City, UT)
- …Stay for the culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management ** at Evolent will serve as a point of contact for processing ... medical treatment requests in accordance with departmental policies, regulatory...contractual agreements. **Collaboration Opportunities** : The Coordinator, Intake Utilization Management reports directly to the Manager, Intake Utilization … more
- Evolent (Salt Lake City, UT)
- …and LPCs, Clinical Reviewers. Opportunities to work collaboratively with other Utilization Management Leaders including our Director may also be available. ... culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management ** at Evolent will serve as a point of...also works with our clinical team, which includes our medical reviews: LVNs, LPNs, and RNs along with our… more
- Prime Therapeutics (Salt Lake City, UT)
- …with data consolidation and modeling + Prior PBM experience or experience working with medical claims , pharmacy claims , healthcare and/or benefits data + ... **Responsibilities** + Under general supervision, analyze or produce reports of varied claims data to assess Prime's products and/or programs; utilize analytics to… more
- Prime Therapeutics (Salt Lake City, UT)
- …+ Experience writing SQL queries + Prior PBM experience or experience working with medical claims , pharmacy claims , healthcare and/or benefits data + ... as assigned **Minimum Qualifications** + Bachelor's Degree in Business Administration, Management , Economics or related area of study, or equivalent combination of… more
- University of Utah (Salt Lake City, UT)
- …managers/case workers, and patients, regarding the status of funding. Works with Medical Director , physicians, and billing offices to determine cost estimates ... Seldom: Bending, reaching overhead. **Minimum Qualifications** Four years experience with medical accounts receivable, insurance claims , or equivalency (one year… more
- SitusAMC (Salt Lake City, UT)
- …team! This role is responsible for aligning business goals with employees and management . The position should anticipate HR needs in a proactive manner and ... communicate these requirements and potential solutions to the management team. This position is the HR point of contact for management and employees for their… more