- Conifer Revenue Cycle Solutions (Detroit, MI)
- JOB SUMMARY The Dir, PA Market is responsible for Conifer's Patient Access day-to-day operating activities. This role is responsible for meeting all goals set for ... quality and accuracy adherence to process standards Relative cost management metrics goals expense, cost, and margin control monthly,...of hospital budgets and ensures and manages human resource utilization at all levels. Analyzes monthly P & L's… more
- Elevance Health (Durham, NC)
- ** Utilization Management Medical Director - NC Medicaid** Location: This role enables associates to work virtually full-time, with the exception of required ... The **Medical Director ** will be responsible for utilization review case management for North Carolina...communities and our business. We offer a range of market -competitive total rewards that include merit increases, paid holidays,… more
- CommonSpirit Health (Phoenix, AZ)
- **Job Summary and Responsibilities** The System Vice President of Utilization Management is a key member of the healthcare organization's leadership team and is ... and accountability for creating, implementing, and leading an integrated system-wide utilization management program which includes comprehensive denials … more
- LA Care Health Plan (Los Angeles, CA)
- …observation) admission in the acute setting. Works with UM leadership, including the Utilization Management Medical Director , on requests where determination ... Utilization Management Admissions Liaison RN II...data presented and established criteria/guidelines, escalating to the medical director if needed. Triages and assesses members for admission… more
- Actalent (Sacramento, CA)
- Job Title: Utilization Management Coordinator Job Description As a Utilization Management Coordinator, you will coordinate and support activities related ... Your role will involve compiling daily inpatient logs, reviewing specified utilization management reports, processing referrals, completing denial letters, and… more
- Intermountain Health (Las Vegas, NV)
- …including social work and complex care planning, transitions of care, and utilization management . The position ensures compliance with state, national, and ... Care Management I reports to the Care Management Director . **Position Details** + Full Time...Demonstrated care management experience. + Authorization or Utilization Management experience. + Leadership experience. **Preferred… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- About The Role BHPS provides Utilization Management services to its clients. The Utilization Management Nurse performs medical necessity and benefit ... coverage while working remotely. Primary Responsibilities * Performs clinical utilization reviews using evidenced based guidelines, policies and nationally… 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 ... staff and function for the system, reporting to the Director of Utilization Management within...limited to specific skills or certifications, years of experience, market changes and required travel. This job is also… more
- Children's Mercy Kansas City (Kansas City, MO)
- …of our hospital. Overview To provide leadership to integrated inpatient teams; assists Director in the management of department; including personnel and fiscal ... of, and training oversight of programs and services. Responsible for effective utilization review and proper resource management of patients, including patient… more
- ChenMed (Louisville, KY)
- …We're rapidly expanding and we need great people to join our team. The Market Clinical Director will directly supervise, performance manage and train Clinical ... workplace concerns. + Reviews/approves center-level referrals and provides back-up for market referral and delegated utilization authorizations. **Other duties… more
- Cardinal Health (Providence, RI)
- …global healthcare services and products company headquartered in Dublin, OH. The _National Director of Sales, Market Access_ serves as the dynamic commercial ... access sales strategy into actionable, target-exceeding results. Furthermore, the _National Director of Sales, Market Access_ will directly support the team's… more
- Ascendis Pharma (Princeton, NJ)
- …to grow and develop their skills. We are looking for an experienced Associate Director , Market Access & Patient Support Marketer, to join our team. This ... Legal, external customers and agency partners. This role will report to the Director , Market Access & Patient Support Marketing. The expectation is in-office… more
- ServiceNow, Inc. (Nashville, TN)
- …a strong ecosystem of partners. **What you get to do in this role** As a **Go-To- Market (GTM) Director ** , you will lead a team of **Services Account Executives ... we work. Fast forward to today - ServiceNow stands as a global market leader, bringing innovative AI-enhanced technology to over 8,100 customers, including 85% of… more
- ChenMed (Atlanta, GA)
- …Regional Medical Director (RMD) is a developmental, pathway role to Market Chief Medical Officer which is responsible for aiding in the administrative oversight ... a designated region. As a member of the Executive Management team, the incumbent in this role, in close...strategic care delivery of various markets. In partnership with Market President(s), General Manager(s) and/or other senior market… more
- Dignity Health (Phoenix, AZ)
- **Job Summary and Responsibilities** The Market Director - Patient Care Services and Quality Arizona is responsible for leading the design, coordination, ... implementation and management of ambulatory practices related to quality, safety and...incorporating evidence-based practices to improve patient outcomes for the market . This key position will oversee an ambulatory quality… more
- Centene Corporation (Salem, OR)
- …+ Must be licensed in Oregon + American Board Certification + Utilization Management experience and knowledge of quality accreditation standards highly ... Director for Trillium Community Health Plan, our Oregon market . Candidates will need an Oregon license and it...business unit. + Provides medical leadership of all for utilization management , cost containment, and medical quality… more
- HCA Healthcare (Tallahassee, FL)
- …**Introduction** Do you want to join an organization that invests in you as a(an) Director PI Bed Management ? At HCA Healthcare, you come first. HCA Healthcare ... make a difference. We are looking for a dedicated Director PI Bed Management like you to...by facility by floor to identify opportunities + Assesses utilization of Bed Management technology for optimal… more
- Humana (Indianapolis, IN)
- …to the Lead Medical Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....with prior experience participating in teams focusing on quality management , utilization management , case … more
- Humana (Little Rock, AR)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....with prior experience participating in teams focusing on quality management , utilization management , case … more
- Centene Corporation (Jefferson City, MO)
- …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
