- Eisai, Inc (Nutley, NJ)
- …research activities and development of external communication materials. The Director facilitates coverage, reimbursement and appropriate utilization based ... Eisai, satisfying unmet medical needs and increasing the benefits healthcare provides to patients, their families, and caregivers is...your profile, we want to hear from you. The Director , US HEOR and RWE (field) is responsible for… more
- Merck & Co. (Lenexa, KS)
- …Communication, Customer Communications, Customer-Focused, Customer Relationship Management (CRM) Utilization , Customer Service , Financial Acumen, High ... leadership, marketing and finance to establish annual budgets.-Allocate and direct utilization of resources to ensure funds are invested appropriately to meet… more
- Jooble (Alexandria, LA)
- …activities Participates in translating policy changes into operational programs and services Healthcare Regulatory Environment Implements programs as needed to ... Description Summary: Manages the nursing services and staff for a department; ensures quality...department heads, and administrators in matters related to nursing service and strategies Standard I: Financial Management Recognizes the… more
- Jooble (Caddo County, LA)
- …activities * Participates in translating policy changes into operational programs and services Healthcare Regulatory Environment * Implements programs as needed ... Description Summary: Manages the designated service line and staff for a facility; ensures...and their families * Ensuring consistent application of nursing services policies and standards throughout the organization * Monitoring… more
- The Career Sphere (Los Angeles, CA)
- Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a ... state or territory of the United States.Reviews appeals for denied services related to current relevant medical experience or knowledge in accordance with appeal… more
- Molina Healthcare (GA)
- …Licensure. JOB DESCRIPTION Job Summary Leads and directs a multidisciplinary team of healthcare services professionals in some or all of the following functions: ... one or more of the following key health care services functions: care management, utilization management, care...clinical services . * Collaborates with and keeps healthcare services senior leadership informed of operational… more
- Prime Healthcare (Inglewood, CA)
- … that are appropriate to the hospital mission and patient/family needs. The Director of Case Management ntegrates and coordinates services using continuous ... core values of quality, compassion, and community. As a member of Prime Healthcare , a Top-15 hospital system in the United States, Centinela Hospital Medical Center… more
- Alameda Health System (Oakland, CA)
- …guidance, training, and performance evaluations. + Monitor and evaluate the utilization of healthcare services , including appropriateness, efficiency, ... Director , Utilization Management + Oakland, CA...Manage quality of performance criteria, policies and procedures, and service standards for the utilization management operations.… more
- Wellpath (Lemoyne, PA)
- …efforts to ensure quality patient care and the appropriate utilization of medical services . The Medical Director of Utilization Management serves as a ... benefits varies based on employee type and length of service . **Why Us** **Now is your moment to make...care support. **How you make a difference** The Medical Director of Utilization Management leads and oversees… more
- Commonwealth Care Alliance (Boston, MA)
- …experience in health plan environment with responsibility for managing the effective utilization of healthcare services , case / disease management, ... Mgmt * Directs, coordinates and evaluates efficiency and productivity of utilization management functions for physical health services and long term… more
- Tufts Medicine (Burlington, MA)
- …health system bringing together the best of academic and community healthcare to deliver exceptional, connected and accessible care experiences to consumers ... the design, development, implementation, and monitoring of the organization's utilization review functions. The position establishes the department's strategy and… more
- AmeriHealth Caritas (Philadelphia, PA)
- **Role Overview:** The Medical Director , Utilization Management, provides organizational leadership in the operational areas of appeals, utilization review, ... and practice initiatives in collaboration with the Corporate Medical Directors, Utilization Management and the Vice President, Medical Affairs. ; **Work… more
- Henry Ford Health System (Clinton Township, MI)
- GENERAL SUMMARY: The Medical Director of Utilization Management shall have responsibility for the medical oversight of activities related to Henry Ford Macomb ... or DO. Two (2) years of physician advisor and/or utilization management experience. Medical Staff membership in good standing...around the world. We offer a full continuum of services - from primary and preventative care to complex… more
- Houston Behavioral Healthcare Hospital (Houston, TX)
- …authorization experience preferred. Experience in a Psychiatric setting. Knowledge of healthcare service delivery systems, and third party reimbursement. ... of West Houston. We have highly qualified caring staff ready to provide exceptional service . The team at Houston Behavioral Healthcare Hospital strives to be the… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …and monitoring the utilization of physical health (PH) medical and healthcare services for members, ensuring compliance with internal and external standards ... service clinical reviews to determine the appropriateness of services requested for the diagnosis and treatment of members'...procedure, identifies and refers potential quality of care and utilization issues to Medical Director . + Utilizes… more
- HCA Healthcare (Charleston, SC)
- …like family! Jump-start your career as a(an) Division Director Clinical Pharmacy Services today with HCA Healthcare . **Benefits** HCA Healthcare offers a ... Are you passionate about the patient experience? At HCA Healthcare , we are committed to caring for patients with...by location._** Come join our team as a Division Director Clinical Pharmacy Services . We care for… more
- Actalent (Sunrise, FL)
- …requests for service authorizations to ensure the appropriate use of services . Under the general supervision of the Director and/or Manager/Supervisor of ... to utilization review across various specialties, medical treatments, and services . The role involves managing complex cases, developing internal processes, and… more
- CommonSpirit Health (Phoenix, AZ)
- …Apply clinical expertise in reviewing and overseeing the medical necessity of healthcare services , treatments, and procedures. Lead medical review activities, ... Utilization Management is a key member of the healthcare organization's leadership team and is charged with meeting...organization's goals and objectives for assuring the effective, efficient utilization of health care services . This role… more
- HCA Healthcare (Corpus Christi, TX)
- …Do you want to be an influencer in healthcare ? **Apply for our Director Emergency Services role today!** **Job Summary and Qualifications** The Director ... Collaborates with administrative team and physicians to enhance existing services or develop new service offerings. +...personal satisfaction and professional growth, apply to join HCA Healthcare as a Director Emergency Services… more
- HCA Healthcare (Austin, TX)
- …Do you want to be an influencer in healthcare ? **Apply for our Director of Emergency Services role today!** **Job Summary and Qualifications** The ... Collaborates with administrative team and physicians to enhance existing services or develop new service offerings. +...apply to join HCA Healthcare as a Director of Emergency Services . **Unlock your leadership… more
