- CVS Health (Springfield, IL)
- …in inter-rater review activities and other quality oversight processes for internal Director UM decisions. If specifically assigned to one business segment ... Account Management in support of Key Clients as assigned. The Medical Director transacts Utilization Management UM activities (prior authorization and appeals)… more
- Ascension Health (Nashville, TN)
- …in utilization management to optimize patient care and partner with the National Senior Director of UM to align on organizational goals. Ready to lead and ... Must be located with in the TN market. We're looking for an experienced Director of Utilization Management to join our team! In this pivotal role, you'll lead… more
- University of Michigan (Flint, MI)
- …work experience is applicable to this position. **Job Summary** Reporting to the Director of UM -Flint EHS, Your role will involve on-campus work, inspections ... safety and health programs as directed by the EHS Director . Improve supporting safety and health program materials. +...SARA Title III EHS and Tier II Reporting for UM -Flint + Annually review and assess DHS COI on… more
- CVS Health (Springfield, IL)
- …regional role that primarily supports the Aetna Better Health Plan of Illinois. This UM (Utilization Management) Medical Director will be a "Work from Home" ... Oklahoma. Support for other regions may occasionally be required. The UM Medical Director will ensure timely and consistent responses to members and providers… more
- University of Maryland, Baltimore (Baltimore, MD)
- The University of Maryland School of Medicine is seeking a Chair and Medical Director of Critical Care for the UM Capital Region Health Medical Center (UMCRH), ... PA They will work closely and in collaboration with the Trauma Medical Director , Chief of Cardiac Surgery, Surgery, Medicine, Neurocritical Care. The Chair will be… more
- Catholic Health Initiatives (Houston, TX)
- …to maintain effective team leadership and oversight. This role supports the UM Director in ensuring efficient operations with all processes, policies, ... **Responsibilities** The Utilization Management ( UM ) Manager is responsible for managing day-to-day ...( UM ) Manager is responsible for managing day-to-day UM operations within the markets, focusing on effective team… more
- Nuvance Health (Norwalk, CT)
- …utilization of Hospital Resources and optimize financial performance. Collaborates with UM Medical Director and Vice President of Medicine. Develops ... *Description* *$30K SIGN ON BONUS - FOR ELIGIBLE EXTERNAL CANDIDATES* Director , Acute Care Hospital Case Management Opportunity! *Required: BSN or MSW with Acute… more
- Provider Solutions & Development (Burbank, CA)
- Providence St. Joseph Medical Center is seeking a Physician Advisor/ UM Medical Director to join a strong leadership team promoting high-value care in Burbank, ... our mission outcomes. You will work closely with the physician leadership, the Director of Care Management, and executive leadership; in particular the CMO, CNO, and… more
- LA Care Health Plan (Los Angeles, CA)
- …the needs of LA Care's culturally diverse membership. The position supports the UM Manager/ Director . This role also assists UM Educator/Manager/ Director ... required to achieve that purpose. Job Summary The Supervisor of Utilization Management ( UM ) RN is responsible for executing the day-to-day operations of the UM… more
- Dignity Health (Rancho Cordova, CA)
- …**Position Summary:** Under the guidance and supervision of the department Manager/ Director the Supervisor of Utilization Management is responsible and accountable ... supervision this position is responsible for coordinating the daily operations of the UM Pre-Authorization team in order to ensure requests are processed in a… more
- University of Miami (Miami, FL)
- …Recovery Coordinator 1 to work in Miami, FL. The Recovery Coordinator 1 ( UM LAORA) assists in the recovery, packaging, preservation and transportation of cadaveric ... organs in approximately 50% of cases. + In conjunction with the Medical Director assumes ultimate responsibility for donor management and the process of donor… more
- Prime Healthcare (Ontario, CA)
- …Responsibilities The Corporate Director of Clinical Utilization ... Company performance. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/172723/corporate- director -of-clinical-utilization-management/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilityPrime Healthcare Management Inc… more
- University of Maryland, Baltimore (Baltimore, MD)
- …physician-scientist with expertise in clinical trial design and execution to serve as Director of Clinical Trial Innovation.* The UM -IHC is a large-scale ... improving the quality of life and longevity of the citizens of Maryland. The UM -IHC, located in North Bethesda, MD, is a collaborative effort of the University of… more
- University of Maryland, Baltimore (Baltimore, MD)
- …Data/Adaptive Clinical Trials*at the University of Maryland-Institute for Health Computing ( UM -IHC) and*Assistant Director for Learning Health System and ... and innovation to win extramural funding and new public-private partnerships involving UM -IHC, respectively. UMGCCC: The role of*Assistant Director for Learning… more
- Excellus BlueCross BlueShield (Buffalo, NY)
- …+ Develops and implements the BH sections of the Quality Management/Utilization Management (QM/ UM ) Plan, including having the BH Medical Director for Children's ... implementation of the Children's Behavioral Health (BH) Carve-In program. The Medical Director for BH Children's Services has overall accountability for BH services… more
- Wellpath (Lemoyne, PA)
- …point of care support. **How you make a difference** The Medical Director of Utilization Management leads and oversees utilization review, case management, quality ... patient care and the appropriate utilization of medical services. The Medical Director of Utilization Management serves as a key liaison with external partners… more
- Sharp HealthCare (San Diego, CA)
- …and employer business practices. **What You Will Do** This Senior Medical Director position provides critical management and oversight for Sharp Health Plan's (SHP) ... practice of medicine. + 5 years' experience as an HMO Health Plan Medical Director . + California Physicians and Surgeons License - Medical Board of CA -REQUIRED… more
- UPMC (Pittsburgh, PA)
- The Regional Medical Director , CC/DP and Utilization Review, provides clinical and management leadership across multiple hospitals within the region. This role ... resource utilization, and length of stay (LOS) strategic oversight. The Medical Director will report to the Vice President of Care Coordination, Discharge Planning,… more
- University of Maryland, Baltimore (Baltimore, MD)
- *The University of Maryland Institute for Health Computing ( UM -IHC)*is a $70M initiative in North Bethesda funded by Montgomery County and the University of Maryland ... Strategic Partnership: MPowering the State. The UM -IHC aims to build a learning health system for...PHYSICALLY LOCATED IN NORTH BETHESDA, MARYLAND.* *Position Overview:* *The Director of Finance and Administration*serves as a leader responsible… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …is right for you, we encourage you to apply! Job Description: The Medical Director participates in the broad array of activities of the Medical Services area ... appeal case reviews and may require peer-to-peer discussions with providers regarding UM case review determinations. + Provides clinical expertise on ARD cases,… more
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