- Humana (Louisville, KY)
- …of our caring community and help us put health first** The Associate Director , Utilization Management utilizes clinical nursing skills to support the ... of medical services and/or benefit administration determinations. The Associate Director , Utilization Management Nursing requires a solid understanding… more
- UPMC (Pittsburgh, PA)
- The Medical Director , Utilization Management is responsible for assuring physician commitment and delivery of comprehensive high-quality health care to UPMC ... care to UPMC Health Plan members. Oversees adherence to quality and utilization standards through committee delegations, and further establishes an effective working… more
- AmeriHealth Caritas (Newtown Square, PA)
- …Discover more about us at www.amerihealthcaritas.com. **Responsibilities:** The Medical Director , Utilization Management provides organizational leadership in ... related policy and practice initiatives in collaboration with the Corporate Medical Director (s), Utilization Management and the Vice President, Medical Affairs.… more
- Wellpath (Lemoyne, PA)
- …education, and point of care support. **How you make a difference** The Medical Director of Utilization Management leads and oversees utilization review, ... efforts to ensure quality patient care and the appropriate utilization of medical services. The Medical Director of Utilization Management serves as a key… more
- BriteLife Recovery (Englewood, NJ)
- What you will be doing? The Director of Utilization Review is responsible for overseeing all utilization review activities to ensure that clients receive ... level of care for each client. This individual leads a team of utilization review specialists and works closely with clinical, admissions, and billing departments to… more
- Ascension Health (Nashville, TN)
- …market. 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 ... **Details** + **Department:** Utilization Management + **Schedule:** Monday - Friday. 40...optimize patient care and partner with the National Senior Director of UM to align on organizational goals. Ready… more
- Tenet Healthcare (Detroit, MI)
- Group Utilization Review Director - 2506000536 Description : The Detroit Medical Center (DMC) is a nationally recognized health care system that serves patients ... most diverse employers in Southeast Michigan. Summary Description SUMMARY: The Group Director , Utilization Review will perform the functions necessary to support… more
- Prime Healthcare (Ontario, CA)
- …Responsibilities The Corporate Director of Clinical ... and 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… more
- Insight Global (Boston, MA)
- Job Description Insight Global is sourcing for a Utilization Management Director to join a not-for-profit community based healthcare organization within the ... fall within the Clinical Performance, Operations, and Innovation organization. The Director is responsible for providing strategic guidance to the business, ensuring… more
- AnMed Health (Anderson, SC)
- The Utilization Review Medical Director supports operations and direction of the Care Coordination, Clinical Documentation, and Utilization Management ... consultation to the leadership and staff who perform the functions of Utilization Management (UM), Case Management (CM), Transition Planning/ Discharge Planning, and… more
- Intermountain Health (Las Vegas, NV)
- …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 medical care is being… more
- Rady Children's Hospital San Diego (San Diego, CA)
- …of physicians and nurses working with the Rady Children's Health Network. The Utilization Management Medical Director will collaborate closely with the clinical ... ideal candidate will have a strong pediatric clinical background. Utilization management experience is a plus. This position is...full benefits with a remote work option. The Medical Director , UM is a clinical subject-matter expert for the… more
- Intermountain Health (Las Vegas, NV)
- **Job Description:** The Utilization Review Care Management Director is responsible for providing leadership and administrative direction for Utilization ... level of care, and attainment of financial goals. Reporting to the Sr. Director /AVP/VP Utilization Management, the role of the Director for Utilization … more
- Intermountain Health (Murray, UT)
- …responsible for the development, implementation, evaluation, and operational management of utilization review programs to include prior authorization, acute and post ... service lines of business(s). The position requires an understanding of utilization management industry benchmarks, best practices and regulatory environment for the… more
- The Cigna Group (Bloomfield, CT)
- …for leading clinical strategy development and product management for pharmacy utilization management and the coordination of rebate contracting efforts to ensure ... alignment across formulary, utilization management, SafeGuard, and other trend solutions. **Essential Functions:** + Ability to manage development and execution of… more
- Ascension Health (Nashville, TN)
- …Direct services, workflow and resources for assigned nursing travelers. + Develop departmental goals and objectives consistent with medical, administrative, legal and ... ethical requirements of the health care delivery system. + Direct clinical activities, including patient assessment, care plan development, service level determination, patient visits, and complaint management. + Prepare and monitor budget(s) and ensure that… more
- Ochsner Health (New Orleans, LA)
- …comply with Federal and State regulations/quality initiatives. Reports to the System Medical Director of Utilization . This job description is a summary of the ... at Ochsner Health and discover your future today!** The Physician Advisor (PA- Utilization Management) serves as the physician leader in matters relating to patient… more
- Gentiva (Mooresville, NC)
- …Manager** to join our team. This position will directly report to the Director of Utilization Management and is responsible for planning, coordinating, ... related to PPD vendors: medical supplies, durable medical equipment, and pharmacy utilization . + Works closely with branch leadership to identify and deploy… more
- Florida Atlantic University (Boca Raton, FL)
- …software and floor plans. + Perform additional duties as assigned by the Assistant Director , Space Utilization and Analysis. Explore Living in Palm Beach County ... employee account. Position Summary: Florida Atlantic University is seeking a Space Utilization Student Assistant - Boca Raton, FL. Summary of Responsibilities: +… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Assistant Director of Case Management supports the Director of Case Management with the overall operation of the Case Management ... Department. At the direction of the Director , this includes oversight of daily activities plus the forward planning of successful strategies to assure timely and… more
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