- BriteLife Recovery (Englewood, NJ)
- What you will be doing? The Director of Utilization Review ...you? + Minimum of 5 years of experience in utilization review , case management , or ... is responsible for overseeing all utilization review activities to ensure that clients receive appropriate, high-quality, and cost-effective care in alignment… more
- Tenet Healthcare (Detroit, MI)
- Group Utilization Review Director -... Management strategy with the specific focus on Utilization Review for the designated Market. Will ... employers in Southeast Michigan. Summary Description SUMMARY: The Group Director , Utilization Review will perform...initiatives and will provide subject matter expertise for Case Management – Utilization Review regulations… more
- Trinity Health (Des Moines, IA)
- …Full time **Shift:** **Description:** **_Are you an experienced Director of Care Management & Utilization Review looking for an interim assignment? Join ... Des Moines. Operational responsibilities include budgeting, strategic planning, patient care management and integration and achieve organizational goals. Acts as a… more
- Ascension Health (Nashville, TN)
- …care plan development, service level determination, patient visits, and complaint management . + Prepare and monitor budget(s) and ensure that assigned nursing ... required. + 10 years of experience preferred. + 2 years of leadership or management experience required. + 5 years of leadership or management experience… more
- Intermountain Health (Las Vegas, NV)
- … management , claims, network management , and finance. As the Medical Director for Utilization Management , you are responsible, in partnership with ... order to be considered for the position.** Performs medical review activities pertaining to utilization review...timely documentation and reporting. + Demonstrated knowledge of case management , utilization management , quality … more
- AnMed Health (Anderson, SC)
- The Utilization Review Medical Director supports operations and direction of the Care Coordination, Clinical Documentation, and Utilization Management ... to the leadership and staff who perform the functions of Utilization Management (UM), Case Management (CM), Transition Planning/ Discharge Planning,… more
- UTMB Health (Friendswood, TX)
- …resource utilization to Director and/or Assistant Director of Utilization Review /Case Management . + Maintains a documentation system of all ... ensure optimal quality, cost, and service/outcomes. Supports and actualizes the UTMB Utilization Review /Case Management program by utilizing clinical… more
- Intermountain Health (Las Vegas, NV)
- **Job Description:** The Utilization Review Care Management Director is responsible for providing leadership and administrative direction for ... Utilization Management and Review for...Utilization Management and Review for the Enterprise. The...and attainment of financial goals. Reporting to the Sr. Director /AVP/VP Utilization Management , the role… more
- Wellpath (Lemoyne, PA)
- …**How you make a difference** The Medical Director of Utilization Management leads and oversees utilization review , case management , quality ... quality patient care and the appropriate utilization of medical services. The Medical Director of Utilization Management serves as a key liaison with… more
- LifePoint Health (Gallatin, TN)
- Monitors adherence to the hospital's utilization review plan to ensure appropriate use of hospital services, hospital admissions and extended hospitals stays. ... Reports to: Director - Case Management Minimum Education Associate's,...or related healthcare field. **Job:** **Nursing* **Organization:** ** **Title:** * Utilization Mgmt Case Manager FT* **Location:** *Tennessee-Gallatin*… more
- Raymond James Financial, Inc. (St. Petersburg, FL)
- …resource budgets, providing forecasts and presenting variances with narrative at appropriate review points to ensure effective utilization . + Develop and manage ... objectives, and comply with the organization's project and program management framework. + Lead the planning and delivery of...can deliver according to time, budget, and quality. + Review existing operations in a major area of work… more
- HCA Healthcare (Fort Pierce, FL)
- …and appropriate resource utilization . **Skills** + In-depth knowledge of case management , discharge planning, and utilization review practices and ... hours volunteering in our communities. As a(an) Mgr Case Mgmt with HCA Florida Lawnwood Hospital you can be...Case Management services reports to the Case Management Director and is responsible for promoting… more
- Hartford HealthCare (Farmington, CT)
- …CDI subject matter expert guidance to CDS team, coding, physician leadership, quality management , utilization management , all providers, and others as ... now have our own identity with a unique payroll, benefits, performance management system, service recognition programs and other common practices across the system.… more
- Mount Sinai Health System (New York, NY)
- …and efficient care to patients, the delivery of comprehensive front-line Case Management services, including utilization management , care facilitation and ... management is preferred Non-Bargaining Unit, BEZ - Utilization Management - WST, Mount Sinai West...by focusing on patient processes. 9. Develops and implements Utilization Review (UR) based on internal data… more
- Ascension Health (Nashville, TN)
- …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, ... **Details** + **Department:** Utilization Management + **Schedule:** Monday -...Develop systems and processes for prospective, concurrent and retrospective utilization review for allself-funded and fully insured… more
- Prime Healthcare (Inglewood, CA)
- …provides leadership and supervision to case managers, social workers and case management coordinators/discharge planners, utilization review coordinators and ... experience, education, credentials and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/200257/ director -of-case- management utilization - management /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306)… more
- Intermountain Health (Murray, UT)
- …plans. This leader is responsible for the development, implementation, evaluation, and operational management of utilization review programs to include prior ... of their healthcare journey. + Oversees program components related to care management and utilization review for the specific line of business, across all… 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 ... Life Changing Medicine happen. **Responsibilities:** + Actively participates in the daily utilization management and quality improvement review processes,… more
- AmeriHealth Caritas (Newtown Square, PA)
- …Discover more about us at www.amerihealthcaritas.com. **Responsibilities:** The Medical Director , Utilization Management provides organizational leadership ... in the operational areas of care management , utilization review , appeals, quality...and practice initiatives in collaboration with the Corporate Medical Director (s), Utilization Management and the… more
- Prime Healthcare (Ontario, CA)
- …Responsibilities The Corporate Director of Clinical ... Utilization Management (UM) provides comprehensive oversight of the Utilization Review process for the self-insured Employee Health Plans, according to… more
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