- CVS Health (Springfield, IL)
- …Michigan, Kansas and Oklahoma. Support for other regions may occasionally be required. The UM Medical Director will ensure timely and consistent responses to ... that primarily supports the Aetna Better Health Plan of Illinois. This UM (Utilization Management) Medical Director will be a "Work from Home" position… 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 ... develop strong collaborative and positive mutually supported relationships between the medical center and its physicians to improve clinical quality, resource… more
- Nuvance Health (Norwalk, CT)
- …cost-effective utilization of Hospital Resources and optimize financial performance. Collaborates with UM Medical Director and Vice President of Medicine. ... *Description* *$30K SIGN ON BONUS - FOR ELIGIBLE EXTERNAL CANDIDATES* Director , Acute Care Hospital Case Management Opportunity! *Required: BSN or MSW with Acute… more
- Dignity Health (Rancho Cordova, CA)
- …review a referral. Fosters the relationship between the Pre-Authorization team and the Medical Director and Physician Reviewers. - Tracks cost savings from ... **Position Summary:** Under the guidance and supervision of the department Manager/ Director the Supervisor of Utilization Management is responsible and accountable… 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 ... Associates, PA They will work closely and in collaboration with the Trauma Medical Director , Chief of Cardiac Surgery, Surgery, Medicine, Neurocritical Care. The… more
- Excellus BlueCross BlueShield (Buffalo, NY)
- …the Quality Management/Utilization Management (QM/ UM ) Plan, including having the BH Medical Director for Children's Services and participate on the BH ... of the Children's Behavioral Health (BH) Carve-In program. The Medical Director for BH Children's Services has...clinical setting). + A minimum of ten (10) years medical experience and strong working knowledge of QM/ UM… more
- University of Miami (Miami, FL)
- …abdominal organs in approximately 50% of cases. + In conjunction with the Medical Director assumes ultimate responsibility for donor management and the process ... to work in Miami, FL. The Recovery Coordinator 1 ( UM LAORA) assists in the recovery, packaging, preservation and... medical record. + Shares on-call responsibility with Medical Director to oversee clinical evaluation and… more
- CVS Health (Springfield, IL)
- …support to Account Management in support of Key Clients as assigned. The Medical Director transacts Utilization Management UM activities (prior authorization ... Fortune 6 company, has an outstanding opportunity for a Medical Director ( Medical Affairs). This...review activities and other quality oversight processes for internal Director UM decisions. If specifically assigned to… more
- Sharp HealthCare (San Diego, CA)
- …the position, and employer business practices. **What You Will Do** This Senior Medical Director position provides critical management and oversight for Sharp ... + 5 years' experience as an HMO Health Plan Medical Director . + California Physicians and Surgeons...+ Achieves and maintains benchmarked utilization and cost management ( UM ) goals and clinical quality improvement (QI) objectives, in… 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 ... utilization, and length of stay (LOS) strategic oversight. The Medical Director will report to the Vice...medical appropriateness, LOS, and reduce denials. + Direct UM functions, collaborating with CC/DP, clinical teams, and attending… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …you see is right for you, we encourage you to apply! Job Description: The Medical Director participates in the broad array of activities of the Medical ... reviews and may require peer-to-peer discussions with providers regarding UM case review determinations. + Provides clinical expertise on...and medical criteria. + Assists with training medical director colleagues and nursing staff ,… 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, case ... in their efforts to ensure quality patient care and the appropriate utilization of medical services. The Medical Director of Utilization Management serves as… more
- CVS Health (Phoenix, AZ)
- …without encumbrances.** In this role you will: + Support Mercy Care + In the Medical Director role you will provide oversight for medical policy ... consistent responses to members and providers. + As a Medical Director you will focus primarily on...patient care experience. *Overnight travel up to 10% *AZ medical license without encumbrances **Preferred Qualifications:** Previous UM… more
- Centene Corporation (Dover, DE)
- …Services and Supports (LTSS) and Medicare-Medicaid Duals populations. Additionally, the Medical Director will collaborate with other key stakeholders to ... medical expertise in the operation of utilization management ( UM ) programs and quality improvement initiatives to ensure compliance...LTSS Only:** A full-time Long Term Services and Supports Medical Officer/ Medical Director (LTSS CMO)… more
- Intermountain Health (Murray, UT)
- …Health division as needed to implement policies and programs for the Office of the Medical Director to manage the provider panel and to maintain high customer ... management system. + Committees: Represent SelectHealth on committees as assigned by the Medical Director . + Delivery Improvement: Serve as a resource for the… 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 ... life and longevity of the citizens of Maryland. The UM -IHC, located in North Bethesda, MD, is a collaborative...of Maryland College Park, and the University of Maryland Medical System, funded with initial grants from the State… more
- University of Maryland, Baltimore (Baltimore, MD)
- …Professor*level (non-tenure track) to join our dynamic team and serve as* Medical Director *of our vibrant community-based academic radiation oncology practice ... **Faculty* **Organization:** **School of Medicine - Clinical Departments* **Title:** * Medical Director - Assistant or Associate Professor Community-Based… more
- University of Maryland, Baltimore (Baltimore, MD)
- …Comprehensive Cancer Center (UMGCCC), located in Baltimore, MD are recruiting for a*full-time Medical Director of the University of Maryland St. Joseph Cancer ... Institute, located in Towson, MD.**_ Administrative duties and responsibilities of the Medical Director role will include, but not limited to the following:_* *… more
- Tenet Healthcare (Detroit, MI)
- Group Director Utilization Review - 2506000536 Description : The Detroit Medical Center (DMC) is a nationally recognized health care system that serves patients ... to help people live happier, healthier lives. The hospitals of the Detroit Medical Center are the Children's Hospital of Michigan, Detroit Receiving Hospital, Harper… 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...the State of Maryland that leverages advanced computation and medical innovation to advance health equity and improve quality… more
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