- Elevance Health (Cary, NC)
- …within 50 miles of one of our Elevance Health locations.** The Medical Director is responsible for the administration of physical and/or behavioral health ... opportunities. May serve as a resource to staff including Medical Director Associates. May be responsible for...of the US. + Minimum of 10 years of physical medicine and rehabilitation clinical experience; or any combination… more
- Elevance Health (Atlanta, GA)
- …50 miles of one of our Elevance Health office locations.** The Medical Director is responsible for the administration of physical and/or behavioral health ... cost of care opportunities. May serve as a resource to staff including Medical Director Associates. May be responsible for an entire clinical program. How you… more
- Elevance Health (Rancho Cordova, CA)
- …plans, and are flexible enough to fit any size business. The ** Medical Director ** is responsible for the administration of physical and/or behavioral health ... Additional experience may be required by State contracts or regulations if the Medical Director is filing a role required by a State agency. Preferred Skills,… more
- City and County of San Francisco (San Francisco, CA)
- …specifically in the Mental Health Service Center + Supervises medical staff, including UM Medical Director , OCC Nurse Practitioner, and the medical ... health services, including psychiatric services. The Behavioral Health Services (BHS) Deputy Medical Director of Managed Care provides effective leadership and… more
- Magellan Health Services (Albuquerque, NM)
- …quality improvement activity (QIA) in collaboration with the clinical lead senior medical director , and quality improvement staff. May participate in various ... to CISC children and youth in need of behavioral, physical and long-term care supports. Is knowledgeable of the...committees or project teams as directed by the senior medical director or vice-president. + Supports senior… more
- CVS Health (Hartford, CT)
- …members' health care and social determinant needs. The Duals Care Management (CM) Medical Director will participate in designing, developing and deploying our ... (ICP) and assisting care management staff as they support of members' physical , behavioral and socioeconomic needs.* Partner closely with the Executive Director… more
- CVS Health (Columbus, OH)
- …resistant illnesses through peer review and educational interventions.* Work with medical director teams focusing on inpatient care management, clinical ... needed* Outward facing position to interact and collaborate with medical / physical professional associates, the local...Actively participate in State Fair Hearings as needed. Understand UM and participate in UM front line… more
- BlueCross BlueShield of Tennessee (Chattanooga, TN)
- Provides clinical leadership and serves as an internal medical consultant to various divisions and committees to support the development, implementation and ... monitoring of medical management and quality improvement activities\. **Job Description:** **Job...physician review to ensure timeliness, accuracy and reliability of UM and Appeals reviews\. + Lead and serve on… more
- CVS Health (Overland Park, KS)
- …at least five (5) years clinical experience with Geriatrics and LTSS population. + The LTSS Medical Director must live in the state of Kansas or be willing to ... relocate to Kansas and obtain a Kansas medical license. The LTSS Director will be...directs healthcare services for individuals of any age with physical , intellectual, and/or developmental disabilities. + The LTSS MD… 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. ... Care Coordination Director Location: Norwalk, CT, United States Requisition ID:...Northern Dutchess Hospital, Putnam Hospital Center and Vassar Brothers Medical Center in New York - plus multiple primary… more
- LA Care Health Plan (Los Angeles, CA)
- …includes liasing with internal Behavioral Health units, the Medical Director of Behavioral Health, attendance at UM Committee, Delegation Oversight ... RN II is responsible for ensuring that delegates contracted to perform Utilization Management ( UM ) functions on behalf of LA Care (LAC) is in compliance with all … 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
- LA Care Health Plan (Los Angeles, CA)
- …Preferred: Experience in Medi-Cal managed care. 1 year of experience in UM /Prior Authorization. Skills Required: Demonstrated proficiency in Medical Terminology ... records and documentation programs. Licenses/Certifications Required Licenses/Certifications Preferred Medical Coding Certification Required Training Physical Requirements… more
- LA Care Health Plan (Los Angeles, CA)
- …Job Summary The Supervisor, Authorization Technician supports the Utilization Management ( UM ) Specialist by handling all administrative and technical functions of ... Authorization Technicians Leads, Authorization Technician and clerical staff in the UM department. Ensure Associate Supervisors are providing consistent and direct… more
- LA Care Health Plan (Los Angeles, CA)
- …setting. Works with UM leadership, including the Utilization Management Medical Director , on requests where determination requires extended review. ... based on clinical data presented and established criteria/guidelines, escalating to the medical director if needed. Triages and assesses members for admission… more
- LA Care Health Plan (Los Angeles, CA)
- …cost cases and reports are maintained and referred to the Physician Advisor/ UM Director . Documents in platform/system of record. Utilizes designated software ... experience in a hospital or HMO setting . Preferred: Managed Care experience performing UM and CM at a medical group or management services organization.… more
- Healthfirst (New York, NY)
- …and medical departments + Conduct ad hoc medical condition research per Medical Director and/or UM Clinical Director requests. + Collaborate with ... regulatory compliance within the Clinical department. Duties/Responsibilities: + Support the Medical Policy and Clinical Utilization Management ( UM ) Governance… more
- LA Care Health Plan (Los Angeles, CA)
- …Managed Long Term Supportive Services (MLTSS) teams alongside a clinical dyad partner (Senior Medical Director II). The role extends to all lines of business ... outcomes for its members. This individual reports directly to the Chief Medical Officer (CMO) and is responsible for operational and administrative management of… more
- University of Miami (Coral Gables, FL)
- …The De par tme nt ofT ea ch ing andLear nin g (TAL) , University of Miami ( UM ) Sc hool of Edu c at i on and Human Development (SEHD), is conducting ase arch for ... successful candidate may accede to the position of Program Director and be responsible for ongoing program development and...her du t ies as outlin ed in the UM Facu l ty M an ual The position… more
- University of Miami (Miami, FL)
- …. The University of Miami is currently seeking a Supervisor, Medical Technologists to work at the UM Hospital in ... The incumbent will supervise laboratory personnel and schedules. The Supervisor, Medical Technologists will participate and assign weekly responsibilities to staff… more