- Tenet Healthcare (Detroit, MI)
- Group Director Utilization Review - 2506000536 Description : The Detroit Medical Center (DMC) is a nationally recognized health care system that serves ... and most diverse employers in Southeast Michigan. Summary Description SUMMARY: The Group Director , Utilization Review will perform the functions… more
- Molina Healthcare (Detroit, MI)
- …or exceeding productivity standards. Educates and interacts with network and group providers and medical managers regarding utilization practices, guideline ... **JOB DESCRIPTION** **Job Summary** The Medical Director for Specialty Medical Services & Market Performance...and effective resource management. + Develops and implements a Utilization Management program and action plan, which includes strategies… more
- Molina Healthcare (Detroit, MI)
- …or exceeding productivity standards. Educates and interacts with network and group providers and medical managers regarding utilization practices, guideline ... utilization and effective resource management. + Develops and implements a Utilization Management program and action plan, which includes strategies that ensure a… more
- Molina Healthcare (Detroit, MI)
- …Summary** Molina's Behavioral Health function provides leadership and guidance for utilization management and case management programs for mental health and chemical ... Health care management programs. **Knowledge/Skills/Abilities** Provides Psychiatric leadership for utilization management and case management programs for mental health… more
- Sunrise Senior Living (West Bloomfield, MI)
- …a big breath of fresh air."_** **_- Sunrise Leader_** The Executive Director is responsible for overall leadership, management, and success of their community. ... & services to seniors better than anyone. The Executive Director is expected to create, in alignment with our...achieving customer engagement. + Leads the development and regular review of the engagement improvement plan. + Effectively resolves… more
- Trinity Health (Livonia, MI)
- …on systems support procedures to ensure functioning software and effective system utilization . Assists the Senior Manager and/or Director with establishing an ... organization, set forth by the guidelines established by the Director and/or Senior Manager. Works closely with team members...software and healthcare fields in order to provide technical review and advice in the evaluation and selection of… more
- Henry Ford Health System (Troy, MI)
- …Payors and facilitate resolution of contracting and operational issues, ie billing, utilization review , credentialing site visits, notification of site closures ... Reporting to Director or Manager, assist in the development of...provisions and rates on behalf of HFHS Hospitals, Medical Group , Behavioral Health Services and other business units. 1.… more
- Henry Ford Health System (Detroit, MI)
- …between HFHS and Payors on contracting and operational issues, ie billing, utilization review , credentialing site visits, notification of site closures or ... its business units. PRINCIPAL DUTIES AND RESPONSIBILITIES: 1. Under supervision of Director or Managed Care Contracting, works directly with Payors to negotiate… more
- Marathon Petroleum Corporation (Detroit, MI)
- …execution management (rounds/logbook/handover). The position will report to the Global Optimization Director for Process Excellence and can be located at any MPC ... strategies as necessary to optimize outcomes. Provides oversight of business adoption and utilization of tools and systems to ensure that progress is maintained in… more
- Henry Ford Health System (Detroit, MI)
- …Coding + ED Coding + Anesthesia Coding + Clinical Documentation Improvement + Utilization Management + Clinical Denial Recovery Unit + Payer Audit + Transcription ... processes. + Use of Artificial Intelligence and Machine Learning to segment review , querying and educational activities in areas most critical to performance areas.… more