- Henry Ford Health System (Clinton Township, MI)
- GENERAL SUMMARY: The Medical Director of Utilization Management shall have responsibility for the medical oversight of activities related to Henry ... REQUIRED: MD or DO. Two (2) years of physician advisor and/or utilization management experience. Medical Staff membership in good standing at Henry… more
- Elevance Health (Dearborn, MI)
- …responsibilities means that the medical director is directly involved in Utilization Management and Case Management . + Daily case reviews for both ... Director ** is responsible for serving as the Operational Medical Director for our care management...director provides clinical expertise in all aspects of utilization review and case management . Provides input… more
- Molina Healthcare (Warren, MI)
- …as a Molina Medical Director + Demonstrated experience in Utilization /Quality Program management + Previous leadership experience + Peer review, ... Summary** Responsible for serving as the primary liaison between administration and medical staff. Assures the ongoing development and implementation of policies and… more
- Molina Healthcare (Warren, MI)
- …, Group/IPA practice, capitation, HMO regulations, managed healthcare systems, quality improvement, medical utilization management , risk management , risk ... resource management . + Develops and implements a Utilization Management program and action plan, which...activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. +… more
- Sevita (Detroit, MI)
- …services for infants, children, adolescents, Military Service Members and Veterans. **Operations Management Executive Director - State of MI** **Do you have ... a team-based workplace that puts people first. As Executive Director of Operations Management , you will be...increase census, maintain occupancy, improve daily attendance, and maximize utilization . + Financial Management : + Oversee billing… more
- Molina Healthcare (Warren, MI)
- …, Group/IPA practice, capitation, HMO regulations, managed healthcare systems, quality improvement, medical utilization management , risk management , risk ... and chemical dependency services. Works closely with the Regional Medical Directors to standardized utilization management...**REQUIRED EXPERIENCE:** * 2 years previous experience as a Medical Director in clinical practice * 3… more
- Molina Healthcare (Warren, MI)
- …closely with regional medical directors to standardize behavioral health utilization management policies and procedures to improve quality outcomes and ... and clinical leadership for health plan and/or market specific utilization management and care management ...health portions of state contracts. * Assists behavioral health medical director lead trainers in the development… more
- Elevance Health (Dearborn, MI)
- …time zone hours.** The ** Medical Director ** will be responsible for utilization review case management for Commercial business in the New England (CT, ... ** Medical Director - Commercial** Location: This role...state or territory of the United States when conducting utilization review or an appeals consideration and cannot be… more
- Veterans Affairs, Veterans Health Administration (Detroit, MI)
- …and contributions of each of their team members. He/she collaborates with the HBPC Medical Director for daily program management . He/she collaborates with ... strategic planning, cost-effectiveness, and quality monitoring. He/she collaborates with the HBPC Medical Director to manage human resources for the HBPC… more
- Henry Ford Health System (Troy, MI)
- …to meet urgent Part D and pharmacy analysis needs. This new Director role establishes dedicated, in-house pharmacy actuarial expertise to strengthen financial ... position HAP for competitive advantage in 2026 and beyond. Position Summary The Director , Actuarial Services - Pharmacy / Part D is responsible for leading all… more
- Sunrise Senior Living (Grosse Pointe Woods, MI)
- …NAME** Sunrise on Vernier **Job ID** 2025-233094 **JOB OVERVIEW** The Executive Director is responsible for overall leadership, management , and success of ... community. Responsibilities include but are not limited to financial management , hiring, supervising, training, team member relations and recognition, communication,… more
- Tenet Healthcare (Detroit, MI)
- Clinical Quality Improvement Director Full Time Days - 2506003005 Description : DMC Sinai-Grace Hospital is DMC's largest hospital, offering a comprehensive heart ... and in conjunction with the DMC Chief Quality and Medical Safety Officer, provides leadership for the development and...including at least one year of experience in the utilization of continuous improvement statistical methods and tools. 3.… more
- Molina Healthcare (Warren, MI)
- …with operational management to identify saving opportunities and areas of medical utilization concerns. + Provide support to financial closing process ... early signs of trends or other issues related to medical care cost. + Design and perform actuarial studies...+ Research and develop reports and analysis for senior management , effectively presenting and communicating results. + Works closely… more
- Corewell Health (Royal Oak, MI)
- …status and level of care. Uses defined resources to guide decisions, including Medical Director Care Management , Physician Advisors, and management ... of care and cost effectiveness through the integration and functions of utilization management , and/or care coordination, discharge planning, and appropriate… more
- Corewell Health (Dearborn, MI)
- …status and level of care. Uses defined resources to guide decisions, including Medical Director Care Management , Physician Advisors, and management ... of care and cost effectiveness through the integration and functions of utilization management , and/or care coordination, discharge planning, and appropriate… more
- Select Medical (Mount Clemens, MI)
- … within the plan of care. + Demonstrates compliance with facility-wide Utilization Management policies and procedures. + Coordinates UR compliance with ... well by doing what is right. The Case Manager is responsible for utilization reviews and resource management , discharge planning, treatment plan management… more
- Henry Ford Health System (Bingham Farms, MI)
- …patient-centered solutions. This leader will shape HAP's pharmacy benefit design, utilization management , PBM relationships, and formulary strategy to improve ... to the Chief Pharmacy Officer. This role also reports indirectly to the HAP Medical Director . PRINCIPLE DUTIES AND RESPONSIBILITIES: + Oversees all aspects of… more
- Ford Motor Company (Dearborn, MI)
- …day-to-day operations across the global organization, effective financial forecast management , enable a streamlined approach to order placement and deliver ... processes. The EVDD Operations Manager will report to the Director of EVDD Business Operations and maintain close cross-functional...performance. This role will not be engaged in resource management and headcount. The ideal candidate will have a… more
- Henry Ford Health System (Troy, MI)
- …relevant contractual requirements and issues to internal customers such as Utilization Management , Finance, Patient Billing, Administration, Legal, etc. 7. ... Reporting to Director or Manager, assist in the development of...contractual provisions and rates on behalf of HFHS Hospitals, Medical Group, Behavioral Health Services and other business units.… more
- Henry Ford Health System (Detroit, MI)
- …coordinates staff activities, provides unit leadership and works in partnership with medical staff, nursing, the health care team, and hospital/system leaders to ... Manager is responsible for carrying out a series of leadership and management activities aimed at customizing education and staff roles, improving unit operations,… more