- Humana (Springfield, IL)
- **Become a part of our caring community and help us put health first** The Utilization Management (UM) Director , Clinical Strategy and Practice for Medicaid ... of how organization capabilities interrelate across the function or segment. The Utilization Management (UM) Director , Clinical Strategy and Practice… more
- Zurich NA (Springfield, IL)
- …+ Experience in development and implementation of cost containment programs + Case management , utilization review, catastrophic or disability experience + 5 or ... AVP, Utilization Review & Pharmacy 123092 Zurich Insurance is...recruiting and retaining team members. + Drive the performance management process by communicating job expectations, monitoring and evaluating… more
- AdventHealth (Bolingbrook, IL)
- … Management Facility Director reports directly to the Division Care Management Director with a matrix reporting relationship dotted line to the Facility ... Providers and keep the CMOs updated. The Facility Care Management Director communicates regularly with the CFO...to achieve goals . Works collaboratively with leaders of Utilization Management to quickly and efficiently address… more
- Humana (Springfield, IL)
- …to RN, LCSW, LCPC. + 8+ years of clinical experience, to include a combination of Utilization Management Case Management and Managed Care. + 5+ years of ... health first** Humana Gold Plus Integrated is seeking a Director of Care Management to lead a...of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or… more
- Centene Corporation (Springfield, IL)
- …unit. This position is REMOTE! + Provides medical leadership of all for utilization management , cost containment, and medical quality improvement activities. + ... Provides medical expertise in the operation of approved quality improvement and utilization management programs in accordance with regulatory, state, corporate,… more
- Humana (Springfield, IL)
- …to the Lead Medical Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....with prior experience participating in teams focusing on quality management , utilization management , case … more
- Evolent (Springfield, IL)
- …classes as needed for new hires to educate and train on Utilization management system and Field Medical Director process, standards and resources. + Acts as ... for the culture. **What You'll Be Doing:** The Medical Director for MSK Surgery is a key member of...reviews appeal cases and/or attends hearings for discussion of utilization management decisions. + Strong partnership with… more
- Evolent (Springfield, IL)
- …impact on patient care in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your ... Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. +… more
- Humana (Springfield, IL)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....with prior experience participating in teams focusing on quality management , utilization management , case … more
- Humana (Springfield, IL)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....with prior experience participating in teams focusing on quality management , utilization management , case … more
- Humana (Springfield, IL)
- …Medical Director , depending on size of team or line of business. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on...with prior experience participating in teams focusing on quality management , utilization management , case … more
- Evolent (Springfield, IL)
- …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + ... you will be a key member of the utilization management team. We can offer you... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National … more
- Evolent (Springfield, IL)
- …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + ... you will be a key member of the utilization management team. We can offer you... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National … more
- CVS Health (Springfield, IL)
- …Account Management in support of Key Clients as assigned. The Medical Director transacts Utilization Management UM activities (prior authorization and ... 6 company, has an outstanding opportunity for a Medical Director (Medical Affairs). This is a remote based, work...commercial client program support. Will share in reviews of utilization management (PA) criteria and clinical policy… more
- American Medical Association (Chicago, IL)
- Director PPD Sales & Account Management Chicago, IL (Hybrid) The American Medical Association (AMA) is the nation's largest professional Association of ... opportunity at our corporate offices in Chicago for a Director PPD Sales & Account Management on...staff to achieve them. + Demonstrated knowledge and successful utilization of professional sales processes such as strategic selling… more
- United Therapeutics (Springfield, IL)
- …is innovative and inspiring where you can truly make a difference. The Regional Field Director , RNS Program Management serves as a director of all clinical ... the commercial non-promotional team. In addition, the Regional Field Director , RNS Program Management will: + Serve...initiation of a UT product, adverse effect mitigation, device utilization , and dosing upon request + Support the Clinical… more
- Grant Thornton (Chicago, IL)
- …to share strategy, to implement process improvements and to roll out capacity management strategies to maximize utilization and drive operational excellence + ... Grant Thornton is seeking an Advisory Capacity & Resource Management (C&RM) Leader to join the team. Approved office...on yearly budget planning for headcount, gross charge hours, utilization , and leverage. You will lead your team to… more
- Rush University Medical Center (Chicago, IL)
- …Office of Advanced Practice **Work Type:** Full Time **General Summary:** The Director of Advanced Practice Providers (APP) Services supports the Office of Advanced ... Practice (OAP) operations in collaboration with the Senior Director of Advanced Practice Providers and is responsible for ensuring the provision of the highest… more
- Sysco (Chicago, IL)
- **Position Summary:** The Director of Local Sales is a member of the senior sales leadership team. This position will be included in all strategic planning, ... leadership team will consist of the VP, Region Sales, Director , Local Sales, Director , New Business Development,...represents an escalation of skills and ability from sales management to sales leadership. Through the senior sales leadership… more
- Humana (Springfield, IL)
- …interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , discharge ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a… more