- Humana (Lansing, MI)
- **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
- Integra Partners (Troy, MI)
- Position Summary + Integra Partners is seeking a full-time Utilization Review Medical Director to support our Utilization Management team. This is a ... the local delivery system rendering the criteria inappropriate, the Utilization Management Nurse will route the case...Nurse will route the case to the UR Medical Director . The UR Medical Director will review… more
- Tenet Healthcare (Detroit, MI)
- … model, staffing and skill mix, complex Case Management , and centralized utilization review · Participate in new hospital Director of Case Management ... Group Director of Case Management - 2506001359...individual in this position has overall responsibility for hospital utilization management , transition management and… more
- Evolent (Lansing, MI)
- …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 (Lansing, MI)
- …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 (Lansing, MI)
- … 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
- Genesis Healthcare (Petoskey, MI)
- …Area Director ). 11. Assumes responsibility for daily staffing and utilization with input from treating therapists, consideration of clinical requirements, and ... management of the rehab department, including oversight related to case management , quality improvement, care planning, clinical utilization , and patient… more
- Corewell Health (Grand Rapids, MI)
- …in coordination with external partners and reports directly to the Senior Director of Utilization Management . Essential Functions Strategic Leadership ... Job Summary The Director , Highly Integrated Dual Eligible Special Needs (HIDE-SNP)...leaders across the enterprise (eg, Medical Directors, Quality Improvement, Utilization Management , Care Management , Medicare… more
- Humana (Lansing, MI)
- … 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 actively uses their medical background, experience, and judgement...with prior experience participating in teams focusing on quality management , utilization management , case … more
- Molina Healthcare (Ann Arbor, MI)
- … and effective resource management . + Develops and implements a Utilization Management program and action plan, which includes strategies that ensure ... IT and data analysts to produce tools to report, monitor and improve Utilization Management . + Actively participates in regulatory, professional and community… more
- Humana (Lansing, MI)
- …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 (Lansing, MI)
- …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 (Lansing, MI)
- …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
- United Therapeutics (Lansing, MI)
- …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 (Southfield, MI)
- …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
- Dart Container (Mason, MI)
- Risk Management Director Apply now " Date: Jun 5, 2025 Location: Mason, MI, US Company: Dart Container We have an opening for a Risk Management Director ... directing all aspects of our organization's insurance program and risk management function. This position requires close coordination with leadership to ensure… more
- Humana (Lansing, MI)
- …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
- Evolent (Lansing, MI)
- …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + ... Surgery 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 (Lansing, MI)
- …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. . ... Oncology, 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
- Trinity Health (Livonia, MI)
- …in terms of quality, safety, service, affordability, and technology. Oversees drug utilization management efforts; manages the pharmaceutical supply chain; and ... Type:** Full time **Shift:** Day Shift **Description:** **POSITION PURPOSE** + The Director Pharmacy Area will lead Pharmacy Services at Trinity Health Livonia and… more