- Elevance Health (Wallingford, CT)
- ** Utilization Management Medical Director - NC Medicaid** Location: This role enables associates to work virtually full-time, with the exception of ... Alternate locations may be considered. The ** Medical Director ** will be responsible for utilization review case management for North Carolina Medicaid.… more
- Elevance Health (Wallingford, CT)
- …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
- Elevance Health (Wallingford, CT)
- …schedule: Monday - Friday. Half day Saturday rotation, once a month.** The ** Medical Director ** is responsible for the administration of behavioral health ... increase effectiveness and quality. + Provides oversight, direction, and guidance to Medical Director Associates. + Works independently with oversight from… more
- Elevance Health (Wallingford, CT)
- ** Medical Director Associate - CarelonRx** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person ... dispensing services to drive affordability and improve member outcomes. The ** Medical Director Associate- CarelonRx** supports pharmacy prior authorization… more
- Elevance Health (Wallingford, CT)
- …for an entire clinical program and/or independently performs clinical reviews. The Medical Director typically has program management responsibilities ... ** Medical Director ** _Please note that per...** Medical Director ** _Please note that per our policy this...state or territory of the United States when conducting utilization review or an appeals consideration and cannot be… more
- Elevance Health (Wallingford, CT)
- …resides within a commutable distance from an office._** The **Business Strategy Plan Director - MedEx ( Medical Expense) Management ** is responsible for ... processes around physician, hospital and ancillary network contract negotiation strategies, utilization management efforts, new products, annual benefit design… more
- Hartford HealthCare (New Britain, CT)
- …of Connecticut's most comprehensive healthcare network. Position Summary: The Regional Director is responsible for managing the strategic operations of facilities ... within the Central Region to ensure that operations, maintenance, and vendor management standards are met in a cost-effective, safe, and efficient manner. The … more
- Marrakech, Inc. (Woodbridge, CT)
- …(HRC), and Utilization Review & Resource (URR). Contract & Vendor Management + Oversee contracts related to behavioral and ancillary clinical services. + Monitor ... friends and acquaintances for their individual qualities and contributions. SUMMARY The Director of Clinical Services plays a vital leadership role in ensuring the… more
- RTX Corporation (Farmington, CT)
- …businesses, is headquartered in Arlington, VA. **Position Overview:** The Associate Director , Hosting Product Manager is responsible for shaping the long-term ... vision, product management direction, and transformation agenda for hosting services. This...operational efficiencies, reduce deployment times, improvements in hosting power utilization , and service placement optimizations. **What You Will Do:**… more
- Fresenius Medical Center (Fairfield, CT)
- …and acting on adverse events and action thresholds in collaboration with facility management . + Maintains integrity of medical records and other organization ... during and post procedure, under the direction of the Facility Manager, Director of Nursing and/or Charge Registered Nurse, utilizing standard nursing techniques to… more
- Hartford HealthCare (Farmington, CT)
- …service/program level management and system support functions including Finance, Utilization Management , Revenue Cycle and Compliance. Works in support of ... functional areas under Revenue Cycle including financial clearance, benefit verification, utilization management , billing/follow-up, denial management and… more
- Fairfield University (Fairfield, CT)
- …clinical competencies. 13. Participates in SHC committee work as assigned by the SHC Director ; Examples include: + The SHC Risk Management Committee which is ... The APRN will provide operational support to the SHC including Risk Management and Quality Assurance Committees. The APRN will provide individual health education… more
- Genesis Healthcare (Forestville, CT)
- …our day-to-day operations. Responsibilities The Attending Physician works with the Center Medical Director to ensure that delivery of clinical services achieves ... Attending Physician's Primary reporting relationship is to the AlignMed Partners Regional Medical Director . The Attending Physician is also accountable to both… more
- Hartford HealthCare (Torrington, CT)
- …14. Participates in quality improvement and evaluation processes related to the Care Management function. Abstracts data from the medical record to enable the ... dress code, corporate compliance, confidentiality and others. Communicates to Administrative Director and/or Management staff needs identified for self, the… more
- Nuvance Health (Danbury, CT)
- …safety tests, complying with codes, and guiding and training health care and medical personnel. * Accepts assignments from Director /Manager and or Coordinator ... responsibility for calibration, repair, maintenance, and documentation of all assigned medical equipment in accordance with the department, hospital and regulatory… more
- Hartford HealthCare (Farmington, CT)
- …CDI subject matter expert guidance to CDS team, coding, physician leadership, quality management , utilization management , all providers, and others as ... Direct supervision of CDS staff. Strong working relationships with medical staff, HIM Coding staff, quality management ,...with medical staff, HIM Coding staff, quality management , leadership teams and others as needed. **Education** .… more
- Hartford HealthCare (Newington, CT)
- …process in collaboration with the physicians, ED, PACU and OR staff and the Medical Director of the Transfer Center. o Develop effective relationships with EVS ... now have our own identity with a unique payroll, benefits, performance management system, service recognition programs and other common practices across the system.… more
- Hartford HealthCare (Meriden, CT)
- …required workload, forecasted units of service and programmatic changes. Assures appropriate fiscal management of COI program and the proper utilization of HHC's ... Under the supervision of the Regional Operations Director for the Connecticut Orthopedic Institute (COI), Central...the surgical episode for the COI program at MidState Medical Center (MMC). Effectively leads the programmatic initiatives including… more