- AmeriHealth Caritas (Newark, DE)
- ** Utilization Management Plan Oversight Manager, Registered Nurse (must reside in DE)** Location: Newark, DE Primary Job Function: Medical Management ... and serves as SME for clinical components DE Medicaid Utilization Management Program. Works in close collaboration... program. + Act as a primary liaison with plan providers including but not limited to physicians, hospital… more
- J&J Family of Companies (West Chester, PA)
- …Services, Internal Audit, and the Business Support COE. The role will have oversight of business plan , forecasting, and monthly and quarterly close activities ... top line growth whilst supporting critical business decisions that optimize resource utilization . In addition, this role will shape and influence critical insights… more
- AmeriHealth Caritas (Newark, DE)
- …in collaboration with the Corporate Medical Director(s), Senior Medical Directors, Utilization Management and the CMO. The following responsibilities are ... Preferred Provider Organization (PPO), large Health Care Organization, health plan or any combination thereof, or Full-time medical facility...+ 5+ years of clinical practice. + Experience in Utilization Management as a Medical Director within… more
- University of Delaware (Newark, DE)
- …Athletics Compliance activities. + Leads the department effort as the primary oversight of liaison with Admissions, Student Financial Services, and the Registrar, ... the future of college athletics. + Responsible for leading the department-wide strategic utilization of ARMS. This includes but is not limited to understanding the… more
- Elevance Health (Wilmington, DE)
- …in a healthcare business, especially with payers and clients. -Acumen in utilization management products, clinical programs, pricing, and service delivery model. ... The Director will be a key leader within Client Management , responsible for ensuring health plan client...and automation for routine client deliverables. * Leverages strong oversight skills to ensure contractual compliance and the proper… more