- Prime Healthcare (Ontario, CA)
- …Responsibilities The Corporate Director of Clinical ... individual and Company performance. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/160505/corporate- director -of-clinical- utilization - management /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilityPrime Healthcare… more
- Virginia Mason Franciscan Health (Bremerton, WA)
- …annual bonus eligibility, and more! **Responsibilities** **Job Summary / Purpose** The Utilization Management (UM) Director is responsible for the ... market(s) development, implementation, evaluation and direction of the Utilization Management Program and staff in support of the CommonSpirit Health Care… more
- Geisinger (Scranton, PA)
- …Establishes and leads execution of a strategic plan for the provision of Utilization Management services across the organization, fostering a spirit of ... provide effective and meaningful educational programs across the department. Responsible for management of the Utilization Review policy and observation … more
- Ascension Health (Austin, TX)
- …Provide strategic direction and oversight of the day-to-day operations of utilization management function within the insurance plan. + Ensure ... integration of utilization management functions with network strategy and claims processing. + Oversee work with provider relations on resolving issues. + Manage… more
- Elevance Health (Columbus, OH)
- **Clinical Operations Medical Director ** ** Utilization Management of Medical Oncology Benefits** **Carelon Benefits Management ** **$20,000 Sign On ... proud member of the Elevance Health family of companies, Carelon Medical Benefits Management , formerly AIM Specialty Health, is a benefit- management leader in… more
- Universal Health Services (San Antonio, TX)
- …Standards, providing on-site education to manage difficult cases, and assisting the Director of Utilization Management with department processes and ... procedures. Key Responsibilities: + Maintains knowledge of all facets of Utilization Management + Supports Director and performs management duties when … more
- Mirror (Newton, KS)
- Job Summary: Under the administrative supervision of the Director of Utilization Management , the URC is responsible for the implementation, and maintenance ... and departmental guidelines. + Other duties as requested by the Director of Utilization Management . Qualifications + High School diploma or equivalent… more
- Universal Health Services (Memphis, TN)
- …Come join our team and love what you do! We are currently hiring a full time Director of Utilization Management (UM) for Compass Intervention Center! The UM ... medical staff, management team and all other departments. The UM Director performs other duties as assigned. Compass Intervention Center is a fully accredited,… more
- AdventHealth (Maitland, FL)
- …The Medical Director is responsible for providing physician review of utilization , claims management , and quality assurance related to inpatient care, ... assigned by the Division CFO/SrVP, Vice President of Revenue Cycle Operations and/or Director , Utilization Review Management ..Reviews data and trends to… more
- Ascension Health (Baltimore, MD)
- …leadership and Sr Dir of CM as appropriate * Performs other duties as assigned Utilization Management : + Ensures integration of utilization management ... insured clients to implement and manage comprehensive outpatient and inpatient utilization management programs. + Oversees implementation and maintenance of… more
- CVS Health (Springfield, IL)
- …to Account Management in support of Key Clients as assigned.The Medical Director transacts Utilization Management UM activities (prior authorization and ... Management in support of Key Clients as assigned.The Medical Director transacts Utilization Management UM activities (prior authorization and appeals) and… more
- Humana (Columbus, OH)
- … 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....time to the Indiana Pathways program to assist the Utilization Management , Care Management , and… more
- Humana (Columbus, OH)
- … 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 (Columbus, OH)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... with prior experience participating in teams focusing on quality management , utilization management , case ...management operational improvements, including those within the medical director area + Participate in call rotation + Develop… more
- Humana (Columbus, OH)
- … 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
- Dignity Health (Rancho Cordova, CA)
- …home.** **Position Summary:** Under the guidance and supervision of the department Manager/ Director , the Supervisor of Utilization Management is responsible ... (Medicare Guidelines, InterQual, Health Plan Benefit Interpretation Guidelines and Medical Management Policies, and DHMF Utilization Management guidelines… more
- Providence (Torrance, CA)
- **Description** Under the supervision of Regional Director of Care Management , the Utilization Management Coordinator is responsible for providing ... support to the Care Management team who coordinates care. This position works closely...**Job Shift:** Variable **Career Track:** Admin Support **Department:** 7000 UTILIZATION MGMT CA SOCAL **Address:** CA Torrance 4180 W… more
- AmeriHealth Caritas (Dublin, OH)
- …Behavioral Health Medical Director + Population Health Director + Integrated Care Management Director + Utilization Management Liaison + Quality ... and strategic direction of clinical, quality, and population health programs across care management , utilization management , quality, and value based care +… more
- Universal Health Services (Colorado Springs, CO)
- … Management Care Coordinator opportunity available, this position reports to the Director of Utilization Management . Schedules vary. About the Position: ... (attached) with a current resume and turn it in to Susan Chambers, Director of Utilization Management , Human Resources or the reception desk on the first… more
- Nuvance Health (Norwalk, CT)
- …including discharge planning, utilization management and high-risk case management . Works collaboratively with the Director of transitions to ensure ... State and Federal Regulations relative to Discharge Planning, Utilization Management and Continuum of Care. Director Care Coordination- Major… more