- CVS Health (Springfield, IL)
- …you'll perform a share of special clinical investigations and research as requested by the Senior Medical Director , Medical Affairs. These projects can ... Account Management in support of Key Clients as assigned.The Medical Director transacts Utilization Management UM...special clinical investigations and research as requested by the Senior Medical Director , Medical… more
- ChenMed (Louisville, KY)
- …P&L leader for the foundational business unit of our care model - the center. The Senior Medical Director (SMD) will partner with the Center Director ... conjunction with the transitional care team; hospital, SNF, post-acute, UM , and home-based services for the division. + Assists... director training prior to promotion to Senior Medical Director , as part… more
- CVS Health (Hartford, CT)
- …care more personal, convenient and affordable. Job Purpose and Summary: The LTSS/SAI National Senior Medical Director , reporting to a Regional CMO of ... LTSS line of business including but not limited to UM , Quality, care management, and network growth as listed...team and develops specific actions to manage LTSS related medical cost trends* Develops benchmarks for LTSS clinical staff… more
- CVS Health (Columbus, OH)
- …resistant illnesses through peer review and educational interventions.* Work with medical director teams focusing on inpatient care management, clinical ... person as needed* Outward facing position to interact and collaborate with medical / physical professional associates, the local provider community, state regulatory… more
- Commonwealth Care Alliance (Boston, MA)
- **Why This Role is Important to Us:** The Director of Utilization Management leads and manages all utilization management ( UM ) functions for physical health ... federal regulatory requirements and all applicable accreditation standards. The Director of Utilization Management is responsible for setting strategic direction,… more
- The Cigna Group (Philadelphia, PA)
- **OVERVIEW:** The Chief Pharmacy Officer ( Senior Director ) oversees and directs the creation, adoption and evaluation of clinical pharmacy programs, product and ... Health Plan book of business. + Partners with the Health Plan National Medical Officer for Pharmacy to develop and deploy clinical affordability solutions for drugs… more
- Magellan Health Services (Albuquerque, NM)
- …clinical quality improvement activity (QIA) in collaboration with the clinical lead senior medical director , and quality improvement staff. May ... day to day physician oversight to an assigned interdisciplinary UM team, including regular involvement in the case management...various committees or project teams as directed by the senior medical director or vice-president.… more
- University of Maryland, Baltimore (Baltimore, MD)
- …physician-scientist with expertise in clinical trial design and execution to serve as Director of Clinical Trial Innovation.* The UM -IHC is a large-scale ... life and longevity of the citizens of Maryland. The UM -IHC, located in North Bethesda, MD, is a collaborative...of Maryland College Park, and the University of Maryland Medical System, funded with initial grants from the State… more
- University of Michigan (Ann Arbor, MI)
- …Services, and partners with the Associate Chief Clinical Officer (ACCO) and the Senior Nursing Director for overall performance and leadership of the ... Ambulatory Care Services + Partners with the ACCO and Senior Nursing Director to effectively oversee, operationalize,...world and has been the site of many groundbreaking medical and technological advancements since the opening of the… more
- AdventHealth (Maitland, FL)
- …Site position** **The role you'll contribute:** As the physician advisor, the Executive Medical Director of Revenue Cycle educates, informs, and advises members ... related to denial prevention measures for our contracted managed care payers. The Medical Director is responsible for providing physician review of utilization,… more
- University of Michigan (Ann Arbor, MI)
- Financial Specialist Senior Apply Now **What You'll Do** General Duties: + Assists the finance intermediate manager in analyzing and monitoring accounting and budget ... is provided by the Financial Intermediate Manager and the CHS Associate Director . This position has no supervision responsibilities. + Under FLSA, incumbents in… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- … leaders for decision making + Apply their clinical knowledge when assessing/auditing medical records and UM letters against medical necessity criteria ... + Accurately plan and scope projects; keep project leads, senior consultants, and Director informed of key...skills and understanding of CMS Part C guidance including UM operational procedures, and CMS guidance including coverage and… more
- University of Miami (Coral Gables, FL)
- …related experience. Bachelor's degree preferred. Position requires significant experience with UM purchasing systems. The Senior Program Coordinator should have ... of Student Affairs, has a great opportunity for a Senior Program Coordinator to work at the Coral Gables...budget of the Student Bar Association, and assist the Director of Programs in managing the budget for the… more
- University of Michigan (Ann Arbor, MI)
- …society. **Responsibilities + Provide administrative and calendar management support to the Senior Associate Chair for Research; Executive Director , Pain & ... Administrative Assistant Senior Healthcare Apply Now **How to Apply** A...with writing a variety of correspondence including faculty and medical school recommendation letters and tracking due dates. +… more
- University of Miami (Coral Gables, FL)
- …Miami School of Law First Star Academy has a great opportunity for a Senior Program Coordinator at the Coral Gables Campus. Summer Temporary Position Job Summary: ... of the summer leadership team, along with the Program Director and Assistant Program Director , to ensure...times for Case Manager and caregiver visits to the UM campus, Therapy sessions and Court appearances by youth… more
- University of Michigan (Ann Arbor, MI)
- Administrative Assistant Senior Healthcare Apply Now **Summary** The Administrative Assistant position will provide high quality administrative support to Clinical ... Nursing Director , Nurse Supervisor, within Internal Medicine. **Mission Statement** Michigan...world and has been the site of many groundbreaking medical and technological advancements since the opening of the… more
- LA Care Health Plan (Los Angeles, CA)
- …(CM), and Managed Long Term Supportive Services (MLTSS) teams alongside a clinical dyad partner ( Senior Medical Director II). The role extends to all lines ... Executive (COE) of LA Care Health Plan is a senior leader focused on core operations to improve clinical...its members. This individual reports directly to the Chief Medical Officer (CMO) and is responsible for operational and… more
- University of Miami (Miami, FL)
- …is currently seeking a full time Sr. Manager, Programs. The Senior Manager, Programs oversees the day-to-day administrative management of assigned program(s) ... to the University faculty and staff and other key stakeholders. Furthermore, the Senior Manager, Programs serves as the liaison to leadership, faculty, students, and… more
- Blue KC (Workman, MN)
- …UM system in accord with UM concurrent review guidelines. Consults with Medical Director on cases outside medical policy, notifies providers and ... of our offerings include:** **Highly competitive total rewards package, including comprehensive medical , dental and vision benefits as well as a 401(k) plan that… more
- Fallon Health (Worcester, MA)
- …presents to the Senior Director , PACE Operations, SE Senior Director of Nursing & Quality, and SE VP/ Medical Director , respectively, according to ... Manager works closely with their counterpart to assist the Senior Director , PACE Operations to manage the...**Is responsible for ensuring accurate payment of the PACE medical claims** : + Responsible for managing the SE… more