- Elevance Health (Cary, NC)
- …within 50 miles of one of our Elevance Health locations.** The Medical Director is responsible for the administration of physical and/or behavioral health ... opportunities. May serve as a resource to staff including Medical Director Associates. May be responsible for...of the US. + Minimum of 10 years of physical medicine and rehabilitation clinical experience; or any combination… more
- Elevance Health (Atlanta, GA)
- …50 miles of one of our Elevance Health office locations.** The Medical Director is responsible for the administration of physical and/or behavioral health ... cost of care opportunities. May serve as a resource to staff including Medical Director Associates. May be responsible for an entire clinical program. How you… more
- Elevance Health (Rancho Cordova, CA)
- …plans, and are flexible enough to fit any size business. The ** Medical Director ** is responsible for the administration of physical and/or behavioral health ... Additional experience may be required by State contracts or regulations if the Medical Director is filing a role required by a State agency. Preferred Skills,… more
- City and County of San Francisco (San Francisco, CA)
- …specifically in the Mental Health Service Center + Supervises medical staff, including UM Medical Director , OCC Nurse Practitioner, and the medical ... health services, including psychiatric services. The Behavioral Health Services (BHS) Deputy Medical Director of Managed Care provides effective leadership and… more
- Magellan Health Services (Albuquerque, NM)
- …quality improvement activity (QIA) in collaboration with the clinical lead senior medical director , and quality improvement staff. May participate in various ... to CISC children and youth in need of behavioral, physical and long-term care supports. Is knowledgeable of the...committees or project teams as directed by the senior medical director or vice-president. + Supports senior… more
- CVS Health (Hartford, CT)
- …members' health care and social determinant needs. The Duals Care Management (CM) Medical Director will participate in designing, developing and deploying our ... (ICP) and assisting care management staff as they support of members' physical , behavioral and socioeconomic needs.* Partner closely with the Executive Director… more
- CVS Health (Columbus, OH)
- …resistant illnesses through peer review and educational interventions.* Work with medical director teams focusing on inpatient care management, clinical ... needed* Outward facing position to interact and collaborate with medical / physical professional associates, the local...Actively participate in State Fair Hearings as needed. Understand UM and participate in UM front line… more
- BlueCross BlueShield of Tennessee (Chattanooga, TN)
- Provides clinical leadership and serves as an internal medical consultant to various divisions and committees to support the development, implementation and ... monitoring of medical management and quality improvement activities\. **Job Description:** **Job...physician review to ensure timeliness, accuracy and reliability of UM and Appeals reviews\. + Lead and serve on… more
- LA Care Health Plan (Los Angeles, CA)
- Medical Director , Medical Management Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time ... net required to achieve that purpose. Job Summary The Medical Director , Medical Management, is...leadership with the creation and implementation of a regional UM model. Duties Continued Provide clinical and policy expertise… more
- Nuvance Health (Norwalk, CT)
- …cost-effective utilization of Hospital Resources and optimize financial performance. Collaborates with UM Medical Director and Vice President of Medicine. ... Care Coordination Director Location: Norwalk, CT, United States Requisition ID:...Northern Dutchess Hospital, Putnam Hospital Center and Vassar Brothers Medical Center in New York - plus multiple primary… more
- CVS Health (Chicago, IL)
- …our members. Aetna Better Health of Illinois (ABHIL) is recruiting for an Executive Director , Health Services Operations, to be known at the health plan as the Chief ... maintain operational excellence through matrixed leadership and oversight of our centralized medical management functions, as well as be the health plan's subject… more
- LA Care Health Plan (Los Angeles, CA)
- …the needs of LA Care's culturally diverse membership. The position supports the UM Manager/ Director . This role also assists UM Educator/Manager/ Director ... required to achieve that purpose. Job Summary The Supervisor of Utilization Management ( UM ) RN is responsible for executing the day-to-day operations of the UM… more
- Intermountain Health (Las Vegas, NV)
- …and education for peer-to-peer reviews, prior authorization reviews, and other education within UM as determined by UM Medical and Operational Leadership. ... Reviewer, you are responsible, in partnership with the Sr. Director of UM and the Director...Job Profile: + Trains and educates on medical review activities pertaining to utilization review, claims review,… more
- LA Care Health Plan (Los Angeles, CA)
- …Job Summary The Supervisor, Authorization Technician supports the Utilization Management ( UM ) Specialist by handling all administrative and technical functions of ... Authorization Technicians Leads, Authorization Technician and clerical staff in the UM department. Ensure Associate Supervisors are providing consistent and direct… more
- LA Care Health Plan (Los Angeles, CA)
- …cost cases and reports are maintained and referred to the Physician Advisor/ UM Director . Documents in platform/system of record. Utilizes designated software ... experience in a hospital or HMO setting. Preferred: Managed Care experience performing UM and CM at a medical group or management services organization.… more
- HCA Healthcare (Englewood, CO)
- …a team of daring managers who care without reservations or limits? Our Swedish Medical Center team is looking for a Manager for Case Management. HCA Healthcare is ... members over the course of three years. **Benefits** Swedish Medical Center, offers a total rewards package that supports...more. + Free counseling services and resources for emotional, physical and financial wellbeing + 401(k) Plan with a… more
- LA Care Health Plan (Los Angeles, CA)
- …cost cases and reports are maintained and referred to the Physician Advisor/ UM Director . Documents in platform/system of record. Utilizes designated software ... experience in a hospital or HMO setting . Preferred: Managed Care experience performing UM and CM at a medical group or management services organization.… more
- University of Miami (Miami, FL)
- …. The University of Miami is currently seeking a Supervisor, Medical Technologists to work at the UM Hospital in ... The incumbent will supervise laboratory personnel and schedules. The Supervisor, Medical Technologists will participate and assign weekly responsibilities to staff… more
- Fallon Health (Worcester, MA)
- …Operations, SE Senior Director of Nursing & Quality, and SE VP/ Medical Director , respectively, according to category (ie, Operations & Administration, ... encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status and other… more
- University of Miami (Miami, FL)
- …processes are in place. Assists the laboratory leadership and Medical Director to secure and maintain the physical facilities, equipment, and supplies, ... address client's needs and testing workflows. Assists the laboratory leadership and Medical Director to develop and implement training and supporting operational… more