- Universal Health Services (Memphis, TN)
- …and love what you do! We are currently hiring a full time Director of Utilization Management ( UM ) for Compass Intervention Center! The UM Director ... with the medical staff, management team and all other departments. The UM Director performs other duties as assigned. Compass Intervention Center is a… more
- CVS Health (Springfield, IL)
- … in support of Key Clients as assigned.The Medical Director transacts Utilization Management UM activities (prior authorization and appeals) and responds ... support of Key Clients as assigned.The Medical Director transacts Utilization Management UM activities (prior authorization and appeals) and responds to… more
- Prime Healthcare (Ontario, CA)
- …Responsibilities The Corporate Director of Clinical Utilization Management ( UM ) provides comprehensive ... 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)
- …assistance, 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… more
- Sharp HealthCare (San Diego, CA)
- …+ Knowledge of medical terminology, healthcare finances, alternative care options, utilization management , health plan criteria, established criteria such as ... requirements for the position, and employer business practices. **What You Will Do** The UM Resource Coord-SCMG serves as a resource to the various teams in the SCMG… more
- Elevance Health (Columbus, OH)
- …being performed. Preferred: -Leadership experience managing teams of physicians in a utilization management clinical operations business inside a health plan or ... Operations team is looking to hire a **Managing Medical Director ** to manage a team of physicians performing clinical...a UM /benefits ...a UM /benefits management firm. -Proven experience leading change management … more
- Elevance Health (Grand Prairie, TX)
- …clinical program and/or independently performs clinical reviews. + The Medical Director typically has program management responsibilities including clinical ... of one of our Elevance Health locations.** The Medical Director is responsible for the administration of physical and/or...state or territory of the United States when conducting utilization review or an appeals consideration and cannot be… more
- YesCare Corp (Brentwood, TN)
- …issues relating to the outpatient/inpatient UM process to the Manager of Utilization Management . + Assist with the data collection and reporting related to ... **Experience & Requirements** + Experience Level: 3 - 5 year's experience in utilization management , case management , quality management . Experience with… more
- Sharp HealthCare (San Diego, CA)
- …skills in area of expertise. + Proficient knowledge and understanding of utilization management , transition planning, alternative options, goals and outcomes, ... End Time** Accredited Case Manager (ACM) - American Case Management Association (ACMA); California Registered Nurse (RN) - CA...governing our division. This position works with the System Director and Vice President of ICM to identify areas… more
- Providence (Seattle, WA)
- **Description** **THE ROLE** The Senior Director Utilization Management & Denials - Administration is 100% remote. The role requires a broad knowledge and ... focus on Utilization Management and Denials principles such as...requires the ability to consistently lead, support, and coach UM /UR staff and leaders. The position requires excellent interpersonal… more
- LA Care Health Plan (Los Angeles, CA)
- …the safety net required to achieve that purpose. Job Summary The Supervisor of Utilization Management ( UM ) RN is responsible for executing the day-to-day ... Supervisor, Utilization Management RN (Outpatient) Job Category:...LA Care's culturally diverse membership. The position supports the UM Manager/ Director . This role also assists … more
- Universal Health Services (Bradenton, FL)
- Responsibilities Palm Shores Behavioral Health is currently seeking a Director of Admissions and Utilization Management Palm Shores Behavioral Health Center ... a proud provider of the Patriot Support Program. The Director of Admissions/ Utilization Management is...is responsible for the hiring and development of the UM Coordinator and the Admission Coordinator positions. This position… more
- Guthrie (Sayre, PA)
- Position Summary: The Utilization Management ( UM ) Reviewer, in collaboration with other internal and external offices, payors, and providers and staff, is ... responsible for the coordinates Utilization Management ( UM ) processes and...the hospital Business Office, physician offices, Care Coordination, Medical Director and other hospital departments as appropriate. a) Serves… 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 ... the relationship between the Pre-Authorization team and the Medical Director and Physician Reviewers. - Tracks cost savings from...clinical experience required. - Three to five (3-5) years Utilization Management ( UM ) experience required.… more
- LA Care Health Plan (Los Angeles, CA)
- …admission in the acute setting. Works with UM leadership, including the Utilization Management Medical Director , on requests where determination requires ... and to support the safety net required to achieve that purpose. Job Summary The Utilization Management ( UM ) Admissions Liaison RN II is primarily responsible… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position ... net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II will...and reports are maintained and referred to the Physician Advisor/ UM Director . Documents in platform/system of record.… more
- Commonwealth Care Alliance (Boston, MA)
- …management and leadership with the development, refinement and enhancement of utilization management workflows, policies and procedures. + Participate in ... Us:** Supervisor & The Team Leader reports to the UM Manager. The Team Leader provides management ,oversight...Leader works in close collaboration with the manager and Director of the UM team. **What You'll… more
- Dignity Health (Rancho Cordova, CA)
- …This position will involve rotating Saturday coverage.** **Position Summary:** The Manager of Utilization Management ( UM ) is responsible for managing the day ... to day operation of Utilization Management Department and Prior Authorization (PA)...Additionally, the Manager will work in conjunction with the Director of UM on a variety of… more
- Immigration and Customs Enforcement (IN)
- …and external stakeholders (eg, Customs and Border Patrol, Veterans Affairs) regarding utilization management ( UM ) processes, trainings, and principles to ... Director for Healthcare Compliance, Office of Health Plan Management . The Senior Utilization Review Consultant will...related issues c. Collection, review, tracking, and reporting of UM related data on a local, regional, and national… more
- Billings Clinic (Billings, MT)
- …leadership and Physician Advisor, per department process or procedure *Insurance and Utilization Management *Maintains working knowledge of CMS requirements and ... prior to starting. Click here (https://billingsclinic.csod.com/ats/careersite/search.aspx?site=15&c=billingsclinic) to learn more! Utilization Review RN CARE MANAGEMENT (Billings Clinic… more