- NorthBay Health (Fairfield, CA)
- At NorthBay Health this Director provides oversight for all aspects of Care Management and Population Health which includes: Utilization Management, Utilization ... Denial Management, and Social Services for the NorthBay Healthcare Group. This director will collaborate with Quality and Operations leadership to support key… more
- Elevance Health (Columbus, OH)
- …Carelon Medical Benefits Management Clinical Operations team is looking to hire a ** Managing Medical Director ** to manage a team of physicians performing ... for our Musculoskeletal (MSK) Solution. (internal title: Manager Clinical Operations Medical Director ) Responsible for providing day-to-day guidance, support,… more
- Sharp HealthCare (San Diego, CA)
- …to the processing of the referral.Consults with supervisor, team lead and/or medical director to discuss requests/care inconsistent to criteria and determine ... 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
- Baylor Scott & White Health (Temple, TX)
- …plan and network managed care performance. + Partner with Provider Networks and Medical Director team in creating and maintaining programs that incentivize ... **JOB SUMMARY** Accountable for managing Health Plan medical costs and...interface with providers, staff, and management. + Knowledge of medical , quality improvement and UM practices in… more
- University of Miami (Coral Gables, FL)
- …anti-melt efforts, course registration, retention, and persistence initiatives. + Assists Director in managing all summer anti-melt efforts including the ... . The University of Miami has a great opportunity for an Assistant Director , Academic Advising to work at the Coral Gables Campus. The Assistant … more
- YesCare Corp (Cumberland, MD)
- …disabled Veteran status. EOE including Disability/Protected Veterans._ **Responsibilities** Regional Medical Director (RMD) is primarily accountable for quality ... is a list of your responsibilities as a **Regional Medical Director ** **(RMD)** with YesCare: **Administrative:** +...safety and chart and site audits. + Adherence to UM programs specific to the contract requirements and corporate's… more
- ChenMed (Louisville, KY)
- …for the foundational business unit of our care model - the center. The Senior Medical Director (SMD) will partner with the Center Director /Center Executive ... The SMD is an earned title where the Center Medical Director completes all necessary primary care...Center Manager/Center General Manager to co-lead center stand-ups. + Managing , mentoring and coaching PCPs in his/her assigned center… 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
- 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, industry benchmarks, demonstrated regulatory requirement experience and medical necessity criteria. The role requires the ability to… more
- University of Miami (Coral Gables, FL)
- …tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The Assistant Director , Student Retention works with undergraduate ... for positively impacting the University's retention and graduation rates by managing programs and services designed to increase student persistence to graduation,… more
- University of Miami (Coral Gables, FL)
- …as well as the planning and implementation of giving across priorities for UM Athletics. Assists the Associate Athletic Director for Development with other ... please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The Development Director will serve as an ambassador of University of… more
- University of Michigan (Ann Arbor, MI)
- …Global REACH initiatives as needed. This may include representing the Asia Program Director to UM community and international partners, supporting other student ... approaches to improving global health 2. To create partnerships that allow our medical school community to collaborate synergistically to improve global health 3. To… more
- University of Miami (Miami, FL)
- …Florida Academic Repository (FLARE). The Louis Calder Memorial Library is located on the UM medical campus near downtown Miami, approximately 8 miles from Coral ... Services of the Louis Calder Memorial Library on the University of Miami ( UM ) Medical Campus, the CDAL Librarian is responsible for identifying, evaluating,… more
- University of Miami (Miami, FL)
- …inquiries. Prepares, maintains, and reports on program effectiveness. Assists with managing program budget by monitoring expenditures. Stays abreast of market trends ... both online and residential, reports directly to the Associate Dean and inaugural director of online MPH, and offers administrative support for the design and… more
- University of Michigan (Ann Arbor, MI)
- …and Training (OPSET). The main focus of OPSET is the Michigan Medical Scientist Training Program (MSTP). The MSTP provides administrative and student services ... supporting current and prospective students, and partnering with the Office of Medical Student Education, Office of Graduate and Postdoctoral Studies, and Rackham… more
- LA Care Health Plan (Los Angeles, CA)
- …Managed Long Term Supportive Services (MLTSS) teams alongside a clinical dyad partner (Senior Medical Director II). The role extends to all lines of business ... outcomes for its members. This individual reports directly to the Chief Medical Officer (CMO) and is responsible for operational and administrative management of… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …senior leaders for decision making + Apply their clinical knowledge when assessing/auditing medical records and UM letters against medical necessity criteria ... and scope projects; keep project leads, senior consultants, and Director informed of key issues/ risks and meet deadlines...of key issues/ risks and meet deadlines by tightly managing deliverables, coordinating input from leaders, and ensuring all… more
- Fallon Health (Worcester, MA)
- …Operations, SE Senior Director of Nursing & Quality, and SE VP/ Medical Director , respectively, according to category (ie, Operations & Administration, ... works closely with their counterpart to assist the Senior Director , PACE Operations to manage the program level operational...**Is responsible for ensuring accurate payment of the PACE medical claims** : + Responsible for managing … more
- Sharp HealthCare (San Diego, CA)
- …for operational planning consistent with existing policies and/or principles and managing Population Health medical management activities to include tracking, ... new programs under the direction of the Manager of Disease Management and Director of Population Health. Collaborates with the Continuum of Care departments to… more
- University of Miami (Coral Gables, FL)
- …. Under the general direction of the Counseling Center Director and Associate Director for Clinical Services, this ... and weekends are required. Through coordination with the Associate Director and Director , a portion of this...of referral resources and community services. + Collaborate with UM Counseling Center "UMCC" staff, community providers and other… more
