- Elevance Health (Las Vegas, NV)
- …+ New Jersey, Morristown **Description** **Clinical Operations Medical Director** ** Utilization Management of Medical Oncology Benefits** **Carelon Benefits ... Medical Director - Utilization Review** + Job Family: MED > Licensed Physician /Doctor/Dentist + Type: Full time + Date Posted:Apr 17, 2024 + Anticipated End… more
- Universal Health Services (Las Vegas, NV)
- …concurrent and retrospective review of inpatient medical records to evaluate the utilization and documentation of acute care services. The goal of concurrent review ... includes facilitation of appropriate physician documentation of care delivered to accurately reflect patient severity of illness and risk of mortality. Specific… more
- Elevance Health (Las Vegas, NV)
- …Develops and enhances relevant clinical guidelines. + Provides clinical leadership for Utilization Management , Case Management , Disease Management , ... Director - Surgery** + Job Family: MED > Licensed Physician /Doctor/Dentist + Type: Full time + Date Posted:Apr 17,...Business Strategy, Product Strategy. + Experience with Managed Care, Utilization Management , Prior Auth, and Benefits … more
- Elevance Health (Las Vegas, NV)
- …in an ambulatory or hospital setting or minimum of 1 year of prior utilization management , medical management and/or quality management , and/or ... state(s) required. **Preferred Skills, Capabilities, and Experiences:** + Familiarity with Utilization Management Guidelines, ICD-9 and CPT-4 coding, and managed… more
- Elevance Health (Las Vegas, NV)
- …in an ambulatory or hospital setting or minimum of 1 year of prior utilization management , medical management and/or quality management , and/or ... state(s) required. **Preferred Skills, Capabilities, and Experiences:** + Familiarity with Utilization Management Guidelines, ICD-10 + Previous utilization … more
- Elevance Health (Las Vegas, NV)
- …Develops and enhances relevant clinical guidelines. + Provides clinical leadership for Utilization Management , Case Management , Disease Management , ... Post Acute Solutions** + Job Family: MED > Licensed Physician /Doctor/Dentist + Type: Full time + Date Posted:Apr 08,...Business Strategy, Product Strategy. + Experience with Managed Care, Utilization Management , Prior Auth, and Benefits … more
- Elevance Health (Las Vegas, NV)
- …being performed. Preferred: -Leadership experience managing teams of physicians in a utilization management clinical operations business inside a health plan or ... **Senior Medical Director, Clinical UM Operations** + Job Family: MED > Licensed Physician /Doctor/Dentist + Type: Full time + Date Posted:Apr 16, 2024 + Anticipated… more
- Universal Health Services (Las Vegas, NV)
- …Our individualized treatment includes a structured, therapeutic environment, intensive physician involvement and oversight, and daily group and educational programs. ... and ambulatory care access points, an insurance offering, a physician network and various related services located in 37...daily census, etc. in conjunction with the CFO. + Lead and provide operational directives for all business office… more
- Elevance Health (Las Vegas, NV)
- …necessary. + Medical experience and Medical terminology preferred + Experience in a Utilization Management role. + Strong navigation skills + Independent thinker ... team to facilitate the administrative components of clinical referrals for case management or disease management services to include home health, nutritional… more
- Elevance Health (Las Vegas, NV)
- … physician , hospital and ancillary network contract negotiation strategies, utilization management efforts, new products, annual benefit design participation, ... negotiates for human capital resources, and partners with care management , claims, IT, and business partners. + Manages and...is designed to advance our strategy but will also lead to personal and professional growth for our associates.… more