- IPG Mediabrands (Los Angeles, CA)
- …are looking for a people-first organization that can offer you the career you crave, UM is your home. We are the destination of choice for the world's best talent, ... are hungry for personal growth and continuous learning. People who thrive at UM are collaborators by nature who pursue diverse perspectives because they understand… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …you see is right for you, we encourage you to apply! Job Description: The Medical Director participates in the broad array of activities of the Medical ... reviews and may require peer-to-peer discussions with providers regarding UM case review determinations. + Provides clinical expertise on...and medical criteria. + Assists with training medical director colleagues and nursing staff ,… more
- CVS Health (Phoenix, AZ)
- …it all with heart, each and every day. **Position Summary** The Radiation Oncology Medical Director supports the CVS Health Specialty oncology business in ... managing oncology specific utilization of providers, clinical reviews of...and assist with growing our oncology footprint. In the Medical Director role, you will provide oversight… more
- BlueCross BlueShield of Tennessee (Chattanooga, TN)
- …is preferred but not required\. In addition to the job responsibilities below, this Medical Director will be responsible for: + Medical necessity reviews ... **Join Our Team as a Medical Review Director \- Behavioral Health\!** Are...physician review to ensure timeliness, accuracy and reliability of UM and Appeals reviews\. + Lead and serve on… more
- Alameda Health System (Oakland, CA)
- Director , Utilization Management + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day + Nursing + Req #:40826-30155 + FTE:1 + ... time off plans **Role Overview:** Alameda Health System is hiring! The Director of Utilization Management holds a critical role encompassing operational oversight,… more
- University of Miami (Coral Gables, FL)
- …this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The Executive Director of the Office of Research Administration ... and management of ORA's mission for the Coral Gables, Rosenstiel, and Medical Campuses for Pre-award, Post-award, and the Strategic Initiatives divisions. The… more
- Dignity Health (Bakersfield, CA)
- **Responsibilities** This position is remote.** **Position Summary:** The Director of Provider Contracting is a key executive leader responsible for the strategic ... Physician Association (IPA) network. This leader oversees a high-performing team managing the full contract lifecycle for physicians, facilities, and ancillary… more
- Catholic Health Services (Melville, NY)
- …the monthly Physician Advisor meeting. Attends hospital Utilization Management ( UM ) committees. Supervises the Facility Physician Advisors. Observes Catholic Health ... Physician Advisor meeting. 3. Training and Education Responsible for hiring and managing Physician Advisors, along with developing and monitoring compliance with an… more
- Molina Healthcare (St. Petersburg, FL)
- …performance metrics in line with state and federal regulations. Responsible for managing the Appeals and Grievance department inventories within the key performance ... * Coordinates with Customer/Member services, Provider Services, Sales, Enrollment, UM , Case Management, Claims, and other departments within Molina Medicare… more
- Elevance Health (Wallingford, CT)
- …will be directly responsible for Behavioral Health Utilization Management (BH UM ) only The **Manager Behavioral Health Services** is responsible for Behavioral ... Health Utilization Management (BH UM ), or Behavioral Health Case Management (BH CM) or...make an impact:** + Serves as a resource for medical management programs. Identifies and recommends revisions to policies/procedures.… more
- Sharp HealthCare (San Diego, CA)
- …operational planning consistent with existing policies and/or principles. Responsible for managing medical management activities to include tracking, trending ... and analyzing UM data. Works in collaboration with regional ...of the manager of in-patient care management and the Director of Utilization Management. **Required Qualifications** + 3 Years… more
- Commonwealth Care Alliance (Boston, MA)
- …with all regulatory, contract and NCQA requirements. + Together with the Director of UM and Sr. Medical Director of medical policy, manage the ... The Manager, Medical Policy reports to the Director of UM , and manages the personnel...team directly through specialized exempt and/or non-exempt employees; developingand managing budgets, schedules, and performance for the MP team… more
- University of Miami (Miami, FL)
- …sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The University of Miami/UHealth Medical Training Lab at the Gordon Center is ... currently seeking a full time Nurse Educator - Medical Simulation and Education Lab to work in Miami,...per year. Training programs include curricula developed by the UM Gordon Center, and other organizations, such as the… more
- Beth Israel Lahey Health (Burlington, MA)
- …patients admitted to the Clinic Attending Physicians: Coordinates appropriate documentation Medical Director for /Managed Care, Physician Advisors Works ... making a difference in people's lives.** Manages the Utilization Management ( UM ) team, maintaining effective and efficient processes for determining appropriate… more
- Houston Methodist (Sugar Land, TX)
- …assurance and quality improvement processes related to admission, concurrent and retrospective UM and medical claims programs. Collaborates with medical ... other areas according to department specifications. + Manages utilization management ( UM ) programs including Medical Claims Review, Precertification and… 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)
- NURSING SUPERVISOR ( Medical Short Stay Units) Apply Now **Job Summary** This position works with patients and staff in the Medical Short Stay Units. Patients in ... Medical Short Stay Units mainly originate from the Emergency Department. The Medical Short Stay Units also provide care to Palliative Care patients. Patients in… more
- Commonwealth Care Alliance (Boston, MA)
- … staff, including nurse reviewers and support personnel. * Act as liaison with medical director , provider relations, case management and quality teams to support ... Management (Authorization) Unit is primarily responsible for the evaluation of the medical necessity, appropriateness, and efficiency of the use of health care… more
- LifePoint Health (Hickory, NC)
- …organizational objectives and will take the lead in the absence of the Director . Accountable for the execution, adaptation, and outcome of care management as ... described in the initial UM plan with regard to resources, appropriateness of care...designated GMLOS for each patient. COMPANY DESCRIPTION Frye Regional Medical Center, located in the beautiful foothills of North… more
- University of Miami (Miami, FL)
- …the program's overall success. + Serves as a liaison between the Program Director (s), administrative leadership, UM /JMH Graduate Medical Education (GME) ... The incumbent oversees and coordinates the daily operations of assigned medical residency or fellowship program(s). The GME Program Administrator (A) supports… more
