- Yale New Haven Health (Norwalk, CT)
- …+ Memorial, and Westerly hospitals; several specialty networks; and Northeast Medical Group, a physician-led multi-specialty group with over 1,000 physician. ... with anesthesiologists, surgeons and other physicians to deliver anesthesia for medical and surgical procedures. Cultivates a patient centric environment which… more
- Whidbey General Hospital (Coupeville, WA)
- …quality initiatives in order to insure high quality and safe patient outcomes. The Director will work with medical staff and hospital leadership to insure ... Director Surgical Services POSITION SUMMARY The Director...be expected to work with both hospital staff and medical staff to insure compliance with evidence-based policies and… more
- Luminis Health (Annapolis, MD)
- Luminis Health: Anne Arundel Medical Center Title: Team Leader RN - Cardiac OR Reports to: Clinical Nursing Director of the Operating Room and Surgeon Leader ... Collaborate with the Surgeons, Charge Capture Coordinator, the Clinical Nursing Director , the Surgical Services Business Manager, Central Sterile Services leadership… more
- Conifer Revenue Cycle Solutions (Detroit, MI)
- …process quality and accuracy adherence to process standards Relative cost management metrics goals expense, cost, and margin control monthly, quarterly, and ... annual financial goal management ESSENTIAL DUTIES AND RESPONSIBILITIES Include the following. Others...of hospital budgets and ensures and manages human resource utilization at all levels. Analyzes monthly P & L's… more
- Fresenius Medical Care (Fitchburg, WI)
- …Facilitates the application process for physician privileges and compliance with FMS Medical Staff By-Laws. Responsible for strong Director and physician ... communicated to and implemented by the facility staff. Maintains integrity of medical records and other FMS administrative and operational records. Complies with all… more
- University of New Mexico - Hospitals (Rio Rancho, NM)
- …- Organize and direct clinical practice in collaboration with the program medical director through development, implementation and maintenance of practice ... UTILIZATION - Facilitate between hospital/system administration, departments, and medical staff ensuring cost-effective utilization of products, services,… more
- Fresenius Medical Care (Greensboro, NC)
- About this role: As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical operations. As ... advance your career into an Area Team Lead or Director of Operations role. Our culture: We believe our...a tremendous asset that sets us apart. At Fresenius Medical Care, you will truly make a difference in… more
- University of New Mexico - Hospitals (Albuquerque, NM)
- …and facilitate communication, problem solving, decision-making, crisis intervention, resource utilization , and conflict management * SUPERVISION - Develop ... objectives, and operating policies and procedures; follow up with Director on any concerns * LIAISON - Act as...emergency measures for sudden, adverse developments in patients * MEDICAL RECORDS - Ensure that patient medical … more
- UPMC (Pittsburgh, PA)
- The UPMC Health Plan is seeking a licensed MD or DO for a fully remote Medical Director , Utilization Management role. The Medical Director , ... full remote role._ Responsibilities: + Actively participates in the daily utilization management and quality improvement review processes, including concurrent,… more
- Elevance Health (Durham, NC)
- ** Utilization Management Medical Director - NC Medicaid** Location: This role enables associates to work virtually full-time, with the exception of ... Alternate locations may be considered. The ** Medical Director ** will be responsible for utilization review case management for North Carolina Medicaid.… more
- Wellpath (Lemoyne, PA)
- …and point of care support. **How you make a difference** The Medical Director of Utilization Management leads and oversees utilization review, ... appropriate utilization of medical services. The Medical Director of Utilization Management serves as a key liaison with external partners and… more
- Humana (Indianapolis, IN)
- … Medical Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of the care received by members in the ... caring community and help us put health first** The Medical Director relies on medical ...healthcare providers, clinical group practice management . + Utilization management experience in a medical… more
- Humana (Little Rock, AR)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an ... caring community and help us put health first** The Medical Director relies on medical ...healthcare providers, clinical group practice management . + Utilization management experience in a medical… more
- CVS Health (Springfield, IL)
- …Management in support of Key Clients as assigned. The Medical Director transacts Utilization Management UM activities (prior authorization and ... Fortune 6 company, has an outstanding opportunity for a Medical Director - Medical Affairs...commercial client program support. Will share in reviews of utilization management (PA) criteria and clinical policy… more
- Dignity Health (Bakersfield, CA)
- …remote patient monitoring, and CRM. - Provide backup support to the Medical Director of Utilization Management in medical review activities, ... offices primarily in the Bakersfield/Central CA region.** **Position Summary:** The Medical Director of Physician Engagement is responsible for developing… more
- Dignity Health (Bakersfield, CA)
- …the managed care populations. This leader will have direct oversight of the Medical Director of Utilization Management (UM) and the Medical ... Relations, Customer Service, and Clinical Oversight functions. + Oversee and manage the medical director capacity to support Managed Care Services and approve… more
- LA Care Health Plan (Los Angeles, CA)
- …vs. observation) admission in the acute setting. Works with UM leadership, including the Utilization Management Medical Director , on requests where ... Utilization Management Admissions Liaison RN II...clinical data presented and established criteria/guidelines, escalating to the medical director if needed. Triages and assesses… more
- CenterWell (Boston, MA)
- …**Additional Information** Will report to the Director of Physician Strategy at Utilization Management . The Medical Director conducts Utilization ... **Become a part of our caring community and help us put health first** The Medical Director , Primary Care relies on medical background and reviews health… more
- UNC Health Care (Morrisville, NC)
- …and well-being of the unique communities we serve. **Summary** : The **Executive System Director of Utilization Management (UM)** is a strategic and ... Executive Director works closely with leaders from various departments-case management , physician advisors, revenue cycle, medical staff, nursing, and… more
- Integra Partners (Troy, MI)
- …as operational needs require. The Senior MD provides clinical oversight to the Utilization Review Medical Director (s), ensures consistent application of ... representing Integra's clinical position to internal and external stakeholders. The Senior Utilization Review Medical Director 's responsibilities include but… more
