- UM FDSP Associates PA (Baltimore, MD)
- SUMMARY: UM FDSP Associates is anon-profit affiliate of the University of Maryland School of Dentistry. UM FDSP Associates is the organization that provides ... winter break from Christmas Day through New Year's Day. Health Coverage : Medical , dental, and vision insurance, along with short-term and long-term disability, and… more
- CHPW (Seattle, WA)
- …against criteria utilized for medical review. Regularly communicates with the UM Manager, Medical Director , physician advisor/reviewer and primary care ... cases that do not meet medical necessity or criteria for medical director review. Communicate effectively with medical director regarding identified… more
- RIT Solutions, Inc. (New York, NY)
- …criteria, Interqual, Milliman, or Health Plan specific guidelines Collaborate with the Medical Director to ensure the integrity of adverse determination notices ... Job Title: UM Nurse (California License) - Must be licensed...recommendations. Role and Responsibilities Perform prospective, retrospective, or concurrent medical necessity reviews for an assigned panel of members… more
- Wellmark, Inc. (Des Moines, IA)
- …about our unique benefit offerings here. Job Description About the opportunity: As Senior Medical Director for Utilization Management ( UM ), you will be an ... Additional Information What you will do as a Sr Medical Director - Utilization Management: a. Demonstrate...UM process and outcomes in close partnership with Director , UM in Health Services. b. Demonstrate… more
- Inland Empire Health Plan (Rancho Cucamonga, CA)
- …and to pivot from a "job" opportunity to an authentic experience! The Medical Director of Behavioral Health is responsible for clinical oversight, clinical ... ( UM ), and grievance and appeals and committee participation. The Medical Director of Behavioral Health oversees the inpatient/concurrent review process,… more
- IPG Mediabrands (New York, NY)
- …globally on behalf of its clients across its full-service agency networks UM , Initiative and Mediahub and through its award-winning specialty business units Healix, ... Summary We are currently looking for someone to join our team as Associate Director , Global Operations. This role will partner closely with Client Ops & Business Ops… more
- IPG Mediabrands (New York, NY)
- …globally on behalf of its clients across its full-service agency networks UM , Initiative and Mediahub and through its award-winning specialty business units Healix, ... countries. Learn more at www.ipgmediabrands.com. Position Summary As Associate Director of Growth Analytics this role will be pivotal...DSPs (eg DBM) Strong MS Excel & PowerPoint skills UM does not require candidates to have a college… more
- CorrHealth (Fort Collins, CO)
- Director of Nursing Location: Fort Collins Schedule: Primarily M-F, with flexibility to support business needs Pay range: $110-114k/annually FT Benefits, including ... 75% Medical Insurance premium paid for you and your qualifying...you and your qualifying family members Position Overview The Director of Nursing is predominantly in charge of managing,… more
- PacificSource (Bend, OR)
- …Care Management and Utilization Management Manager, as needed. Work collaboratively with the UM Director and Manager Team to develop, implement, and oversee the ... - Friday 8:00am to 5:00pm Essential Responsibilities: Work closely with the HS Director and other HS Managers to facilitate the development and implementation of new… more
- Connecticut Children's (Hartford, CT)
- …under the guidance and support of the Manager of Case Management and Director of the Center. Provides leadership and direction around scheduling, supervision and ... criteria to screen for appropriateness of level of care based on medical record documentation. -9% Gathers clinical information to conduct continued stay utilization… more
- WELLSPACE HEALTH (Sacramento, CA)
- …Sacramento, CA Description Clinical Care Manager Department: Nexus Location: 164 Reports to: UM Director Status: Full-Time FLSA: Non-Exempt Pay Range: $101,100 - ... always been to offer a full range of quality medical care, dental care, mental health and behavioral health...certified by the Joint Commission as a Primary Care Medical Home and a Behavioral Health Home. Position Summary… more
- Blue Shield of California (Rancho Cordova, CA)
- …escalated calls. Serve as a liaison between the Clinical and Non-Clinical FEP UM and CM teams. Manage the development and implementation of processes involving ... least two (2) times per month (for roles below Director -level) or once per week (for Director -level...plan for periodic office visits. o For employees with medical conditions that may impact their ability to work… more
- Liberty Health (Wilmington, NC)
- …and other documents incoming and outgoing. Assist Utilization Management RNs and Director with projects as needed. Attend and contribute to all internal Utilization ... Management meetings Ability to be an interactive UM team member to ensure compliant execution of UM program Review admissions and service requests for the… more
- The University of Miami (Miami, FL)
- …Meets requirements of Clinical Trials Chemotherapy Nurse 50% Works closely with the medical director and the pediatric nursing director . Administers research ... clinic is well prepared consisting of all supplies and medical records (print and electronic) are up to date...Hospital Wide Magnet Accreditation vision and process. Compliance with UM , Hospital and department policies and procedures Other duties… more
- Iconma LLC (Syracuse, NY)
- …determine coverage under the member's benefit. Routes cases directly to the pharmacist/ medical director for final determination, as directed. Issues verbal and ... written member notification as required. Reviews and interprets prescription and medical benefit coverage across all lines of business including Medicare D to… more
- Copa Health (Magna, UT)
- …barriers to quality care and opportunities for improvement and reports them to the Director of Nursing. Participates in UM and QI activities as required. Reads ... for educational advancement. Affordable Health Care Plans : Choose from comprehensive Medical , Vision, and Dental plans. Flexible Spending Accounts : Utilize HSA,… more
- The University of Miami (Miami, FL)
- …position will serve as the SCCC Manager of research administration for the Director of the Sylvester Comprehensive Cancer Center, Dr. Stephen Nimer. This position ... procedures, and that technical/research personnel is informed of and comply with UM fiscal and personnel policies and procedures; maintains appropriate files and… more
- Tucson Medical Center (Tucson, AZ)
- SUMMARY : Under the direction of the Director of Professional Staff Services, the Utilization Manager acts as a liaison to hospital leadership, Case Management, ... This position is part of an interdisciplinary team consisting of the Director of Professional Staff Services and Utilization Management Physician Advisors that… more
- UnitedHealth Group (Syracuse, NY)
- …PCP, HBMC interdisciplinary teammates and consultants, and as needed, the health plan Medical Director and other health professionals, to develop and carry out ... Consults with hospital physicians following notification of member transfer Collaborates with UM staff and PCPs/facility staff to enable medical necessity… more
- CVS Health (Springfield, IL)
- …Michigan, Kansas and Oklahoma. Support for other regions may occasionally be required. The UM Medical Director will ensure timely and consistent responses to ... that primarily supports the Aetna Better Health Plan of Illinois. This UM (Utilization Management) Medical Director will be a "Work from Home" position… more
