- 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 ... an environment whereemployees can thrive both professionally and personally. Overview: UM FDSP Associates,P.A. is a non-profit affiliate corporation of the… more
- Wellmark, Inc. (Des Moines, IA)
- …unique benefit offerings here. Job Description About the opportunity: As Senior Medical Director for Utilization Management ( UM ), you will be an effective change ... and efficiency of UM process and outcomes in close partnership with Director , UM in Health Services. b. Demonstrate deep expertise in delivering UM … more
- RIT Solutions, Inc. (New York, NY)
- Job Title: UM Nurse (California License) - Must be licensed in California- Remote Opportunity Work Hrs : (8am - 5pm PDT) would like to include evening, weekend and ... Ready to Hire ASAP. JD: The role of the UM Nurse is to promote quality, cost-effective outcomes for...or Health Plan specific guidelines Collaborate with the Medical Director to ensure the integrity of adverse determination notices… 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
- 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 - ... $131,430/year EEO-1: Professional Organization Information WellSpace Health believes that everyone deserves to be seen, no matter who you are, where you come from, where you work or what place you call home. We see you and are here for you. To that end, we've… 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
- Inland Empire Health Plan (Rancho Cucamonga, CA)
- …pivot from a "job" opportunity to an authentic experience! The Medical Director of Behavioral Health is responsible for clinical oversight, clinical leadership, and ... but are not limited to, case management, quality management, utilization management ( UM ), and grievance and appeals and committee participation. The Medical … 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
- CHPW (Seattle, WA)
- …case 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 variances… 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 ... you and your qualifying family members Position Overview The Director of Nursing is predominantly in charge of managing,...treatment is completed ✓ Monitors inmate hospitalization closely with UM management to ensure early release when possible ✓… more
- The University of Miami (Coral Gables, FL)
- …tickets, social media graphics, website graphics, and large scale environmental branding. The Director of Graphic Design will also work closely with other members of ... with all internal and external stakeholders. Collaborate with other departments within UM Athletics and Legends Sports Properties to help them leverage graphics 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 ... and follows all policies and procedures. Performs specialized duties as required by unique clinical situations or treatment populations consistent with nursing licensure and scope of practice. Ensures compliance & adequate services for all members served.… more
- White Plains Hospital - WH (White Plains, NY)
- …skills and expertise needed to manage the department, in conjunction with the UM manager and department director . Participates in and ensures department ... variances on a monthly basis, as required by the department director . Assures compliance with state regulations and accreditation standards. Ensures completion… 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 team member to ensure compliant execution of UM program Review admissions and service requests for the… 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...below Director -level) or once per week (for Director -level roles and above).Exceptions: o Member-facing and approved out-of-state… 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
- The University of Miami (Miami, FL)
- …of Clinical Trials Chemotherapy Nurse 50% Works closely with the medical director and the pediatric nursing director . Administers research study agents, ... in the Hospital Wide Magnet Accreditation vision and process. Compliance with UM , Hospital and department policies and procedures Other duties as assigned, such… 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 ... rapidly changing regulatory environment. Lead will provide support to the hospital's UM Committee as needed and collaborate with multiple leaders at various levels… more
- Iconma LLC (Syracuse, NY)
- …coverage under the member's benefit. Routes cases directly to the pharmacist/medical director for final determination, as directed. Issues verbal and written member ... Provides phone coverage for incoming calls as required to support the UM process. This may include authorization inquiries and information requests, claim inquiries,… 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
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