- Commonwealth Care Alliance (Boston, MA)
- …and performance monitoring and - Leads the Utilization Management team in managing and continuously improving UM program design, policies, procedures, workflows, ... dental and other vendors to assure integration, oversight, and efficiency of UM processes and functions. - Ensures compliance with all contract requirements, state… more
- BlueCross BlueShield of Tennessee (Chattanooga, TN)
- …to ensure appropriate coordination of care\. + Seek the advice of the Medical Director when appropriate, according to policy\. + Assists non\-clinical staff ... for letters, retrospective claim review, special review requests, and UM pre\-certifications and appeals, utilizing medical appropriateness criteria,… 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
- Commonwealth Care Alliance (Boston, MA)
- …and performance monitoring and * Leads the Utilization Management team in managing and continuously improving UM program design, policies, procedures, workflows, ... dental and other vendors to assure integration, oversight, and efficiency of UM processes and functions. * Ensures compliance with all contract requirements, state… 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
- ChenMed (Margate, FL)
- …We're rapidly expanding and we need great people to join our team. The Medical Director , Center is specifically responsible for executing the ChenMed Way and ... assigned center. Under the direction of the Market Chief Medical Officer (MCMO), the Medical Director...assigned center, he/she will also assist the MCMO in managing day-to-day clinical and business operations and building positive… more
- University of Miami (Miami, FL)
- …institutions of higher education in the US for its academic excellence, superior medical care, and cutting-edge research. At the U, we are committed to attracting ... to create an environment where everyone contributes to making UM a great place to work. We are one...Overview:The Philanthropy Officer is responsible for planning, developing, and managing the fundraising strategies and initiatives to support the… 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
- 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
- Veterans Affairs, Veterans Health Administration (Miami, FL)
- Summary The Miami VA medical Center is looking for recruit for Registered Nurse - Utilization Management / Float who is responsible and accountable for all elements ... supervisors and is accountable to the Chief Nurse of Operations, Deputy Associate Director of Patient Care Services and ultimately the Associate Director of… 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
- University of Michigan (Ann Arbor, MI)
- …STU INSTR Apply Now **How to Apply** Interested applicants must submit through the UM Jobs portal (umjobs.org) as one document: their CV/resume and a cover letter ... Instructor (GSI) for ALA 211 Winter 2026 term. The GSI works with GSP's Director in order to provide high-quality instruction for this course. This is a limited… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …Social Work, Behavioral Health, Respiratory Therapy, Registered Dietitian, Registered Nurse, Medical Director , Pharmacist, Geriatrics, etc.) to ensure continuity ... policy and leadership, current NYS DOH, CMS regulations and standards if managing members of Medicare programs, and other regulatory requirements as applicable. +… more
- University of Michigan (Ann Arbor, MI)
- …care complexes in the world and has been the site of many groundbreaking medical and technological advancements since the opening of the U-M Medical School ... victor for the greater good. **What Benefits can you Look Forward to?** + Excellent medical , dental and vision coverage effective on your very first day + 2:1 Match… more
- Corewell Health (Royal Oak, MI)
- …status and level of care. Uses defined resources to guide decisions, including Medical Director Care Management, Physician Advisors, and management staff. 5. ... hospital outpatient, observation or inpatient services. 4. May review cases for medical necessity, uses InterQual and/or other UR/ UM Committee-approved … more
- University of Miami (Miami, FL)
- …to IRBs, sponsors and master agreements, and coordinates with the Research Program Director on remediation. + Coordinates the efforts of relevant team members to ... for clinical trial and research areas. + Provides consultation and guidance for UM held INDs and IDEs. + Develops, implements, maintains and oversees internal… more
