- 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
- 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
- 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, ... than 130 countries. Learn more at www.ipgmediabrands.com. Position Summary As Associate Director of Growth Analytics this role will be pivotal in managing… more
- Liberty Health (Wilmington, NC)
- …queues, 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… more
- CHPW (Seattle, WA)
- …against criteria utilized for medical review. Regularly communicates with the UM Manager, Medical Director , physician advisor/reviewer and primary care ... care team, the patient, the patient's family, co-workers, and internal and external customers to achieve optimal patient outcomes....not meet medical necessity or criteria for medical director review. Communicate effectively with … 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 ... the success of the PacificSource Care Management program development and performance internal measures as well as those established by regulatory entities. Qualified… 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
- The University of Miami (Miami, FL)
- …the University of Miami, please click here to log in to Workday to use the internal application process. To learn how to apply for a faculty or staff position using ... position will serve as the SCCC Manager of research administration for the Director of the Sylvester Comprehensive Cancer Center, Dr. Stephen Nimer. This position… 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 ... here to log in to Workday to use the internal application process. To learn how to apply for...clinic is well prepared consisting of all supplies and medical records (print and electronic) are up to date… more
- Blue Shield of California (Rancho Cordova, CA)
- …you will: Direct department specific programs/projects that may involve multiple internal stakeholders across multiple lines of business, sharing best practices with ... 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… 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 ... Opportunities : Thrive with us through diverse career paths and internal development programs. Career Development : Access ongoing training and development… more
- University of Miami (Miami, FL)
- …abdominal organs in approximately 50% of cases. + In conjunction with the Medical Director assumes ultimate responsibility for donor management and the process ... the LAORA electronic medical record. + Shares on-call responsibility with Medical Director to oversee clinical evaluation and management of potential organ… more
- Excellus BlueCross BlueShield (Buffalo, NY)
- …the Quality Management/Utilization Management (QM/ UM ) Plan, including having the BH Medical Director for Children's Services and participate on the BH ... of the Children's Behavioral Health (BH) Carve-In program. The Medical Director for BH Children's Services has...clinical setting). + A minimum of ten (10) years medical experience and strong working knowledge of QM/ UM… more
- Sharp HealthCare (San Diego, CA)
- …the position, and employer business practices. **What You Will Do** This Senior Medical Director position provides critical management and oversight for Sharp ... Officer. **Required Qualifications** + Doctor of Medicine (MD) - Internal Medicine or Family Practice + **OR** Doctor of...+ 5 years' experience as an HMO Health Plan Medical Director . + California Physicians and Surgeons… more
- UPMC (Pittsburgh, PA)
- The Regional Medical Director , CC/DP and Utilization Review, provides clinical and management leadership across multiple hospitals within the region. This role ... utilization, and length of stay (LOS) strategic oversight. The Medical Director will report to the Vice...Collaboration + Serve as a liaison and consultant for internal UM functions, promoting effective communication and… 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 ... supports the Aetna Better Health Plan of Illinois. This UM (Utilization Management) Medical Director ...care experience - Board certification in Family Medicine or Internal Medicine / Pediatrics - Prior UM … 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
- University of Maryland, Baltimore (Baltimore, MD)
- …Professor level (non-tenure track) to join our dynamic team and serve as Medical Director of our vibrant community-based academic radiation oncology practice at ... **Faculty* **Organization:** **School of Medicine - Clinical Departments* **Title:** * Medical Director Assistant/Associate Professor Community-Based Physician Faculty*… more
