- Henry Ford Health System (Clinton Township, MI)
- GENERAL SUMMARY: The Medical Director of Utilization Management shall have responsibility for the medical oversight of activities related to Henry ... REQUIRED: MD or DO. Two (2) years of physician advisor and/or utilization management experience. Medical Staff membership in good standing at Henry… more
- Elevance Health (Dearborn, MI)
- …responsibilities means that the medical director is directly involved in Utilization Management and Case Management . + Daily case reviews for both ... Director ** is responsible for serving as the Operational Medical Director for our care management...director provides clinical expertise in all aspects of utilization review and case management . Provides input… more
- Henry Ford Health System (Troy, MI)
- …manager to provide administrative, operational, and organizational support for the Utilization Management teams. PRINCIPLE DUTIES AND RESPONSIBILITIES: + ... authorization request review and present to the designated HAP Medical Director for approval or denial. +...and compliance with CMS and privacy policies. + Provides Utilization Management staff support and liaison support… more
- Molina Healthcare (Sterling Heights, MI)
- …, Group/IPA practice, capitation, HMO regulations, managed healthcare systems, quality improvement, medical utilization management , risk management , risk ... resource management . + Develops and implements a Utilization Management program and action plan, which...activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. +… more
- Sevita (Detroit, MI)
- …for infants, children, adolescents, Military Service Members and Veterans. **Operations Management Executive Director - State of MI** **Compensation: ... a team-based workplace that puts people first. As Executive Director of Operations Management , you will be...increase census, maintain occupancy, improve daily attendance, and maximize utilization . + Financial Management : + Oversee billing… more
- Molina Healthcare (Sterling Heights, MI)
- …, Group/IPA practice, capitation, HMO regulations, managed healthcare systems, quality improvement, medical utilization management , risk management , risk ... and chemical dependency services. Works closely with the Regional Medical Directors to standardized utilization management...**REQUIRED EXPERIENCE:** * 2 years previous experience as a Medical Director in clinical practice * 3… more
- Molina Healthcare (Sterling Heights, MI)
- …closely with regional medical directors to standardize behavioral health utilization management policies and procedures to improve quality outcomes and ... and clinical leadership for health plan and/or market specific utilization management and care management ...health portions of state contracts. * Assists behavioral health medical director lead trainers in the development… more
- Gentiva (Southfield, MI)
- …Transform Care through Compassionate Hospice Leadership.** We are seeking a dedicated Hospice Medical Director to join our leadership team and provide expert ... substances. + Hospice and Palliative Medicine board certification and/or Hospice Medical Director Certification Board certification preferred. + Current Medicare… more
- Elevance Health (Dearborn, MI)
- ** Medical Director Associate - CarelonRx** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person ... dispensing services to drive affordability and improve member outcomes. The ** Medical Director Associate- CarelonRx** supports pharmacy prior authorization… more
- Gentiva (Southfield, MI)
- …budgeting while driving branch revenue growth through census development, referral management , and efficient resource utilization + Maintain strong relationships ... exciting and rewarding opportunity for a RN Hospice Executive Director to join our leadership team. This role is...experience in hospice care, home health, or clinical operations management . If you're a natural leader who is passionate… more
- City of Detroit (Detroit, MI)
- Business Opportunity Director Print (https://www.governmentjobs.com/careers/detroit/jobs/newprint/5138487) Apply Business Opportunity Director Salary ... services, professional services, and construction. * Report on supplier diversity utilization , identification, and engagement of diverse vendors. * Partner with… more
- TEKsystems (Detroit, MI)
- TEKsystems is currently hiring for a Patient Access Director for a large hospital in Detroit, MI! **Please only apply if you have a Bachelor's degree, 4+ years of ... Director experience, and 2 years of experience managing multi-level...and accuracy - Adherence to process standards -Relative cost management metrics goals - Expense, cost, and margin control… more
- Arrow Electronics (Plymouth, MI)
- **Position:** Sales Engineering Director - Cloud, Data/AI **Job Description:** **The start date for this position is estimated to be in January 2026.** Arrow is ... seeking a Sales Engineering Director (SED) to provide strategy, technical direction and business...responsibility to, and tight alignment with, Sales and Supplier/Vendor Management . The SED will have leadership responsibility for the… more
- Erickson Living (Novi, MI)
- …and dehydration. + Participating in Wound Rounds, Operations Meetings, Utilization Review, and Performance Improvement/Risk Management /Safety (PI/RM/S) ... Erickson Senior Living Join our team as the Assistant Director of Nursing is responsible for clinical leadership and...which builds on our mission, vision and values + Medical , dental and vision packages, including an annual reimbursement… more
- Tenet Healthcare (Detroit, MI)
- Clinical Quality Improvement Director Full Time Days - 2506003005 Description : DMC Sinai-Grace Hospital is DMC's largest hospital, offering a comprehensive heart ... and in conjunction with the DMC Chief Quality and Medical Safety Officer, provides leadership for the development and...including at least one year of experience in the utilization of continuous improvement statistical methods and tools. 3.… more
- Henry Ford Health System (Troy, MI)
- …medical criteria for all prior authorizations within our system in partnership with our Medical Director . If you are computer savvy, have a strong work ethic ... of care requirements. + Coordinates peer-to-peer conversations with the Medical Director and provider at the time...the time of the denial and distributes to the Utilization Management Services staff for processing. +… 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 ... of care and cost effectiveness through the integration and functions of utilization management , and/or care coordination, discharge planning, and appropriate… more
- Select Medical (Mount Clemens, MI)
- … within the plan of care. + Demonstrates compliance with facility-wide Utilization Management policies and procedures. + Coordinates UR compliance with ... well by doing what is right. The Case Manager is responsible for utilization reviews and resource management , discharge planning, treatment plan management… more
- Select Medical (Pontiac, MI)
- … within the plan of care. + Demonstrates compliance with facility-wide Utilization Management policies and procedures. + Coordinates UR compliance with ... well by doing what is right. The Case Manager is responsible for utilization reviews and resource management , discharge planning, treatment plan management… more
- AmeriHealth Caritas (Southfield, MI)
- …leadership in medical management is required. Prior experience as a Medical Director or Chief Medical Officer within a managed care organization ... + Lead strategic direction and oversight of clinical programs, including care management , utilization management , and value-based care. + Play… more