- Humana (Nashville, TN)
- **Become a part of our caring community and help us put health first** The Utilization Management (UM) Director , Clinical Strategy and Practice for Medicaid ... of how organization capabilities interrelate across the function or segment. The Utilization Management (UM) Director , Clinical Strategy and Practice… more
- Ascension Health (Nashville, TN)
- …TN market. Must be located with in the TN market. We're looking for an experienced Director of Utilization Management to join our team! In this pivotal role, ... **Details** + **Department:** Utilization Management + **Schedule:** Monday -... to optimize patient care and partner with the National Senior Director of UM to align… more
- Zurich NA (Nashville, TN)
- …+ Experience in development and implementation of cost containment programs + Case management , utilization review, catastrophic or disability experience + 5 or ... AVP, Utilization Review & Pharmacy 123092 Zurich Insurance is...recruiting and retaining team members. + Drive the performance management process by communicating job expectations, monitoring and evaluating… more
- Humana (Nashville, TN)
- …to the Lead Medical Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....with prior experience participating in teams focusing on quality management , utilization management , case … more
- Evolent (Nashville, TN)
- …classes as needed for new hires to educate and train on Utilization management system and Field Medical Director process, standards and resources. + Acts as ... for the culture. **What You'll Be Doing:** The Medical Director for MSK Surgery is a key member of...reviews appeal cases and/or attends hearings for discussion of utilization management decisions. + Strong partnership with… more
- Evolent (Nashville, TN)
- …impact on patient care in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your ... Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. +… more
- Humana (Nashville, TN)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....with prior experience participating in teams focusing on quality management , utilization management , case … more
- Humana (Nashville, TN)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....with prior experience participating in teams focusing on quality management , utilization management , case … more
- Humana (Nashville, TN)
- …Medical Director , depending on size of team or line of business. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on...with prior experience participating in teams focusing on quality management , utilization management , case … more
- Evolent (Nashville, TN)
- …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + ... you will be a key member of the utilization management team. We can offer you... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National … more
- Evolent (Nashville, TN)
- …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + ... you will be a key member of the utilization management team. We can offer you... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National … more
- United Therapeutics (Nashville, TN)
- …is innovative and inspiring where you can truly make a difference. The Regional Field Director , RNS Program Management serves as a director of all clinical ... the commercial non-promotional team. In addition, the Regional Field Director , RNS Program Management will: + Serve...initiation of a UT product, adverse effect mitigation, device utilization , and dosing upon request + Support the Clinical… more
- Humana (Nashville, TN)
- …interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , discharge ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a… more
- Evolent (Nashville, TN)
- …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + ... Rehab you will be a key member of the utilization management team. We can offer you... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National … more
- Evolent (Nashville, TN)
- …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. . ... Oncology, you will be a key member of the utilization management team. We can offer you... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National … more
- HCA Healthcare (Nashville, TN)
- …departments to include management and coordination of clinical activities, fiscal management , and quality patient care. The Director shall assume overall ... perform all job duties and tasks in accordance with national and state professional governing guidelines and state practice...of Tennessee preferred. + 3-5 years of previous healthcare management experience at an Assistant Director level,… more
- HCA Healthcare (Nashville, TN)
- …purpose and integrity. We care like family! Jump-start your career as a(an) Director of Supply Chain today with TriStar Skyline Medical Center. **Benefits** TriStar ... vary by location._** Come join our team as a(an) Director of Supply Chain. We care for our community!...Service Center and the facility. Your functions include inventory management , vendor relationship management , and managing supply… more
- Community Health Systems (Clarksville, TN)
- As the Director of the Laboratory at Tennova Healthcare - Clarksville, you will be instrumental in delivering exceptional care to our patients. We offer our ... smooth transition. Join us in making a difference. **Job Summary** The Director , Laboratory oversees a wide variety of administrative, fiscal, and technical… more
- Evolent (Nashville, TN)
- …leadership is preferred. + Familiarity with value-based care models and utilization management frameworks is preferred. **Technical Requirements:** We require ... of our specialty programs and administrative platform. **Role Overview** The Associate Director role on Client Analytics will support both internal teams (EAS,… more
- Elevance Health (Nashville, TN)
- …preferred. + Extensive orthopedic surgery experience preferred. + Experience with utilization management , especially with CMS guidelines preferred. For ... **Clinical Operations Associate Medical Director ** **Orthopedic Surgery** **Virtual** : This role enables associates to work virtually full-time, with the exception… more