- Conifer Revenue Cycle Solutions (Detroit, MI)
- …process quality and accuracy adherence to process standards Relative cost management metrics goals expense, cost, and margin control monthly, quarterly, and ... annual financial goal management ESSENTIAL DUTIES AND RESPONSIBILITIES Include the following. Others...of hospital budgets and ensures and manages human resource utilization at all levels. Analyzes monthly P planning, assigning… more
- 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
- Integra Partners (Troy, MI)
- The UM Coordinator assists and supports the clinical team (UM Nurses/ Medical Director ) with administrative and non-clinical tasks related to processing ... Utilization Management prior authorization sand appeals. JOB...with authorization requests + Contact requesting providers to obtain medical records or other necessary documentation related to specific… 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)
- …of health care services provided to plan members. * Supports plan utilization management program and accompanying action plan(s), which includes strategies ... the most appropriate care at the most effective setting. *Evaluates effectiveness of utilization management (UM) practices - actively monitoring for over and… 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)
- …need. * Offers a positive leadership role in key segment/product medical management initiatives aimed a optimizing utilization of medical resources. * ... and at least 2 years as a medical director in managed care organization supporting utilization management /quality program management , or equivalent… 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
- 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
- Molina Healthcare (Sterling Heights, MI)
- …with operational management to identify saving opportunities and areas of medical utilization concerns. + Provide support to financial closing process ... early signs of trends or other issues related to medical care cost. + Design and perform actuarial studies...+ Research and develop reports and analysis for senior management , effectively presenting and communicating results. + Works closely… more
- Molina Healthcare (Sterling Heights, MI)
- …+ Manage projects spanning multiple domains + Supports Market and Enterprise management and other team members are related to all things financially related ... reserves for appropriateness monthly + Work collaboratively with Actuarial and Medical Economics partners to evaluate correlation among various parameters impacting… more
