- Rady Children's Hospital San Diego (San Diego, CA)
- …team of physicians and nurses working with the Rady Children's Health Network. The Utilization Management Medical Director will collaborate closely with the ... benefits with a remote work option. JOB SUMMARY: The Medical Director , UM is a...UM is a clinical subject-matter expert for the Utilization Management Team and shall assist in the oversight… 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 ... + 5 years' experience as an HMO Health Plan Medical Director . + California Physicians and Surgeons...logs and other sources. + Achieves and maintains benchmarked utilization and cost management ( UM ) goals and… more
- Sharp HealthCare (San Diego, CA)
- …for medical necessity are issued under the direction of the Medical Director or designee.Assists with transfers, when necessary. + Demonstrates knowledge ... or services, readmissions to acute or visit to the Emergency Department.Informs Director , QI/ UM of any quality issues.Attends hospitalists rounds, as required,… more
- Magellan Health Services (San Diego, CA)
- …relationships at all levels within HAI-CA. Interact with HAI-CA CMC Chief Clinical Officer, Medical Director and Associate Medical Director , Physician ... customer's site. Including, but not limited to, Network, QI, UM , and DVOD meetings. + Track agenda and follow... data; under the direction of the supervisor or Medical Director , assists with discharge planning and… more