- 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
- HCA Healthcare (Bowling Green, KY)
- …a part of our team. **Job Summary and Qualifications** The Facility Case Management Director has the overall responsibility for managing and coordinating ... join an organization that invests in you as a(an) Director Case Management ? At TriStar Greenview Regional...to ensure continuity of care and optimal clinical resource utilization . The Director has oversight for all… 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 actively uses their medical background, experience, and judgement...with prior experience participating in teams focusing on quality management , utilization management , case … more
- Molina Healthcare (Bowling Green, KY)
- … and effective resource management . + Develops and implements a Utilization Management program and action plan, which includes strategies that ensure ... IT and data analysts to produce tools to report, monitor and improve Utilization Management . + Actively participates in regulatory, professional and community… 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. + ... Surgery 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 (Bowling Green, KY)
- …effective labor management , including position control, scheduling excellence, productivity management , and premium pay utilization to maintain staffing to ... invested over 156,000 hours impacting our communities. As a Medical Surgical Nurse Director with TriStar Greenview Regional Hospital, you can be a manager in an… more
- HCA Healthcare (Bowling Green, KY)
- …labor management , including position control, scheduling excellence, productivity management , and premium pay utilization . Maintains staffing to ensure ... care in 21 states and the United Kingdom. We are looking for a Director Emergency Services for our TriStar Greenview Regional Hospital team where excellence creates… more
- HCA Healthcare (Nashville, TN)
- …while following evidence-based practices established by Clinical Operations Group and Medication Management Alignment. The Director will serve as a leader and ... role in defining implementation strategies to support adoption at go-live. The Director will also collaborate with Change Management and Communication teams… more
- HCA Healthcare (Brentwood, TN)
- …is incentive eligible. **Introduction** Do you have the career opportunities as a ** Director of Physician Resource Group** you want with your current employer? We ... of colleagues. Do you want to work as a Director of Physician Resource Group where your passion for...flow, patient satisfaction, practice volume, billing and collections, service utilization , coding, physician and staff training + Have strategic… more