- Yakima Valley Farm Workers Clinic (Salem, OR)
- …and staff, ensure compliance with industry regulations, and uphold high practice management standards. The Director 's impact will extend beyond the clinic ... Join our team as a Clinic Director in Woodburn, Oregon! Please read the following...mentors and trains direct report staff. Provides continuous performance management and conducts employee performance evaluations. Addresses performance and/or… more
- Shannon Health (San Angelo, TX)
- …and consults with the supervisor, manager, or team member when appropriate. Time Management : Works efficiently and manages duties to ensure that tasks are completed ... work policies and procedures. Speed and consistency of output and time utilization of job duties. Computer Knowledge & Electronic Equipment Use: Demonstrates ability… more
- Methodist Hospital Northeast (San Antonio, TX)
- …a Nurse Manager of Critical Care ICU who is responsible to the Director , Vice President and/or the Chief Nursing Officer for facilitating, coordinating and ... responsible 24 hours a day for the staffing and management of patient care in each of his/her units,...patient care area, and for the acquisition, development, and utilization of resources (human and material) needed to fulfill… more
- Alameda Health System (Oakland, CA)
- Director , Utilization Management + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day + Nursing + Req ... off plans **Role Overview:** Alameda Health System is hiring! The Director of Utilization Management holds a critical role encompassing operational… more
- UNC Health Care (Morrisville, NC)
- …and well-being of the unique communities we serve. **Summary** : The **Executive System Director of Utilization Management (UM)** is a strategic and ... operational leader responsible for designing, implementing, and standardizing utilization management functions across a large healthcare system, including a… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …of Minnesota Position Title: Senior Director of Health Services - Utilization Management Location: Hybrid | Eagan, Minnesota Career Area: Health Services ... difference, join us. The Impact You Will Have The Senior Director of Health Services, Utilization Management is responsible for the design, strategic… more
- Fallon Health (Worcester, MA)
- … to identify and prioritize the cost of care opportunities related to Utilization Management . + Works with VP/ Medical Director to set agenda related to UM ... strategic leadership and oversight responsibility for the clinical and operational utilization management activities for all inpatient and outpatient care,… more
- Centene Corporation (Richmond, VA)
- …including a fresh perspective on workplace flexibility. **Position Purpose:** Directs the utilization management team to ensure the appropriate application of ... manages Utilization Operations specific to the daily operations of Utilization Management including timeliness, quality and performance outcomes, provider… more
- Healthfirst (NY)
- …to maintain and improve department performance + Collect, analyze, and report on utilization trends, patterns, and impacts to identify areas for improvement + Lead ... closely with other Operations leaders including but not limited to Care Management , Clinical Eligibility, Behavioral Health, and Appeals and Grievances teams to… more
- Insight Global (New York, NY)
- …turn-around times for clinical reviews. * Collaborate with other departments on Utilization Management Operations. * Lead key projects and drive initiatives ... leading and overseeing a team of physicians ensuring efficient management and adherence to quality standards. Primary Duties and...3+ years of clinical practice * 2+ years of utilization review experience in a managed care plan (health… more
- Elevance Health (Indianapolis, IN)
- ** Utilization Management Medical Director - Indiana Medicaid** **Location:** This role enables associates to work virtually full-time, with the exception of ... Internal Medicine, and Family Medicine specialties preferred. + 3-5 years of Utilization Management experience preferred. + Indiana license or the ability… more
- Wellpath (Cleveland, OH)
- …education, and point of care support. **How you make a difference** The Medical Director of Utilization Management leads and oversees utilization ... care and the appropriate utilization of medical services. The Medical Director of Utilization Management serves as a key liaison with external partners… more
- Huron Consulting Group (Chicago, IL)
- …regulatory agencies, and hospital contractual payor agreements. This position reports to the Director of Utilization Management and works with hospital ... review staff and function for the system, reporting to the Director of Utilization Management within Revenue Cycle. Assists with leading recruiting,… more
- UPMC (Pittsburgh, PA)
- …UPMC Health Plan is seeking a licensed MD or DO for a fully remote Medical Director , Utilization Management role. The Medical Director , Utilization ... policies of the Health Plan. + Actively participates in the daily utilization management and quality improvement review processes, including concurrent,… more
- Prime Healthcare (Inglewood, CA)
- …Workers, and Clinical Coordinators. This leader will oversee all facets of utilization management , discharge planning, and care coordination to ensure patients ... ie full-time or part-time. Responsibilities We are seeking a strategic and compassionate Director of Case Management to lead our dynamic Case Management… more
- Humana (Raleigh, NC)
- …a Lead Medical Director , depending on the line of business. The Medical Director conducts Utilization Management or clinical validation of the care ... 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
- Humana (Washington, DC)
- … 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
- Ventura County (Ventura, CA)
- …and communicates matters of VCHCP medical policy with the Health Care Agency Director and Insurance Administrator, Utilization Management staff and Quality ... surgical procedures, referrals, tests, medication approvals requiring authorization.) + Develops utilization management standards and guidelines for approval by… more
- CVS Health (Madison, WI)
- …regional role that primarily supports the Aetna Better Health Plan of Oklahoma. This UM ( Utilization Management ) Medical Director will be a "Work from Home" ... every day. **Position Summary:** Ready to take your Medical Director skills to the next level with a Fortune...and appeal request. This position is primarily responsible for Utilization Management , including prior authorization as well… more
- Integra Partners (Troy, MI)
- … (Senior MD) serves as the clinical and strategic leader for Integra's Utilization Management (UM) and Credentialing programs. This is a full-time, 40+ ... quality and inter-rater reliability, overseeing audit readiness, and chairing Integra's Utilization Management Committee and Credentialing Committee. This role… more
