- Humana (Pierre, SD)
- **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
- Actalent (Sunrise, FL)
- Actalent is hiring UM nurses!Job Description The Utilization Management Nurse (UMN) plays a crucial role in optimizing the utilization of healthcare ... services. Working under the general supervision of the Director and/or Manager/Supervisor of Medical Management , and...on department activities. Essential Skills + Clinical review + Utilization review + Utilization management … more
- LA Care Health Plan (Los Angeles, CA)
- Supervisor, Utilization Management RN Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full ... safety net required to achieve that purpose. Job Summary The Supervisor of Utilization Management (UM) RN is responsible for executing the day-to-day operations… more
- Elevance Health (Morgantown, WV)
- RN Utilization Management /Review Nurse - InPatient Medicaid (JR155056) **Location:** This position requires you to **reside in the state of West Virginia.** ... treatment is medically necessary and provides consultation to Medical Director on cases that are unclear or do not...clinical experience, ie ER, critical care, ICU, etc. + Utilization Review/ Utilization Management a plus.… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position ... support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and approves… more
- Genesis Healthcare (Mount Vernon, MO)
- …Clinicians in Action professional development program. Responsibilities The Market Director is responsible for the efficient management of mobile ... conjunction with the Clinical Operations Area Director ) within their assigned market . Assumes responsibility for daily staffing and utilization with input… more
- AdventHealth (Altamonte Springs, FL)
- …experience + Five years' progressively responsible leadership experience + Previous case management , utilization management , or related discipline experience ... Altamonte Springs, 32701 **The role you'll contribute:** Under minimal supervision, the Director - Care Management - System develops and coordinates… more
- Katmai (Fort Carson, CO)
- …(BSN) is required. + Minimum of two (2) years of prior experience in Utilization Management . + Must possess a current, active, full, and unrestricted Registered ... background checks. **DESIRED QUALIFICATIONS & SKILLS** + Certification by a Utilization Management -specific program such as Certified Professional in Healthcare… more
- Teva Pharmaceuticals (Parsippany, NJ)
- …teams monitor trends and utilization of patient support services and utilization management (ie: prior authorization submissions & approvals); + Develop ... Director , Market Access Strategy (Pull-Through) Date:...pharmaceutical or payer industry. Prior payer marketing, brand marketing, market research, field sales, account management , or… more
- ChenMed (Louisville, KY)
- …We're rapidly expanding and we need great people to join our team. The Market Clinical Director will directly supervise, performance manage and train Clinical ... workplace concerns. + Reviews/approves center-level referrals and provides back-up for market referral and delegated utilization authorizations. **Other duties… more
- Monte Nido (Miami, FL)
- …while providing the opportunity for people to realize their healthy selves. ** Utilization Review Clinician** **Monte Nido** **Remote - Pacific hours** **Monte Nido ... to provide comprehensive care within an intimate home setting. The Utilization Review **Clinician** is responsible for conducting daily administrative and… more
- Sanofi Group (Morristown, NJ)
- **Job title** : Associate Director , Market Access Digital Enablement - Vaccines **Location:** Morristown, NJ **About the Job** The Associate Director , ... Access Digital Enablement will lead digital transformation initiatives to enhance market access capabilities across Sanofi's vaccine portfolio. This role **serves as… more
- HCA Healthcare (Austin, TX)
- …Do you want to join an organization that invests in you as a Market Director Clinical Development? At St. David's Medical Center, you come first. ... and you have the opportunity to make a difference. We are looking for a dedicated Market Director Clinical Development like you to be a part of our team. **Job… more
- Otsuka America Pharmaceutical Inc. (Augusta, ME)
- …medical needs and nutraceutical products for the maintenance of everyday health. As a Director , US Market Access Strategy and Innovation you will be a champion ... preparation across the Team. This position reports to Senior Director , US Market Access Strategy and Innovation...and future lifecycle stages + Support the development and management of a clear US Market Access… more
- HonorHealth (AZ)
- …hospitals, health plans and vendors, as required. Works closely with the Medical Director , Utilization Management , Nursing, the Chief Medical Officer and ... Arizona. Learn more at HonorHealth.com. Responsibilities Job Summary The Case Management Director is accountable and responsible for departmental assessment,… more
- CenterWell (Tallahassee, FL)
- …for managing populations and coordinating care to reduce acute and post-acute care utilization . The Divisional Director role is a hybrid with travel requirements ... CMO, Market President, RMDs) and CIT market managers and supervisors. The Divisional Director ...management and negotiation skills to ensure clinicians and market leaders feel engaged and respected in CIT and… more
- ChenMed (Atlanta, GA)
- …Regional Medical Director (RMD) is a developmental, pathway role to Market Chief Medical Officer which is responsible for aiding in the administrative oversight ... a designated region. As a member of the Executive Management team, the incumbent in this role, in close...strategic care delivery of various markets. In partnership with Market President(s), General Manager(s) and/or other senior market… more
- CVS Health (Austin, TX)
- …ensuring timely and consistent responses to members and providers. As a Medical Director you will focus primarily on overseeing utilization review / quality ... willing to obtain a Texas License. In the Medical Director role you will provide oversight for medical policy...of clinical / medical programs and expand Aetna's medical management programs to address member needs across the continuum… more
- LifePoint Health (Johnstown, PA)
- …**Case Management /Social Services* **Organization:** ** **Title:** * Market Director Case Managemen* **Location:** *Pennsylvania-Johnstown* **Requisition ... Position Summary: Provide Case Management leadership and management for hospitals within a market of... program.Ensure staff competencies in all areas of care management to include utilization review, transition/discharge planning,… more
- PagerDuty (San Francisco, CA)
- …marketing, sales, product, and other departments to ensure alignment and effective utilization of market intelligence. **Required Qualifications:** + 10+ years ... Inc. (NYSE:PD) is a global leader in digital operations management . Half of the Fortune 500 and nearly 70%...and insightful people leader to build and lead our Market Intelligence function. In this strategic role, that will… more