- Evolent (Olympia, WA)
- …Appropriately identifies and refers quality issues to the Senior Director of Medical Management or Medical Director . + Appropriately identifies potential ... write clearly. + Reviews adverse determinations against criteria and medical policies + Creates adverse determination notifications that meet...patient care + **Minimum one year of experience with Utilization Review ( UM ) in a managed care… more
- Molina Healthcare (Seattle, WA)
- **JOB DESCRIPTION** **Job Summary** The Medical Director for Specialty Medical Services & Market Performance will provide clinical expertise and support to ... at the most effective setting. Evaluates the effectiveness of UM practices. Actively monitors for over and under- utilization...activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. +… more
- Molina Healthcare (Spokane, WA)
- …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... at the most effective setting. Evaluates the effectiveness of UM practices. Actively monitors for over and under- utilization...experience, including: + 2 years previous experience as a Medical Director in a clinical practice. +… more
- Evolent (Olympia, WA)
- …Stay for the culture. **What You'll Be Doing:** Evolent is seeking an **Associate Medical Director - Cardiovascular Medicine** to play a critical role in ... developing cardiovascular programs that include improvements to clinical effectiveness of utilization management ( UM ) and risk-based models.** + Process… more
- Molina Healthcare (Seattle, WA)
- …Board Certification in Psychiatry **REQUIRED EXPERIENCE:** * 2 years previous experience as a Medical Director in clinical practice * 3 years' experience in ... practice, capitation, HMO regulations, managed healthcare systems, quality improvement, medical utilization management, risk management, risk adjustment, disease… more
- Whidbey General Hospital (Coupeville, WA)
- …and background to assure compliance with CMS Conditions of Participation regarding Utilization Review and Discharge Planning. The RN - Care Manager will lead ... regime, etc. The RN - Care Manager follows the hospital's Case Management/ Utilization Plan that integrates the functions of utilization review, discharge… more
- Providence (Everett, WA)
- …and evaluation of appropriate services and resources to maximize optimum outcomes. The UM Supervisor assists the Washington NWR Director of Care Management in ... **Description** The Supervisor for Utilization Management provides a key role in leading,...- they're invaluable. Join our team at Providence Regional Medical Center Everett and thrive in our culture of… more