- Evolent (Columbus, OH)
- …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 (Columbus, OH)
- …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
- Humana (Columbus, OH)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... with prior experience participating in teams focusing on quality management , utilization management , case ...management operational improvements, including those within the medical director area + Participate in call rotation + Develop… more
- Elevance Health (Lima, OH)
- …clinical consultation and serve as clinical/strategic advisor to clinical operations including utilization management , care management and quality ... **Medical Director -Long Term Support and Services- MyCare OHIO**...services for target populations strongly preferred. + 1-2 years Utilization Management experience strongly preferred. + Strong… more
- Molina Healthcare (Columbus, OH)
- …of health care services provided to plan members. * Supports plan utilization management program and accompanying action plan(s), which includes strategies ... the most appropriate care at the most effective setting. *Evaluates effectiveness of utilization management (UM) practices - actively monitoring for over and… more
- Gentiva (Circleville, OH)
- …budgeting while driving branch revenue growth through census development, referral management , and efficient resource utilization + Maintain strong relationships ... exciting and rewarding opportunity for a RN Hospice Executive Director to join our leadership team. This role is...experience in hospice care, home health, or clinical operations management . If you're a natural leader who is passionate… more
- Evolent (Columbus, OH)
- …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
- Select Medical (Cleveland, OH)
- **Overview** **Cleveland Clinic Rehabilitation Hospital - Fairhill** ** Director of Quality Management ** **(DQM)** **Opening in October, the Cleveland Clinic ... protected under applicable law_ _._ Apply for this job (https://jobs-selectmedicalcorp.icims.com/jobs/336890/ director -of-quality- management inpatient-rehab/job?mode=apply&apply=yes&in\_iframe=1&hashed=1374627814) Share this job **Job ID**… more
- Molina Healthcare (OH)
- …health oversight and clinical leadership for health plan and/or market specific utilization management and care management behavioral health programs ... - working closely with regional medical directors to standardize behavioral health utilization management policies and procedures to improve quality outcomes and… more
- Baylor Scott & White Health (Columbus, OH)
- …patterns to key stakeholders. This will include close partnership with the BSWH utilization management function to gather information and resolve issues with ... **Job Summary** The Director , Denial Resource Center is responsible for the...business objectives. + Directs daily operations of clinical denial management , including the development and implementation of utilization… more