- Molina Healthcare (Columbus, GA)
- …experience as a Molina Medical Director + Demonstrated experience in Utilization /Quality Program management + Previous leadership experience + Peer review, ... of prior authorization, inpatient concurrent review, discharge planning, case management and interdisciplinary care team activities. + Ensures that authorization… more
- Kyndryl (Albany, NY)
- …ultimately supporting execution. Partners will be focused on financial impact, utilization and contribution, client impact and leadership. **Contribute to Profitable ... as a strategic partner. + Bring consulting experience-preferably in the Healthcare space-to tailor engagements that resonate with industry-specific needs and… more
- UCLA Health (Los Angeles, CA)
- …of multiple clinical programs and medical services with an emphasis on optimizing Utilization Management for the Faculty Practice Group (FPG) Management ... Description We are seeking a highly skilled and dynamic Director of Clinical Services to lead the development, evaluation,...the delivery of program functionalities in all aspects of Utilization Management and its integration with other… more
- Kyndryl (New York, NY)
- …ultimately supporting execution. Partners will be focused on financial impact, utilization and contribution, client impact and leadership. **Contribute to Profitable ... development; Secure client references **Operational Excellence:** + Achieve individual and team utilization targets + Lead the design of complex engagements and take… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …of the Medical Services area including, but not limited to, Medical and Pharmacy Utilization Management , quality management , member care management , and ... State and Federal Mandates and maintains current and working knowledge of Utilization Management Standards. + Clinical skills are excellent and evidence-based… more
- Kyndryl (Atlanta, GA)
- …in contact center environments. + Excellent communication, presentation, and stakeholder management skills with C-Level. + Healthcare industry experience is ... leading healthcare -focused journey redesign from eligibility verification to care management . + Align contact center transformation with healthcare business… more
- Community Health Systems (Bullhead City, AZ)
- **Job Summary** The Director , Practice Management is responsible for the operational, financial, and clinical oversight of physician practices within the ... healthcare system. This role ensures optimal resource utilization...+ Ensures compliance with regulatory agencies, accreditation bodies, and healthcare laws governing physician practice management , billing,… more
- Community Health Systems (Valparaiso, IN)
- …+ Refers cases not meeting criteria to the Physician Advisor or Utilization Management Committee and ensures appropriate follow-up. + Identifies avoidable ... Life and disability insurance and more **Job Summary** The Director , Care Management is responsible for overseeing...experience required + 3-5 years of experience in care management or utilization review required + 1-3… more
- Access Dubuque (Dubuque, IA)
- …on improving outcomes, reducing unnecessary utilization , and optimizing healthcare resources. The director collaborates with clinical teams, operational ... Regional Director Care Management **UnityPoint Health Finley...recognized as a Top 150 Place to Work in Healthcare by Becker's Healthcare several years in… more
- Humana (St. Paul, MN)
- …Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a medical ... Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in… more