- Humana (Topeka, KS)
- …focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience + Working with health insurance ... our caring community and help us put health first** The Corporate Medical Director (CMD) relies on medical background to review health claims and preservice appeals.… more
- UNC Health Care (Smithfield, NC)
- …develop, oversee and maintain high-quality, cost-effective integrated pharmacy programs. The Director of Pharmacy will exercise management responsibility in ... strategies, policies and procedures, budget process, project implementations, human resource management and committee representation. The Director of Pharmacy is… more
- Humana (Springfield, IL)
- … management of behavioral and physical health services, including Utilization Management (UM), Quality Improvement, and value-based payment programs. ... models in their practices + Coordinates with the Medical Director to integrate the administration and management ...Management (QM) program; and work closely with the Utilization Management (UM) of services and associated… more
- STG International (West Seneca, NY)
- …compliance and patient safety. * Design and participate in quality improvement, care management , risk management , peer review, utilization review, clinical ... STGi is currently seeking a Medical Director to provide services at our Community Based...$135.00/hour STGi is a workforce solutions company providing comprehensive healthcare delivery, Head Start and management consulting… more
- STG International (Kingston, NY)
- …compliance and patient safety. + Design and participate in quality improvement, care management , risk management , peer review, utilization review, clinical ... A FUTURE OPENING STGi is currently seeking a Medical Director to provide services at our Community Based Outpatient...job. STGi is a workforce solutions company providing comprehensive healthcare delivery, Head Start and management consulting… more
- Community Health Systems (Tucson, AZ)
- …to maintain efficient operations and regulatory compliance. + Oversees inventory management , including ordering, storage, and utilization of supplies and ... available for qualified candidates!! Relocation available!** **This is a full time Director of Cardiovascular Services responsible for the oversight of the Cath Lab… more
- Elevance Health (Indianapolis, IN)
- …preferred. + Extensive spine surgery experience preferred. + Experience with utilization management , especially with CMS guidelines preferred. + **Orthopedic ... Medical Director ** **Orthopedic Spine Surgery** **Carelon Medical Benefit Management ** **Schedule: 10:30 AM-7 PM Central** **Virtual:** This role enables… more
- Banner Health (Scottsdale, AZ)
- …Banner experience for current BSN-prepared Registered Nurses) Sound knowledge of behavioral healthcare management as typically obtained through a minimum of five ... oversees the leadership of clinical, financial, and personnel management of the assigned areas. The Director ...years of progressively responsible behavioral healthcare management in a behavioral … more
- UTMB Health (Galveston, TX)
- …CMS, Joint Commission, and other accreditation requirements. + Familiarity with healthcare finance, including budgeting, revenue cycle management , and ... Director of Operations - Sealy Heart and Vascular...responsible** **for strategic planning, operational and financial oversight, and management oversight to enhance SHVI's day-to-day operations to ensure… more
- Tufts Medicine (Lowell, MA)
- …has oversight of all clinical and administrative functions of the case management and social work departments in a four-time designated ANCC Magnet designated ... entities and providers in support of system and organization care management goals. . **Job Description** **Minimum Qualifications:** 1. Massachusetts RN Licensure.… more