- Sharp HealthCare (San Diego, CA)
- …physician executive in a managed care environment, preferably as an HMO Medical Director . + California Physicians and Surgeons License - Medical Board of CA ... other sources. + Achieves and maintains benchmarked utilization and cost management ( UM ) goals and clinical quality improvement (QI) objectives, in conjunction with… more
- University of Miami (Coral Gables, FL)
- …for organization of educational materials on Compliance website. + Responsible for UM Compliance Twitter and Facebook pages and education provided on all forms ... additional duties and special projects as directed by the Associate Athletic Director for Compliance. This list of duties and responsibilities is not intended… more
- UCLA Health (Los Angeles, CA)
- Description We are seeking a highly skilled and dynamic Director of Clinical Services to lead the development, evaluation, and implementation of multiple clinical ... care. You will: + Oversee the development and execution of multiple UM processes and workflows, while continuously identifying and evaluating areas for improvement… more
- BronxCare Health System (Bronx, NY)
- …activities and monitoring on a quarterly basis and reports findings/analysis to Director . - Conducts educational/feedback sessions with UM staff related to ... order to prepare a response for submission in appeal. - In absence of Director , will review denial correspondence to determine validity of denial reason and course… more
- CVS Health (Austin, TX)
- …care experience *Preferred licensed in TX, CA, or FL *Previous UM experience with a Health plan/payor experience. *Electronic medical systems/record experience ... *Managed Care experience *Board certification in Internal Medicine, Family Medicine, Emergency Medicine, or Med/PM&R **Education** *Active and current state medical license without encumbrances *M.D. or DO, Board Certification in a recognized specialty… more
- Catholic Health Services (Melville, NY)
- …the monthly Physician Advisor meeting. Attends hospital Utilization Management ( UM ) committees. Supervises the Facility Physician Advisors. Observes Catholic Health ... Physician Advisors and provide feedback for standardizing the Catholic Health Physician Advisor role across the system. Serves as a resource for Catholic Health Physician Advisors to provide guidance and assistance. Provides coaching to Catholic Health… more
- Integra Partners (Troy, MI)
- The Utilization Management ( UM ) Nurse Supervisor is responsible for providing direct leadership and oversight to the UM nursing team. This role ensures team ... for frontline staff. Salary: $75,000.00/Annually JOB QUALIFICATIONS: KNOWLEDGE/SKILLS/ABILITIES The UM Nurse Team Lead's responsibilities include but are not limited… more
- LA Care Health Plan (Los Angeles, CA)
- …Job Summary The Authorization Technician II supports the Utilization Management ( UM ) Specialist by handling all administrative and technical functions of the ... required by clinical staff to render decisions, assists the Manager and Director of the Utilization Management department in meeting regulatory time lines by… more
- Sharp HealthCare (San Diego, CA)
- …managing medical management activities to include tracking, trending and analyzing UM data. Works in collaboration with regional medical directors, ambulatory care ... and hospital case management departments. Participates in the development of the annual UM plan and implementation of corrective action plans related to health plan… more
- Alkegen (DE)
- …thorough evaluation of all CARs (capital expenditures). + Support the Director , Regional Controller for the holding management (including filings, tax integration). ... weltweit, darunter Experten fur Isolierung und Filtration, ist Alkegen einzigartig positioniert, um Kunden dabei zu helfen, die Umwelt auf sinnvolle Weise zu… more