- Fallon Health (Worcester, MA)
- …we strive to be the leading provider of government-sponsored health insurance programs -including Medicare, Medicaid, and PACE ( Program of All-Inclusive Care for ... Description and annually evaluate the effectiveness of the program . + Represents the UM Department in...related to Utilization Management. + Works with VP/ Medical Director to set agenda related to UM … more
- Houston Methodist (Katy, TX)
- At Houston Methodist, the Director Centralized Utilization Review (UR) position is responsible for strategic, administrative, and operational leadership for the ... Utilization Management ( UM ) department across the Houston Methodist system. This position oversees all aspects of utilization review to ensure medical necessity,… more
- University of Michigan (Ann Arbor, MI)
- …UMH-West, and Oakland County + Work in partnership with Head Orthopedic Team Physician for UM Athletics and Medical Director for UM Athletics to assure ... Associate Director , Sports Medicine Apply Now **Job Summary** Leadership of Sports Medicine at UM Health will be vested in a multi-disciplinary triad leadership… more
- Wellpath (Cleveland, OH)
- …UM updates and participate in meetings. + Establish and monitor progress towards UM program goals, maintain offsite service and UM tracking/reporting, and ... * Tuition Assistance and dependent Scholarships * Employee Assistance Program (EAP) including free counseling and health coaching *...is your moment to join our mission to provide quality care to every patient with compassion, collaboration, and… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …as well as with the payment integrity team to maximize the value and efficiency of programs and products within UM and payment integrity. * This role will also ... characteristic. Blue Cross and Blue Shield of Minnesota Position Title: Senior Director of Health Services - Utilization Management Location: Hybrid | Eagan,… more
- Healthfirst (NY)
- …identify areas for improvement + Lead initiatives to improve efficiency, cost-effectiveness, and quality in the UM program , sometimes through the ... requirements + Deliver on Healthfirsts Mission by ensuring optimum quality of member care in a cost-effective manner +...subject matter expert on business development efforts related to UM programs , including the launch of new… more
- Magellan Health Services (Albuquerque, NM)
- …+ Leads and organizes the ongoing evaluation of the utilization management program against quality and utilization benchmarks and targets. Identifies ... quality of care including the development and coordination of in-service education programs for vendors, providers, UM staff, and case managers. Makes… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …is right for you, we encourage you to apply! Job Description: The Medical Director participates in the broad array of activities of the Medical Services area ... including, but not limited to, Medical and Pharmacy Utilization Management, quality management, member care management, and medical policy processes, and support for… more
- University of Maryland, Baltimore (Baltimore, MD)
- …physician-scientist with expertise in clinical trial design and execution to serve as Director of Clinical Trial Innovation.* The UM -IHC is a large-scale ... email address. **Job:** **Faculty* **Organization:** **School of Medicine - Centers/ Programs /ORCs* **Title:** *Physician-Scientist, Director Of Clinical Trial… more
- Alameda Health System (Oakland, CA)
- Director , Utilization Management + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day + Nursing + Req #:40826-30155 + FTE:1 + ... time off plans **Role Overview:** Alameda Health System is hiring! The Director of Utilization Management holds a critical role encompassing operational oversight,… more