- Integra Partners (Troy, MI)
- …operational needs require. The Senior MD provides clinical oversight to the Utilization Review Medical Director (s), ensures consistent application of criteria, ... Integra's clinical position to internal and external stakeholders. The Senior Utilization Review Medical Director 's responsibilities include but are not… more
- Integra Partners (Troy, MI)
- The Utilization Review Medical Director is responsible for conducting clinical reviews of Durable Medical Equipment (DME) and related requests to support ... and are committed to consistency, compliance, and evidence-based decision making. The Utilization Review Medical Director 's responsibilities include but are not… more
- Elevance Health (Indianapolis, IN)
- ** Utilization Management Medical Director - Indiana Medicaid** **Location:** This role enables associates to work virtually full-time, with the exception of ... by law. Alternate locations may be considered. The **Medical Director ** is responsible for reviewing cases for IN Medicaid...state or territory of the United States when conducting utilization review or an appeals consideration and cannot be… more
- LifeCenter Northwest (Bellevue, WA)
- …response to case activity or operational needs. + Collaborate with the Director , Organ Utilization , to manage departmental budgets and identify cost-management ... proficiency and participate in on-call schedule as directed by the Director , Organ Utilization , available for consultation outside of regular working hours as… more
- Huron Consulting Group (Chicago, IL)
- …agencies, and hospital contractual payor agreements. This position reports to the Director of Utilization Management and works with hospital leadership to ... review staff and function for the system, reporting to the Director of Utilization Management within Revenue Cycle. Assists with leading recruiting, orienting,… more
- Sacramento Behavioral Healthcare Hospital (Santa Rosa, CA)
- …RANGE: LVN/LPT $35.00-44.19 Per Hour RN/LCSW/LMFT/LPCC $54.00-68.18 Per Hour REPORTS TO: Director of Utilization Review DESCRIPTION OF POSITION: Work as member ... and optimize reimbursement for external reviewers/third party payers. The Utilization Review Clinician maintains knowledge of, participates in further training… more
- Prime Healthcare (Inglewood, CA)
- …full-time or part-time. Responsibilities We are seeking a strategic and compassionate Director of Case Management to lead our dynamic Case Management Team consisting ... and Clinical Coordinators. This leader will oversee all facets of utilization management, discharge planning, and care coordination to ensure patients receive… more
- Humana (Indianapolis, IN)
- …to the Lead Medical Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of the care received by members in the ... a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The Medical Director … more
- Humana (Baton Rouge, LA)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an ... a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The Medical Director … more
- CVS Health (Springfield, IL)
- …Account Management in support of Key Clients as assigned. The Medical Director transacts Utilization Management UM activities (prior authorization and appeals) ... CVS Health, a Fortune 6 company, has an outstanding opportunity for a Medical Director - Medical Affairs (Oncology) We need a Board Certified Oncologist for this… more