- Defense Health Agency (Falls Church, VA)
- …for the effective execution and operation of the Department of Defense (DoD) worldwide medical mission, which is to provide medical services and support to ... specified categories of individuals entitled to DoD medical care, providing support to the Uniformed Services in...in the management and administration of TRICARE, administering and managing the Defense Health Program budget and the management… more
- University of Michigan (Ann Arbor, MI)
- …member of the critical care transport leadership team with responsibility for managing schedules for five different dynamic groups of 125+ staff members. Controls ... Supervises process of recruitment for the Critical Care hiring team. Obtains director approval to create job postings and update posting descriptions. Works closely… more
- Veterans Affairs, Veterans Health Administration (Orlando, FL)
- …Nurse Manager is accountable to the Consolidated Patient Account Center (CPAC) Director , manages RUR Assistant Nurse Managers, RUR Nurses, and general schedule (GS) ... Care System personnel and engages effectively with customers, including VA Medical Center service lines within the assigned region, community providers, third-party… more
- US Tech Solutions (Columbia, SC)
- …back up review determinations. Identifies and makes referrals to appropriate staff ( Medical Director , Case Manager, Preventive Services, Subrogation, Quality of ... week. + M-F 8:30am - 5pm. + From the Manager: -Experience: Hospital experience, UM experience -Description: office work, at a desk 8 hours per day, reading clinical… more
- Excellus BlueCross BlueShield (Dewitt, NY)
- …Social Work, Behavioral Health, Respiratory Therapy, Registered Dietitian, Registered Nurse, Medical Director , Pharmacist, Geriatrics, etc.) to ensure continuity ... policy and leadership, current NYS DOH, CMS regulations and standards if managing members of Medicare programs, and other regulatory requirements as applicable. +… more
- Corewell Health (Farmington Hills, MI)
- …status and level of care. Uses defined resources to guide decisions, including Medical Director Care Management, Physician Advisors, and management staff. + ... hospital outpatient, observation or inpatient services. + May review cases for medical necessity, uses InterQual and/or other UR/ UM Committee-approved medical… more
- Corewell Health (Royal Oak, MI)
- …status and level of care. Uses defined resources to guide decisions, including Medical Director Care Management, Physician Advisors, and management staff. 5. ... hospital outpatient, observation or inpatient services. 4. May review cases for medical necessity, uses InterQual and/or other UR/ UM Committee-approved … more
- LA Care Health Plan (Los Angeles, CA)
- …to the Supervisor of ECM and receives clinical supervision as needed from the Medical Director of Care Management. The position is responsible for providing ... internal LA Care departments such as Care Management (CM), Utilization Management ( UM ), Managed Long Term Services and Support (MLTSS), Social Services, Behavioral… more
- University of Miami (Miami, FL)
- …to IRBs, sponsors and master agreements, and coordinates with the Research Program Director on remediation. + Coordinates the efforts of relevant team members to ... for clinical trial and research areas. + Provides consultation and guidance for UM held INDs and IDEs. + Develops, implements, maintains and oversees internal… more
- CareFirst (Baltimore, MD)
- …to act as a resource for the nurses to conduct concurrent review for medical necessity and appropriate level of care for Commercial and Government lines of business. ... **We are looking for an experienced Registered Nurse and people leader with UM /CM experience** **living within the Washington DC and/or Virginia area** . The… more