- Blue KC (MO)
- …clinical initiatives by providing direction to physicians and other providers, Provides utilization management for medical, surgical and pharmacy activity. + ... medical policy updates. + Serves as expert/resource on appeals related to utilization management issues. + Provides medical leadership and physician advice… more
- Elevance Health (Lima, OH)
- …clinical consultation and serve as clinical/strategic advisor to clinical operations including utilization management , care management and quality ... **Medical Director -Long Term Support and Services- MyCare OHIO**...services for target populations strongly preferred. + 1-2 years Utilization Management experience strongly preferred. + Strong… more
- Humana (San Juan, PR)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... with prior experience participating in teams focusing on quality management , utilization management , case ...management operational improvements, including those within the medical director area + Participate in call rotation + Develop… more
- CVS Health (Springfield, IL)
- …in new and exciting ways every day. Aetna is recruiting for an Executive Director , Network Management who provides strategic leadership and oversight for network ... management and provider relations within the Heartland ...the network's performance and effectiveness by analyzing network data, utilization patterns, and market trends to identify… more
- Centene Corporation (Raleigh, NC)
- …the American Osteopathic Association's Department of Certifying Board Services + Utilization Management experience and knowledge of quality accreditation ... the business unit. + Provides medical insights and/or interpretation for utilization management , cost containment, and medical quality improvement activities.… more
- LACI (Los Angeles, CA)
- …Pilots LACI launched our Innovation Pilots program in 2019 to test market -ready technology, business model and policy model innovations at the community level ... local governments and community-based organizations to deploy, test, and increase utilization of zero emission transportation, clean energy, and sustainable cities… more
- Horizon Services, Inc. (Hayward, CA)
- …of front-line support and milieu staff to ensure full census and efficient utilization management at assigned program(s). Engages in marketing, client retention, ... JOB TITLE: Associate Director of Outpatient & Prevention Program Operations LOCATION:...youth prevention, youth and adult outpatient, sobering programs, withdrawal management , and co-occurring capable residential programs to support the… more
- CenterWell (Columbia, SC)
- …patient care and business outcomes. **KEY RESPONSIBILITIES** **Leadership & Organizational Management :** + Understand organizational & market priorities, trends, ... teams **Dyad Partnership:** + Collaborate with operational leaders (Associate Operations Director and/or Market President) and Shared Services partners to… more
- Catholic Health Initiatives (Omaha, NE)
- …and aspire to national best practices. + Works (in partnership with Executive Managed Market Director and CHI Health leadership) to build an integrated culture ... of all CVSL subcommittees and other committees as directed by Executive Managed Market Director and senior leadership. + In collaboration with the Executive… more
- Marriott (Bethesda, MD)
- …annually **Bonus Eligible:** Y **Expiration Date:** 11/07/2025 **JOB SUMMARY** The Account Director is responsible for providing total account management for a ... and team-based sales principles to cross-discipline groups including Revenue Management , Market , Region, Property and Owner/Franchise partners. + Attend… more