- UPMC (Pittsburgh, PA)
- The Regional Medical Director , CC/DP and Utilization Review, provides clinical and management leadership across multiple hospitals within the region. This ... utilization, and length of stay (LOS) strategic oversight. The Medical Director will report to the Vice...documentation of all physician advisory activities in the UPMC Care Management information system. + Conduct or… more
- Trinity Health (Silver Spring, MD)
- …guide staff interactions with external agencies. + Collaborate with the Medical Director of Care Management and other leaders to implement departmental ... **Employment Type:** Full time **Shift:** Day Shift **Description:** ** Director , Documentation Quality and Care Transitions**...specialty. + **Experience:** + Minimum of 5 years in care management or a related field. +… more
- Elevance Health (Metairie, LA)
- …Medical Director ** is responsible for serving as the Operational Medical Director for our care management models for our National Account clients. ... serve. The medical director supports product strategy/design through medical management that impact health care quality, cost, and outcomes, and… more
- LA Care Health Plan (Los Angeles, CA)
- …Supervisor of ECM and receives clinical supervision as needed from the Medical Director of Care Management . The position is responsible for providing ... Enhanced Care Management Clinical Specialist II Job...or chronic conditions in collaboration with members and interdisciplinary care professionals in a hospital, medical group… 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 ... evaluates appropriateness of admission or continued stay based on medical necessity. The overall goal of the position is...of all hospitalized patients. + Identifies patients that need care management services (ie utilization review; … 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 ... evaluates appropriateness of admission or continued stay based on medical necessity. The overall goal of the position is...of all hospitalized patients. 1. Identifies patients that need care management services (ie utilization review; … more
- CVS Health (Tallahassee, FL)
- …* Work with medical director teams focusing on inpatient care management , clinical coverage review, member appeals clinical review, medical ... health populations to optimize risk adjustment, clinical quality, and care management . * Actively participate in meetings...as needed. * Develop and guide the implementation of Medical Management programs to ensure providers deliver… more
- Humana (Jackson, MS)
- …region or line of business. The Medical Director conducts Utilization Management of the care received by members in an assigned market, member ... caring community and help us put health first** The Medical Director relies on medical ...based care , population health, or disease or care management . Medical Directors support… more
- Humana (Raleigh, NC)
- …region or line of business. The Medical Director conducts Utilization Management of the care received by members in an assigned market, member ... caring community and help us put health first** The Medical Director relies on medical ...business metrics. + Experience working with Case managers or Care managers on complex case management , including… more
- Humana (Baton Rouge, LA)
- …region or line of business. The Medical Director conducts Utilization Management of the care received by members in an assigned market, member ... **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement… more