- University of Maryland, Baltimore (Baltimore, MD)
- …Data/Adaptive Clinical Trials*at the University of Maryland-Institute for Health Computing ( UM -IHC) and*Assistant Director for Learning Health System and ... and innovation to win extramural funding and new public-private partnerships involving UM -IHC, respectively. UMGCCC: The role of*Assistant Director for Learning… more
- LA Care Health Plan (Los Angeles, CA)
- …achieve that purpose. Job Summary The Authorization Technician II supports the Utilization Management ( UM ) Specialist by handling all administrative and ... information required by clinical staff to render decisions, assists the Manager and Director of the Utilization Management department in meeting regulatory time… more
- Fallon Health (Worcester, MA)
- …policies and standards; problems lacking clear precedent are usually reviewed with the Director , UM and PA prior to taking action. **Responsibilities** **Primary ... not limited to preservice, concurrent and retrospective reviews for medical necessity or benefit review. Along with other members...+ Attends FH committee meetings as assigned by the Director of UM and PA, such as… more
- CVS Health (Lansing, MI)
- …Health, Health Equity and Quality programs. 2. Collaborating with the Medical Management stakeholders both internally ( UM /CM, Pharmacy, Quality, network, ... excellence, achieving measurable health outcomes, and supporting quality and medical management in a highly matrixed environment. The CMO...and analyze data and trends at State level in: UM , CM, Pop Health and Health Equity in order… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …help us transform healthcare? Bring your true colors to blue. The Role:The Medical Clinical Program Manager will focus on utilization management compliance and ... the organization + Apply their clinical knowledge when assessing/auditing medical records and UM letters against ...ability to navigate, interpret, & analyze information from the utilization management medical management data as well… more
- University of Maryland, Baltimore (Baltimore, MD)
- …senior level Neonatologist to join UM -SJMC as the level III NICU Medical Director . This position requires someone with strong clinical, operational, and ... * Medical Director , Level III Neonatal Intensive Care Unit* *University of Maryland St Joseph's Medical Center ( UM -SJMC) * *I. GENERAL SUMMARY* The… more
- Community Health Systems (Gadsden, AL)
- …Conducts daily reviews of medical records to assess the appropriateness, medical necessity, and utilization of hospital services, escalating cases as needed ... a **Care Manager - LPN** position at Gadsden Regional Medical Center Unit: Care Management Shifts Available: M-F 8...to the Physician Advisor or Utilization Management ( UM ) committee. + Identifies avoidable… more
- Community Health Systems (Bentonville, AR)
- …Conducts daily reviews of medical records to assess the appropriateness, medical necessity, and utilization of hospital services, escalating cases as needed ... holidays and illness + Health insurance, including coverage for medical , dental, vision and prescription drugs + 401(k) retirement...to the Physician Advisor or Utilization Management ( UM ) committee. + Identifies avoidable… more
- CommonSpirit Health Mountain Region (Salt Lake City, UT)
- …a collaborative partnership with the Medical Director CDI, Enterprise Director Case Management, UM Hub Director , and Care Coordination Leaders ... City Area._ _The Physician Advisor reports directly to the Medical Director Physician Advisor/UR and is responsible...assigned sites. This position provides support to the facility Utilization Management Committees, medical staff, UM… more
- Cedars-Sinai (Beverly Hills, CA)
- …member eligibility before processing authorizations. + Contacts facilities identified by the UM Nurses/Manager/ Director / Medical Director to research any ... and requests Letter-of-Agreements when requested. + Requests support documentation from IPAs / Medical Groups as requested by the UM Nurses, Medical … more