- University of Miami (Miami, FL)
- …the program's overall success. + Serves as a liaison between the Program Director (s), administrative leadership, UM /JMH Graduate Medical Education (GME) ... The incumbent oversees and coordinates the daily operations of assigned medical residency or fellowship program(s). The GME Program Administrator (A) supports… 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...with members and interdisciplinary care professionals in a hospital, medical group or managed care setting, such as a… more
- Centene Corporation (Jefferson City, MO)
- …management strategy, clinical effectiveness initiatives, and Authorization Rules. Supports the Chief Medical Director of Medical Management with the ... edits implemented. + Supports projects delegated to the Chief Medical Director of Medical Management...uploaded to the medical management platform for medical necessity review by the UM team.… more
- Defense Health Agency (Falls Church, VA)
- …Health Services (CAFBHS); Family Advocacy Program (FAP); BH Training (BHTRAINING); BHSL Utilization Management (BHSL UM ); Primary Care Behavioral Health (PCBH); ... and operation of the Department of Defense (DoD) worldwide medical mission, which is to provide medical ...Health issues and initiatives. Represents and speaks for the Director , DHN in presenting, explaining, defining and negotiating DHN… more
- Excellus BlueCross BlueShield (Dewitt, NY)
- …Social Work, Behavioral Health, Respiratory Therapy, Registered Dietitian, Registered Nurse, Medical Director , Pharmacist, Geriatrics, etc.) to ensure continuity ... consistent and quality health care services. Examples may include: Utilization Management, Quality, Behavioral Health, Pharmacy, Registered Dietitian and Respiratory… more
- University of Michigan (Ann Arbor, MI)
- …for accuracy and investigate and implement potential cost savings strategies. Track utilization of products and make recommendations for PAR changes and new products ... Supervises process of recruitment for the Critical Care hiring team. Obtains director approval to create job postings and update posting descriptions. Works closely… more
- Ivyhill Technologies LLC (Bethesda, MD)
- …duty and reserve/guard referrals under the supplemental health care program. Coordinate with Medical Director , Product Line leaders, and/or RM leadership for all ... have three (3) years of clinical nursing experience. Referral Management (RM) and Utilization Management ( UM ) experience is preferred. Full-time employment in a… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …mandatory trainings as required. + May be required to attend Fair Hearings with Medical Director relating to specific cases. + Works independently, as well as ... Community Health Assessment (CHA) Tools to determine functional status, medical , behavioral, psychological, and community resource needs for coordinating,… more
- Highmark Health (Wexford, PA)
- …) coverage requests and prepares such cases for clinical review by a pharmacist and/or medical director when required. (20%) + Within the context of the request, ... + Responsible for all preauthorization entries into applicable databases (ie internal medical claims systems, PBM pharmacy systems) to ensure swift and appropriate… more
- University of Miami (Doral, FL)
- …on-the-job performance of staff and collaborates with the Patient Access Training Director to identify opportunities for improvement. + Develop training to maintain ... + Oversees cash management procedures to ensure staff adherence with established UM cash management guidelines. + Verifies that the end of day cash-drawer… more