- Alameda Health System (Oakland, CA)
- Director , Utilization Management + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day + Nursing + Req ... plans **Role Overview:** Alameda Health System is hiring! The Director of Utilization Management holds...or applicant for employment based on race, color, religion, national origin, age, gender, sex, ancestry, citizenship status, mental… more
- Tufts Medicine (Burlington, MA)
- … review and management . The position develops and leads the Utilization Management operations, strategy and implementation of the Utilization ... of Science in Nursing (BSN). 2.Massachusetts RN Licensure. 3. Current certification in case/ utilization management (ACM, CCM, CMAC) 4. Seven (7) years of UM/Case… more
- AmeriHealth Caritas (Philadelphia, PA)
- ; **Responsibilities:** The Medical Director , Utilization Management provides organizational leadership in the operational areas of care management , ... and related policy and practice initiatives in collaboration with the Corporate Medical Director (s), Utilization Management and the Vice President, Medical… more
- Prime Healthcare (Inglewood, CA)
- …Workers, and Clinical Coordinators. This leader will oversee all facets of utilization management , discharge planning, and care coordination to ensure patiens ... ie full-time or part-time. Responsibilities We are seeking a strategic and compassionate Director of Case Management to lead our dynamic Case Management… more
- Commonwealth Care Alliance (Boston, MA)
- … will be responsible for providing leadership and subject matter expertise to our utilization management (UM) group. This role is a key role in helping ... other medical management team members. + Support the development of utilization management policy initiatives. + Support the development and implementation… more
- Elevance Health (Winston Salem, NC)
- ** Utilization Management Medical Director - NC Medicaid** Location: This role enables associates to work virtually full-time, with the exception of required ... may be considered. The **Medical Director ** will be responsible for utilization review case management for North Carolina Medicaid. May be responsible… more
- Insight Global (Boston, MA)
- Job Description Insight Global is sourcing for a Utilization Management Director to join a not-for-profit community based healthcare organization within the ... federal, state, and local regulatory guidelines. -Support the development of utilization management policy initiatives. -Support the development and… more
- MVP Health Care (Tarrytown, NY)
- …thinking and continuous improvement. To achieve this, we're looking for a **Medical Director , Post-Acute Care Utilization Management ** to join #TeamMVP. If ... reviews, continued stay requests, and handling first-level appeals. + Collaborate with Utilization Management , Case Management , Quality Department and other… more
- Henry Ford Health System (Clinton Township, MI)
- GENERAL SUMMARY: The Medical Director of Utilization Management shall have responsibility for the medical oversight of activities related to Henry Ford ... REQUIRED: MD or DO. Two (2) years of physician advisor and/or utilization management experience. Medical Staff membership in good standing at… more
- Ascension Health (Milwaukee, WI)
- **Details** + **Department:** Utilization Management + **Schedule:** Full Time, Partially Remote + **Hospital:** Multiple Ascension Hospitals in WI + ... **Responsibilities** Provide strategic direction and oversight of the day-to-day operation of utilization management function within the insurance plan. + Ensure… more
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