- Rady Children's Hospital San Diego (San Diego, CA)
- …This position is part time with full benefits with a remote work option. The Medical Director , UM is a clinical subject-matter expert for the Utilization ... with the Rady Children's Health Network. The Utilization Management Medical Director will collaborate closely with the...Team and shall assist in the oversight of all UM activities. This position serves as a resource to… more
- CVS Health (Springfield, IL)
- …Michigan, Kansas and Oklahoma. Support for other regions may occasionally be required. The UM Medical Director will ensure timely and consistent responses to ... that primarily supports the Aetna Better Health Plan of Illinois. This UM (Utilization Management) Medical Director will be a "Work from Home" position… more
- Provider Solutions & Development (Burbank, CA)
- Providence St. Joseph Medical Center is seeking a Physician Advisor/ UM Medical Director to join a strong leadership team promoting high-value care in ... develop strong collaborative and positive mutually supported relationships between the medical center and its physicians to improve clinical quality, resource… more
- Nuvance Health (Norwalk, CT)
- …cost-effective utilization of Hospital Resources and optimize financial performance. Collaborates with UM Medical Director and Vice President of Medicine. ... *Description* *$30K SIGN ON BONUS - FOR ELIGIBLE EXTERNAL CANDIDATES* Director , Acute Care Hospital Case Management Opportunity! *Required: BSN or MSW with Acute… more
- Dignity Health (Rancho Cordova, CA)
- …review a referral. Fosters the relationship between the Pre-Authorization team and the Medical Director and Physician Reviewers. - Tracks cost savings from ... **Position Summary:** Under the guidance and supervision of the department Manager/ Director the Supervisor of Utilization Management is responsible and accountable… more
- Dignity Health (Bakersfield, CA)
- …Gathering all information needed to make a determination and/or coordinate with the Medical Director as needed. - Responsible to coordinate with contracting to ... decision-making. - Ensures that there is evidence that the UM nurse reviewer documented communications with the requesting provider...for accessibility within the network. - Consults with the medical director on cases that do not… more
- Excellus BlueCross BlueShield (Buffalo, NY)
- …the Quality Management/Utilization Management (QM/ UM ) Plan, including having the BH Medical Director for Children's Services and participate on the BH ... of the Children's Behavioral Health (BH) Carve-In program. The Medical Director for BH Children's Services has...clinical setting). + A minimum of ten (10) years medical experience and strong working knowledge of QM/ UM… more
- University of Maryland, Baltimore (Baltimore, MD)
- The University of Maryland School of Medicine is seeking a Chair and Medical Director of Critical Care for the UM Capital Region Health Medical Center ... Associates, PA They will work closely and in collaboration with the Trauma Medical Director , Chief of Cardiac Surgery, Surgery, Medicine, Neurocritical Care. The… more
- University of Miami (Miami, FL)
- …abdominal organs in approximately 50% of cases. + In conjunction with the Medical Director assumes ultimate responsibility for donor management and the process ... to work in Miami, FL. The Recovery Coordinator 1 ( UM LAORA) assists in the recovery, packaging, preservation and... medical record. + Shares on-call responsibility with Medical Director to oversee clinical evaluation and… more
- Evolent (Augusta, ME)
- …Appropriately identifies and refers quality issues to the Senior Director of Medical Management or Medical Director . + Appropriately identifies potential ... and write clearly. + Reviews adverse determinations against criteria and medical policies + Creates adverse determination notifications that meet all accreditation,… more