- Commonwealth Care Alliance (Boston, MA)
- …dental and other vendors to assure integration, oversight, and efficiency of UM processes and functions. * Ensures compliance with all contract requirements, state ... the CMO and VPMA to develop and advance the UM program and leads and organizes the ongoing evaluation...* Minimum five (5) years of clinical experience in medical or behavioral health care delivery Required Knowledge, Skills… more
- CVS Health (Frankfort, KY)
- …do it all with heart, each and every day. **Position Summary:** Ready to take your Medical Director skills to the next level with a Fortune 6 company? Checkout ... and the Southeast Region (FL, LA and WV). This Medical Director will be a "Work from...Medicine, Emergency Medicine, Internal Medicine-Pediatrics Specialty Preferred. - Prior UM experience working at Health Plan / Insurer or… more
- Alameda Health System (Oakland, CA)
- Director , Utilization Management + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day + Nursing + Req #:40826-30155 + FTE:1 + ... time off plans **Role Overview:** Alameda Health System is hiring! The Director of Utilization Management holds a critical role encompassing operational oversight,… more
- University of Miami (Coral Gables, FL)
- …this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The Executive Director of the Office of Research Administration ... and management of ORA's mission for the Coral Gables, Rosenstiel, and Medical Campuses for Pre-award, Post-award, and the Strategic Initiatives divisions. The… more
- Veterans Affairs, Veterans Health Administration (Florence, KY)
- Summary The Clinical Medical Director directly reports the Chief of Primary Care / ACOS and will be responsible for all aspects of medical care delivered to ... information, refer to Required Documents below. Responsibilities The Clinical Medical Director must be able to perform...but are not limited to: Participate in all required UM /QM activities relating to Primary Care to monitor the… more
- Molina Healthcare (UT)
- …Certification in Psychiatry **REQUIRED EXPERIENCE:** * 2 years previous experience as a Medical Director in clinical practice * 3 years' experience in ... * Provide regional medical necessity reviews and cross coverage * Standardizes UM practices and quality and financial goals across all LOBs * Responds to… more
- University of Michigan (Ann Arbor, MI)
- CLINICAL NURSING DIRECTOR (CS Mott Children's Hospital: 10-West Pediatric Cardiothoracic Intensive Care Unit- PCTU) Apply Now **Job Summary** The Pediatric ... from state, regional, national, and international referrals. PCTU specializes in the medical and surgical care of infants, children, adolescents, and adults with… more
- University of Maryland, Baltimore (Baltimore, MD)
- */ Director /**, Maryland Epilepsy and Functional Neurosurgery Program* *Department of Neurosurgery* *University of Maryland School of Medicine (UMSOM)* *University of ... a highly qualified and motivated neurosurgeon to join our team as the Director of the Epilepsy and Functional Neurosurgery Program.*The recruitment aligns with the… more
- Molina Healthcare (Fort Worth, TX)
- JOB DESCRIPTION Job Summary Provides medical oversight and expertise in appropriateness and medical necessity of services provided to members, targeting ... and cost-effective member care. Essential Job Duties * Determines appropriateness and medical necessity of health care services provided to plan members. * Supports… more
- ChenMed (Margate, FL)
- …We're rapidly expanding and we need great people to join our team. The Medical Director , Center is specifically responsible for executing the ChenMed Way and ... assigned center. Under the direction of the Market Chief Medical Officer (MCMO), the Medical Director...with the transition of care team; hospital, SNF, post-acute, UM , and home-based services for the market. + Assists… more