- AmeriHealth Caritas (LA)
- …authorize services and appropriately identify and refer requests to the Medical Director when indicated. The BH UM Reviewers are responsible to ensure that ... medical necessity review. It is within the BH UM Reviewer's discretion to retain requests for additional information...services and appropriately identify and refer requests to the Medical Director when indicated + Ensure the… more
- Corewell Health (Grand Rapids, MI)
- …Priority Health - 1231 E Beltline - Grand Rapids Department Name PH - Executive Medical Director Employment Type Full time Shift Day (United States of America) ... trend and cost of care, potentially including partnering with the care delivery system ( internal and external) on UM /CM best practices and shared operations. +… more
- LA Care Health Plan (Los Angeles, CA)
- …setting. Works with UM leadership, including the Utilization Management Medical Director , on requests where determination requires extended review. ... based on clinical data presented and established criteria/guidelines, escalating to the medical director if needed. Triages and assesses members for admission… more
- Guthrie (Cortland, NY)
- …as necessary with the hospital Business Office, physician offices, Care Coordination, Medical Director and other hospital departments as appropriate. + Serves ... work within specified time frames. Knowledge of health benefit plans and related UM requirements preferred. Experience with CPT/ICD coding, medical record or… more
- University of Miami (Miami, FL)
- …in staff development and in-service training + Other duties as assigned by the UM COACH and PCIT Director Manuscript preparation: + Conduct literature reviews + ... here (https://www.myworkday.com/umiami/d/task/1422$7248.htmld) to log in to Workday to use the internal application process. To learn how to apply for a faculty… more
- University of Miami (Miami, FL)
- …here (https://www.myworkday.com/umiami/d/task/1422$7248.htmld) to log in to Workday to use the internal application process. To learn how to apply for a faculty ... this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The University of Miami/UHealth Medical Training Lab at the Gordon Center is currently… more
- Saint Francis Health System (Tulsa, OK)
- …for individual patient situations, reporting them promptly to the Process Improvement/Quality Director , to appropriate clinicians and to the UM Manager. Reviews ... and their receipt of necessary services and appropriate discharge planning. UM Coordinators participate in treatment teams, communicating with providers the details… more
- Point32Health (MA)
- …developed by all accrediting and regulatory guidelines + Facilitates communication between Pharmacy UM department and other internal departments by acting as a ... + Performs other roles/duties and projects as assigned by the Pharmacy UM Supervisor or Director **Salary Range** $107,646.86 -$161,470.30 **Compensation &… 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
- University of Miami (Miami, FL)
- …here (https://www.myworkday.com/umiami/d/task/1422$7248.htmld) to log in to Workday to use the internal application process. To learn how to apply for a faculty ... other presentation materials. + Responds to routine inquiries from external or internal sources with standard correspondence or other messaging. + Plans meetings and… more