- HCA Healthcare (Conroe, TX)
- …a data-driven environment of quality and cost improvement and develops systems to review utilization of resources and objectively measure outcomes of care in ... clinical program development, and overall hospital strategy. + Provides medical director services to facility-level physician credentialing, business… more
- Molina Healthcare (Las Vegas, NV)
- …experience, including: + Minimum 5 years clinical practice. + 5 years in a Medical Director role. + 4 years HMO/Managed Care experience, including Utilization ... Predictive Modeling, and Disease Management. + Leads the health plan's analysis of medical care cost and utilization data. Leads and manages the development… more
- AdventHealth (Orlando, FL)
- …with Senior Medical Officers with contracted managed care payers regarding utilization review management activities and maintain a positive and supportive ... care providers). Works in close coordination with the processes of the Utilization Review Management staff for continual process improvement and reporting.… more
- Fresenius Medical Center (Farmerville, LA)
- …with all legal, compliance and regulatory requirements and programs. Collaborates with the Medical Director and the Clinical Coordinator /Charge Nurse or Nurse ... RN or Nurse Supervisor acting as nurse manager, the Medical Director , and the physicians regarding the...+ Addressing patient concerns, issues, and questions including the review of patient satisfaction surveys. + Developing and communicating… more
- Whidbey General Hospital (Coupeville, WA)
- …experience and background to assure compliance with CMS Conditions of Participation regarding Utilization Review and Discharge Planning. The RN - Care Manager ... hospital's Case Management/ Utilization Plan that integrates the functions of utilization review , discharge planning, and resource management into a singular… more
- UNC Health Care (Goldsboro, NC)
- …with reputation as an excellent clinician. Physician leadership experience as a Medical Director , Clinical Chair or other significant medical -administrative ... system initiatives into Wayne UNC Health Care. 3. Assists Medical Staff in the review of the...the following hospital departments: Medical Staff Services, Medical Staff Performance Improvement, Utilization Management, Clinical… more
- Sharp HealthCare (San Diego, CA)
- …under the direction of the manager of in-patient care management and the Director of Utilization Management. **Required Qualifications** + 3 Years Experience in ... in-patient Care Management program that includes initial and concurrent review ; case management/discharge planning activities. Responsible for operational planning… more
- Guthrie (Troy, PA)
- …years of experience in an acute care setting with strong care management, utilization review , and payer knowledge. A Case Management certification or obtaining ... health and community providers. a) Works closely with the Medical Director and other members of the...other members of the healthcare team to provide appropriate medical management and resource utilization utilizing established/approved… more
- Corewell Health (Royal Oak, MI)
- …patients. 1. Identifies patients that need care management services (ie utilization review ; care coordination; and/or discharge/transition planning). 2. ... status and level of care. Uses defined resources to guide decisions, including Medical Director Care Management, Physician Advisors, and management staff. 5.… more
- Corewell Health (Dearborn, MI)
- …patients. + Identifies patients that need care management services (ie utilization review ; care coordination; and/or discharge/transition planning). + ... status and level of care. Uses defined resources to guide decisions, including Medical Director Care Management, Physician Advisors, and management staff. +… more
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