- Provider Solutions & Development (Torrance, CA)
- Providence Little Company of Mary is seeking a Physician Advisor/ UM Medical Director to join a strong leadership team promoting high-value care in Torrance, ... our mission outcomes. You will work closely with the physician leadership, the Director of Care Management, and executive leadership; in particular the CMO, CNO, and… more
- Provider Solutions & Development (Mission Hills, CA)
- Providence Holy Cross Medical Center is seeking a Physician Advisor/ UM Medical Director to join a strong leadership team promoting high-value care in Mission ... mission outcomes. You will work closely with the physician leadership, the Director of Care Management, and executive leadership; in particular the CMO, CNO,… more
- Centene Corporation (Jefferson City, MO)
- …ALJ hearings, STARS metrics + Previous experience with ensuring high quality medical director training to review Medicare UM and appeals, Clinical review quality ... oversight and management. + Utilization Management experience and knowledge of quality accreditation standards preferred. + Experience analyzing and working with complex data sets and knowledge of population health preferred + Experience treating or managing… more
- Humana (Little Rock, AR)
- …a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The Medical Director ... or data requires an in-depth evaluation of variable factors. The Medical Director actively uses their medical background, experience, and judgement to make… more
- Humana (Providence, RI)
- …of our caring community and help us put health first The Medical Director actively uses their medical background, experience, and judgement to make determinations ... month with compensated days off during the work week The Medical Director 's work includes reviewing of all submitted medical records, synthesizing complex… more
- Centene Corporation (Jefferson City, MO)
- …a fresh perspective on workplace flexibility. **Position Purpose:** Supervisory Medical Director at Centene plays a critical role in delivering medical, people ... cost-effective care to our members. This role further assists the Senior Medical Director or Chief Medical Officer in execution of strategic clinical initiatives. +… more
- University of Michigan (Ann Arbor, MI)
- …UMH-West, and Oakland County + Work in partnership with Head Orthopedic Team Physician for UM Athletics and Medical Director for UM Athletics to assure ... Associate Director , Sports Medicine Apply Now **Job Summary** Leadership of Sports Medicine at UM Health will be vested in a multi-disciplinary triad leadership… more
- Integra Partners (Troy, MI)
- …Strategic and Operational Leadership + Collaborate with the SVP of Operations, UM Director , Credentialing leadership, and other internal teams to drive ... clinical leadership and oversight to the Utilization Review Medical Director (s) and clinical UM team. + Ensure consistent, accurate, and compliant application of… more
- UNC Health Care (Morrisville, NC)
- …well-being of the unique communities we serve. **Summary** : The **Executive System Director of Utilization Management ( UM )** is a strategic and operational ... of healthcare resources in alignment with institutional goals. The Executive Director works closely with leaders from various departments-case management, physician… more
- Integra Partners (Troy, MI)
- …call center and other internal & external sources + Other duties as assigned by UM Director + Strong organizational skills, ability to adapt quickly to change ... The UM Coordinator assists and supports the clinical team ( UM Nurses/Medical Director ) with administrative and non-clinical tasks related to processing… more
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