- Intermountain Health (Las Vegas, NV)
- **Job Description:** The Utilization Review Care Management Director is responsible for providing leadership and administrative direction for ... Utilization Management and Review for...Utilization Management and Review for the Enterprise. The...and attainment of financial goals. Reporting to the Sr. Director /AVP/VP Utilization Management , the role… more
- UPMC (Pittsburgh, PA)
- The Regional Medical Director , CC/DP and Utilization Review , provides clinical and management leadership across multiple hospitals within the region. ... hospital in their region. Key Responsibilities + Leadership & Management **: + Oversee Utilization Management ...care organizations, providers, and payers to address benefit coverage, utilization review , and quality assurance. + Promote… more
- Select Medical (Mesa, AZ)
- …and Care Planning Management , Fiscal Management and Payer/Referral Management , Utilization Review . The Director of Case Management is also ... allotted time frame; assuring payments of hospital-based services meeting patient-related utilization management criteria, and implementation of safe and… more
- Commonwealth Care Alliance (Boston, MA)
- … Management reports to the Director of Utilization Management * Oversees clinical decision review for services requiring prior authorization in a ... for overseeing and managing the daily operation of the Utilization Management Review Nurse and...and support personnel. * Act as liaison with medical director , provider relations, case management and quality… more
- Commonwealth Care Alliance (Boston, MA)
- …**Position Summary:** Reporting to the Senior Medical Director of Medical Policy and Utilization Review , the Utilization Review Medical Director ... Serve as the lead for CCA's Utilization Review functions working closely with other medical management...+ Primary care discipline, prior experience as Associate Medical Director (or equivalent) or physician reviewer in a Managed… more
- Integra Partners (Troy, MI)
- …Summary + Integra Partners is seeking a full-time Utilization Review Medical Director to support our Utilization Management team. This is a salaried, ... the local delivery system rendering the criteria inappropriate, the Utilization Management Nurse will route the case...the UR Medical Director . The UR Medical Director will review the case and may… more
- Alameda Health System (Oakland, CA)
- Director , Utilization Management + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day + Nursing + Req ... plans **Role Overview:** Alameda Health System is hiring! The Director of Utilization Management holds...the classification. + Lead and manage a team of utilization review professionals providing guidance, training, and… more
- Mount Sinai Health System (New York, NY)
- …and efficient care to patients, the delivery of comprehensive front-line Case Management services, including utilization management , care facilitation and ... management is preferred Non-Bargaining Unit, BEZ - Utilization Management - WST, Mount Sinai West...by focusing on patient processes. 9. Develops and implements Utilization Review (UR) based on internal data… more
- UPMC (Pittsburgh, PA)
- The Medical Director , Utilization Management is responsible for assuring physician commitment and delivery of comprehensive high-quality health care to UPMC ... Life Changing Medicine happen. **Responsibilities:** + Actively participates in the daily utilization management and quality improvement review processes,… more
- Prime Healthcare (Inglewood, CA)
- …provides leadership and supervision to case managers, social workers and case management coordinators/discharge planners, utilization review coordinators and ... Workers, and Clinical Coordinators. This leader will oversee all facets of utilization management , discharge planning, and care coordination to ensure patiens… more
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