- Excellus BlueCross BlueShield (Rochester, NY)
- …you see is right for you, we encourage you to apply! Job Description: The Medical Director participates in the broad array of activities of the Medical ... reviews and may require peer-to-peer discussions with providers regarding UM case review determinations. + Provides clinical expertise on...and medical criteria. + Assists with training medical director colleagues and nursing staff ,… more
- Centene Corporation (Dover, DE)
- …Services and Supports (LTSS) and Medicare-Medicaid Duals populations. Additionally, the Medical Director will collaborate with other key stakeholders to ... medical expertise in the operation of utilization management ( UM ) programs and quality improvement initiatives to ensure compliance...LTSS Only:** A full-time Long Term Services and Supports Medical Officer/ Medical Director (LTSS CMO)… 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
- Intermountain Health (Las Vegas, NV)
- …utilization management, care management, claims, network management, and finance. As the Medical Director for Utilization Management, you are responsible, in ... claims, and claims knowledge and experience including demonstrated experience managing claims and claims appeals levels 1-3 are a...be engaged in these important projects along with traditional UM activities: Member of the Medical Leadership… more
- University of Maryland, Baltimore (Baltimore, MD)
- …52 start-up companies*.* In the latest /US News & World Report/ ranking of the Best Medical Schools, published in 2021, the UM School of Medicine is ranked *#9* ... Division of General Obstetrics and Gynecology is seeking a Generalist Division Director who will lead the clinical, administrative, educational, and research goals… more
- Catholic Health Services (Melville, NY)
- …the monthly Physician Advisor meeting. Attends hospital Utilization Management ( UM ) committees. Supervises the Facility Physician Advisors. Observes Catholic Health ... Physician Advisor meeting. 3. Training and Education Responsible for hiring and managing Physician Advisors, along with developing and monitoring compliance with an… more
- Catholic Health Initiatives (Houston, TX)
- …to maintain effective team leadership and oversight. This role supports the UM Director in ensuring efficient operations with all processes, policies, ... **Responsibilities** The Utilization Management ( UM ) Manager is responsible for managing day-to-day UM operations within the markets, focusing on effective… more
- University of Miami (Miami, FL)
- …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 seeking a full time Nurse Educator - Medical Simulation and Education Lab to work in Miami,...per year. Training programs include curricula developed by the UM Gordon Center, and other organizations, such as the… more
- Beth Israel Lahey Health (Burlington, MA)
- …patients admitted to the Clinic Attending Physicians: Coordinates appropriate documentation Medical Director for /Managed Care, Physician Advisors Works ... making a difference in people's lives.** Manages the Utilization Management ( UM ) team, maintaining effective and efficient processes for determining appropriate… more
- Houston Methodist (Sugar Land, TX)
- …assurance and quality improvement processes related to admission, concurrent and retrospective UM and medical claims programs. Collaborates with medical ... other areas according to department specifications. + Manages utilization management ( UM ) programs including Medical Claims Review, Precertification and… more
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