- Rady Children's Hospital San Diego (San Diego, CA)
- …team of physicians and nurses working with the Rady Children's Health Network. The Utilization Management Medical Director will collaborate closely with the ... with full benefits with a remote work option. The Medical Director , UM is a...UM is a clinical subject-matter expert for the Utilization Management Team and shall assist in the oversight… more
- CVS Health (Springfield, IL)
- …Account Management in support of Key Clients as assigned. The Medical Director transacts Utilization Management UM activities (prior authorization and ... Fortune 6 company, has an outstanding opportunity for a Medical Director ( Medical Affairs). This...review activities and other quality oversight processes for internal Director UM decisions. If specifically assigned to… more
- Dignity Health (Rancho Cordova, CA)
- …review a referral. Fosters the relationship between the Pre-Authorization team and the Medical Director and Physician Reviewers. - Tracks cost savings from ... home.** **Position Summary:** Under the guidance and supervision of the department Manager/ Director the Supervisor of Utilization Management is responsible and… more
- Dignity Health (Bakersfield, CA)
- …Gathering all information needed to make a determination and/or coordinate with the Medical Director as needed. - Responsible to coordinate with contracting to ... for accessibility within the network. - Consults with the medical director on cases that do not...information, PHI and HIPAA regulations. **Preferred Qualifications:** - Prior Utilization Management ( UM ) experience strongly preferred. -… more
- CVS Health (Springfield, IL)
- …that primarily supports the Aetna Better Health Plan of Illinois. This UM ( Utilization Management) Medical Director will be a "Work from Home" position ... Support for other regions may occasionally be required. The UM Medical Director will ensure...and appeal request. This position is primarily responsible for Utilization Management, including prior authorization as well as concurrent… more
- Evolent (Augusta, ME)
- …Appropriately identifies and refers quality issues to the Senior Director of Medical Management or Medical Director . + Appropriately identifies potential ... write clearly. + Reviews adverse determinations against criteria and medical policies + Creates adverse determination notifications that meet...patient care + **Minimum one year of experience with Utilization Review ( UM ) in a managed care… more
- UPMC (Pittsburgh, PA)
- The Regional Medical Director , CC/DP and Utilization Review, provides clinical and management leadership across multiple hospitals within the region. This ... , and length of stay (LOS) strategic oversight. The Medical Director will report to the Vice...region. Key Responsibilities + Leadership & Management**: + Oversee Utilization Management ( UM ) across assigned hospitals, ensuring… more
- Wellpath (Lemoyne, PA)
- …training, education, and point of care support. **How you make a difference** The Medical Director of Utilization Management leads and oversees ... patient care and the appropriate utilization of medical services. The Medical Director ...admissions. + Evaluate and recommend policy improvement related to utilization reviewsystem, andprovide UM updates and participate… more
- Tenet Healthcare (Detroit, MI)
- Group Director Utilization Review - 2506000536 Description : The Detroit Medical Center (DMC) is a nationally recognized health care system that serves ... most diverse employers in Southeast Michigan. Summary Description SUMMARY: The Group Director , Utilization Review will perform the functions necessary to support… more
- Alameda Health System (Oakland, CA)
- Director , Utilization Management + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day + Nursing + Req #:40826-30155 + ... paid time off plans **Role Overview:** Alameda Health System is hiring! The Director of Utilization Management holds a critical role encompassing operational… more
Recent Jobs
-
Lead Software Engineer (Full Stack) - Build Reliability
- SpaceX (Hawthorne, CA)
-
Principal / Sr. Principal Electrical Test Engineer
- Northrop Grumman (Los Angeles, CA)
Related Job Searches:
Director,
Director UM,
Director Utilization,
Medical,
Medical Director,
UM Medical Director,
Utilization