- Integra Partners (Troy, MI)
- …( Senior MD) serves as the clinical and strategic leader for Integra's Utilization Management (UM) and Credentialing programs. This is a full-time, 40+ hour ... quality and inter-rater reliability, overseeing audit readiness, and chairing Integra's Utilization Management Committee and Credentialing Committee. This role… more
- Fallon Health (Worcester, MA)
- …strategic leadership and oversight responsibility for the clinical and operational utilization management activities for all inpatient and outpatient care, ... and staff across all product lines. **Responsibilities** ** Utilization Management :** + Oversees all administrative, operational and clinical functions related to… more
- CommonSpirit Health (Phoenix, AZ)
- …the senior leadership team, the System Vice President of Utilization management will contribute to high-level organizational decision-making, working closely ... **Job Summary and Responsibilities** The System Vice President of Utilization Management is a key member of the healthcare organization's leadership team and is… more
- Centene Corporation (Sacramento, CA)
- …knowledge of regulations, accreditation standards, and industry best practices related to utilization management + Works with utilization management ... ensure appropriate care to members. Supervises day-to-day activities of utilization management team. + Monitors and tracks...applicable guidelines, policies, and procedures + Works with the senior management to develop and implement UM… more
- Access Dubuque (Dubuque, IA)
- … and Accreditation Program Manager UnityPoint Health Finley Hospital Utilization Management Nurse Cottingham & Butler/ SISCO CNA Psychiatric Unit ... Utilization Management CNA **Cottingham & Butler/... Utilization Management CNA **Cottingham & Butler/ SISCO** 1 Positions...MercyOne CNA Surgical Unit - PT Days MercyOne CNA Senior Care - PT Evenings MercyOne Entry Level Sales… more
- Houston Methodist (Houston, TX)
- …improvements as needed. + Collaborates with HMCPA on care transition and utilization management initiatives. + Provides strategic vision and execution for ... for providing executive leadership and strategic oversight for all hospital-based Case Management Directors and the Central Utilization Review Director across… more
- University of Michigan (Ann Arbor, MI)
- …Senior Director leads interdisciplinary teams in advancing care coordination, utilization management , discharge planning, psychosocial care, and innovative ... SENIOR DIRECTOR (Care Management and Social...(5) years progressive leadership experience in acute care, case management , social work, utilization review, or discharge… more
- Centene Corporation (Jefferson City, MO)
- …Clinical review quality oversight and management . + Utilization Management experience and knowledge of quality accreditation standards preferred. + ... Purpose:** Lead a team of medical directors and supervise MD's responsible for utilization management and appeals functions to ensure members receive medically… more
- Ventura County (Ventura, CA)
- …Inpatient Psychiatric unit of the Ventura County Medical Center including utilization management , transfer coordination, discharge planning, and securing ... Senior Mental Health Nurse Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5061656) Apply ...and review; + Performs daily clinical reviews to support utilization and quality management , ensuring compliance with… more
- UPMC (Pittsburgh, PA)
- …with all relevant policies, procedures, guidelines and all other regulatory and accreditation standards. The Senior Strategic Sourcing Manager (Sr. SSM) will ... to grow in your career at UPMC UPMC is looking for a full-time Senior Strategic Sourcing Manager. This position works Monday- Friday, standard daylight hours. This… more