- Evolent (Springfield, IL)
- …selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with the Senior Medical Director. ... , you will be a key member of the utilization management team. We can offer you... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National… more
- Evolent (Springfield, IL)
- …selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with the Senior Medical Director. ... the mission. Stay for the culture. **What You'll Be Doing:** **Cardiovascular Utilization Management Reviewer (Interventional Cardiologist)** Are you ready to… more
- Evolent (Springfield, IL)
- …selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with the Senior Medical Director. ... Director you will be a key member of the utilization management team. We can offer you... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National… more
- Evolent (Springfield, IL)
- …Doing:** As a Field Medical Director, Oncology, you will be a key member of the utilization management team. We can offer you a meaningful way to make a ... Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. .… more
- Evolent (Springfield, IL)
- …Doing:** Job Description As a FMD, Radiology you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference ... Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. +… more
- Rush University Medical Center (Chicago, IL)
- …physician orientations. * Develops and revises credentialing forms as necessary. * Senior point person for external/internal accreditation requests to provide ... depending on the circumstances of each case. **Summary:** Acts as Senior Credentialing Coordinator for Medical Staff Services operations. Supervises and coordinates… more
- CVS Health (Springfield, IL)
- … in support of Key Clients as assigned. The Medical Director transacts Utilization Management UM activities (prior authorization and appeals) and responds to ... programs and commercial client program support. Will share in reviews of utilization management (PA) criteria and clinical policy revisions/reviews. - Directors… more
- The Boeing Company (Mascoutah, IL)
- …analysis and metrics to solve complex problems and provide consultation to senior leadership and customers. + Directs research, design, development, improvement, and ... cost, and improve quality, for large scale systems integration and asset utilization . + Consults on plans and programs for facility/factory modifications and… more
- Evolent (Springfield, IL)
- …members and providers + Appropriately identifies and refers quality issues to the Senior Director of Medical Management or Medical Director. + Appropriately ... policies + Creates adverse determination notifications that meet all accreditation , State, and Federal criteria + Uses Plain Language...identifies potential cases for Care Management programs + Communicates appropriate information to other staff… more