- Conifer Revenue Cycle Solutions (Detroit, MI)
- …process quality and accuracy adherence to process standards Relative cost management metrics goals expense, cost, and margin control monthly, quarterly, and ... annual financial goal management ESSENTIAL DUTIES AND RESPONSIBILITIES Include the following. Others...of hospital budgets and ensures and manages human resource utilization at all levels. Analyzes monthly P & L's… more
- Humana (Lansing, MI)
- … Director , depending on the line of business. The Medical Director conducts Utilization Management or clinical validation of the care received ... caring community and help us put health first** The Medical Director actively uses their medical...healthcare providers, clinical group practice management . + Utilization management experience in a medical… more
- Humana (Lansing, MI)
- … Medical Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of the care received by members in the ... caring community and help us put health first** The Medical Director relies on medical ...healthcare providers, clinical group practice management . + Utilization management experience in a medical… more
- Humana (Lansing, MI)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an ... caring community and help us put health first** The Medical Director relies on medical ...healthcare providers, clinical group practice management . + Utilization management experience in a medical… more
- CenterWell (Lansing, MI)
- …**Additional Information** Will report to the Director of Physician Strategy at Utilization Management . The Medical Director conducts Utilization ... **Become a part of our caring community and help us put health first** The Medical Director , Primary Care relies on medical background and reviews health… more
- Integra Partners (Troy, MI)
- …as operational needs require. The Senior MD provides clinical oversight to the Utilization Review Medical Director (s), ensures consistent application of ... representing Integra's clinical position to internal and external stakeholders. The Senior Utilization Review Medical Director 's responsibilities include but… more
- Integra Partners (Troy, MI)
- The Utilization Review Medical Director is responsible for conducting clinical reviews of Durable Medical Equipment (DME) and related requests to support ... Integra's Utilization Management (UM) operations. This full-time, salaried...committed to consistency, compliance, and evidence-based decision making. The Utilization Review Medical Director 's… more
- Molina Healthcare (Ann Arbor, MI)
- …clinical practice experience, and at least 2 years as a medical director in managed care setting supporting utilization management /quality management ... care team (ICT) activities. * Recruits, hires, trains, mentors and develops medical director staff as needed. * Ensures that authorization decisions… more
- CVS Health (Lansing, MI)
- …a team that's making a difference in the lives of patients facing complex medical journeys. As a Utilization Management (UM) Nurse Consultant specializing ... to authorize procedures/services or initiate a Medical Director referral as needed. + Assists management ...systems. + 1+ Year of Utilization Review Management and/or Medical Management experience.… more
- Integra Partners (Troy, MI)
- …appeals for DMEPOS. This individual will play a key role in collaborating with our Medical Director to perform benefit and medical necessity reviews and ... medical necessity criteria + Refer cases to the Medical Director that do not meet ...we help deliver better health outcomes and more efficient management of complex healthcare benefits. Integra Partners is a… more
