- Integra Partners (Troy, MI)
- …as operational needs require. The Senior MD provides clinical oversight to the Utilization Review Medical Director (s), ensures consistent application ... Integra's clinical position to internal and external stakeholders. The Senior Utilization Review Medical Director 's responsibilities include but are… 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 ... and are committed to consistency, compliance, and evidence-based decision making. The Utilization Review Medical Director 's responsibilities include but… more
- CenterWell (Lansing, MI)
- … Director of Physician Strategy at Utilization Management. The Medical Director conducts Utilization review of the care received by members in an ... understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to… more
- Integra Partners (Troy, MI)
- … and process clinical and administrative appeals; coordinate with Medical Director when required. + Generate and review daily/weekly reporting on ... in a payer or managed care environment. + Strong understanding of utilization review , authorizations, and appeals processes. + Excellent verbal/written… more
- Evolent (Lansing, MI)
- …non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional ... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National...process. + May assist the Senior Medical Director in research activities/questions related to the Utilization… more
- Humana (Lansing, MI)
- …will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex ... management. + Utilization management experience in a medical management review organization, such as Medicare... Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management… more
- Integra Partners (Troy, MI)
- The UM Coordinator assists and supports the clinical team (UM Nurses/ Medical Director ) with administrative and non-clinical tasks related to processing ... Utilization Management prior authorization sand appeals. JOB RESPONSIBILITIES +...RESPONSIBILITIES + Monitor incoming faxes + Enter UM authorizations review requests in UM platform using ICD-10 and HCPCS… more
- Humana (Lansing, MI)
- …will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex ... Medicaid. + Utilization management experience in a medical management review organization, such as Medicare...on size of region or line of business. The Medical Director conducts Utilization Management… more
- Evolent (Lansing, MI)
- …per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management process, ... culture. **What You'll Be Doing:** As a Cardiology, Field Medical Director you will be a key... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National… more
- Evolent (Lansing, MI)
- …per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management process, ... **What You'll Be Doing:** As a Vascular Surgery, Field Medical Director you will be a key... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National… more