- Humana (Nashville, TN)
- **Become a part of our caring community and help us put health first** The Utilization Management (UM) Director , Clinical Strategy and Practice for Medicaid ... of how organization capabilities interrelate across the function or segment. The Utilization Management (UM) Director , Clinical Strategy and Practice… more
- Ascension Health (Nashville, TN)
- …TN market. Must be located with in the TN market. We're looking for an experienced Director of Utilization Management to join our team! In this pivotal role, ... **Details** + **Department:** Utilization Management + **Schedule:** Monday -... to optimize patient care and partner with the National Senior Director of UM to align… more
- Zurich NA (Nashville, TN)
- …+ Experience in development and implementation of cost containment programs + Case management , utilization review, catastrophic or disability experience + 5 or ... AVP, Utilization Review & Pharmacy 123092 Zurich Insurance is...recruiting and retaining team members. + Drive the performance management process by communicating job expectations, monitoring and evaluating… more
- Select Medical (Memphis, TN)
- …focus on resource management . + Demonstrating compliance with facility-wide Utilization Management policies and procedures. + Coordinating UR compliance with ... **Overview** **Critical Illness Recovery Hospital** ** Director of Case Management ** Position Will...growth of the department, including, but not limited to: Utilization Review (UR) and resource management , discharge… more
- Community Health Systems (Powell, TN)
- …+ Refers cases not meeting criteria to the Physician Advisor or Utilization Management Committee and ensures appropriate follow-up. + Identifies avoidable ... available. Day shift with Monday-Friday Schedule. **Job Summary** The Director , Care Management is responsible for overseeing...experience required + 3-5 years of experience in care management or utilization review required + 1-3… more
- Humana (Nashville, TN)
- …to the Lead Medical Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....with prior experience participating in teams focusing on quality management , utilization management , case … more
- Evolent (Nashville, TN)
- …classes as needed for new hires to educate and train on Utilization management system and Field Medical Director process, standards and resources. + Acts as ... for the culture. **What You'll Be Doing:** The Medical Director for MSK Surgery is a key member of...reviews appeal cases and/or attends hearings for discussion of utilization management decisions. + Strong partnership with… more
- Humana (Nashville, TN)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....with prior experience participating in teams focusing on quality management , utilization management , case … more
- Evolent (Nashville, TN)
- …impact on patient care in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your ... Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. +… more
- Humana (Nashville, TN)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....with prior experience participating in teams focusing on quality management , utilization management , case … more