- Humana (Louisville, KY)
- **Become a part of our caring community and help us put health first** The Associate Director , Utilization Management utilizes clinical nursing skills to ... documentation and communication of medical services and/or benefit administration determinations. The Associate Director , Utilization Management Nursing… 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 -...optimize patient care and partner with the National Senior Director of UM to align on organizational goals. Ready… more
- Ascension Health (Nashville, TN)
- …internal Ascension Travel Program, please visit our site (https://about.ascension.org/our-work/ associate -travel-program) . **Benefits** Paid time off (PTO) Various ... care plan development, service level determination, patient visits, and complaint management . + Prepare and monitor budget(s) and ensure that assigned nursing… more
- LA Care Health Plan (Los Angeles, CA)
- Supervisor, Utilization Management RN Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full ... safety net required to achieve that purpose. Job Summary The Supervisor of Utilization Management (UM) RN is responsible for executing the day-to-day operations… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position ... support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and approves… more
- Vanderbilt University Medical Center (Nashville, TN)
- …Operating Officer - Vanderbilt Transplant Center. The Executive Director and Associate Operating Officer shall provide general management for the operations ... Director and Associate ...+ Lead activities related to performance, improvement, and risk management programs to establish and meet clinical quality goals,… more
- AmeriHealth Caritas (Dover, DE)
- …Under the direction of a supervisor, the Clinical Care Reviewer - Utilization Management evaluates medical necessity for inpatient and outpatient services, ... policies. When necessary, cases are escalated to the Medical Director for further review. The reviewer independently applies medical...in a fast-paced environment. ;The Clinical Care Reviewer - Utilization Management will also be counted upon… more
- Gilead Sciences, Inc. (Santa Monica, CA)
- …Join Kite and help create more tomorrows. **Job Description** The ** Associate Director of Clinical Trial Planning, Resource Management , and Reporting** is a ... clinical plans + update project templates and styles. Resource Management & Reporting: + Support Director of...+ Stakeholder communication + Risk assessment & mitigation + Utilization of project management core principles (PMP… more
- University of Florida (Gainesville, FL)
- … Professor. The Assistant Director for Clinical Services assists the Associate Director for Clinical Services in providing leadership, vision, coordination, ... and oversight for clinical services and operations. They are responsible to the Director or Associate Director of Clinical Services or appropriate… more
- AmeriHealth Caritas (Charleston, SC)
- …**Responsibilities:** Under the direction of the Supervisor, the Behavioral Health Utilization Management Reviewer is responsible for completing medical ... and appropriately identify and refer requests to the Medical Director when indicated. The BH UM Reviewers are responsible...of behavioral health and substance use disorder experience.; + Utilization management experience in a managed care… more