- Humana (Lansing, MI)
- …a Lead Medical Director , depending on the line of business. The Medical Director conducts Utilization Management or clinical validation of the care ... **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement… more
- University of Miami (Miami, FL)
- …and documentation of potentially compensable events to Chief Medical Risk Officer, Director of Medical Claims and Assistant General Counsel. Conduct ... Management has an exciting opportunity for a full-time Director , Risk Management to work on the...shall provide consultation to UM leadership that includes: Senior Management , Faculty and Staff, Medical Leadership and… more
- CenterWell (Boston, MA)
- …us put health first** The Medical Director , Primary Care relies on medical background and reviews health claims . The Medical Director , Primary ... The Medical Director relies on medical background and reviews health claims . The...the Director of Physician Strategy at Utilization Management . The Medical Director conducts… more
- Humana (Indianapolis, IN)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Lead Medical Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of the care received by members in the… more
- Humana (Little Rock, AR)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an… more
- Rush University Medical Center (Chicago, IL)
- …Chicago, Illinois Business Unit: Rush Medical Center Hospital: Rush University Medical Center Department: RUH Health Information Mgmt **Work Type:** Full ... depending on the circumstances of each case. **Summary:** The Director of Health Information Management will lead... record and forms automation, prevent denials related to medical record submission, train staff, ensure timely claims… more
- Guthrie (Cortland, NY)
- …as necessary with the hospital Business Office, physician offices, Care Coordination, Medical Director and other hospital departments as appropriate. + Serves ... Summary The LPN Utilization Management (UM) Reviewer, in collaboration with Care Coordination,...requirements and to assist in ensuring generation of clean claims in a timely manner + Securing authorization as… more
- Guthrie (Towanda, PA)
- …Leads any payer specific external claim audit activity, worked in combination with Management , Compliance, Medical Records and Clinical Operations. 9. Serves as ... Insurance Billing Specialists I and related support staff. Works closely with Director , Manager, Supervisor and Application Analyst on day to day priorities and… more
- Fluor (Greenville, SC)
- …and resolution of claims * Work with Construction, Engineering, Supply Chain Management , Legal, and Insurance and Risk Management to assist in facilitating ... Defense and the Intelligence Community. **Job Description** This position assists in the management of prime contracts in conjunction with the Project Director … more
- ABM Industries (Atlanta, GA)
- …Design and implement best practices, policies, and procedures to ensure efficient claims management and regulatory compliance. + Continuously assess the ... **Overview** The Director of Workers' Compensation Claims is...evaluate performance of external partners, including TPAs, legal firms, medical management vendors, and investigative services. +… more
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