- Trinity Health (Des Moines, IA)
- …UM Lead is responsible for overseeing day-to-day activities within the Utilization Management (UM) department, including staffing, assignment management , ... policies to ensure adherence. **Minimum Qualifications:** + Comprehensive knowledge of Utilization Management , typically gained through a bachelor's degree in… more
- Mount Sinai Health System (New York, NY)
- …**Program Leadership & Expansion** * Lead , expand, and sustain the SNF Utilization Management Initiative across a network; SNF partners. * Support post-acute ... **Program Director (Licensed)** is responsible for leading and sustaining a Utilization Management Initiative supporting ACO and value-based care populations.… more
- CommonSpirit Health (Phoenix, AZ)
- …the senior leadership team , the System Vice President of Utilization management will contribute to high-level organizational decision-making, working closely ... is a key member of the healthcare organization's leadership team and is charged with meeting the organization's goals...patient care. **Essential Key Responsibilities:** + Leadership & Strategy: Lead the System-level Utilization Management … more
- UNC Health Care (Morrisville, NC)
- …of high-quality, value-based care across the healthcare system. **Responsibilities** : 1. ** Utilization Management ** - Develop and lead a system-wide ... we serve. **Summary** : The **Executive System Director of Utilization Management (UM)** is a strategic and...current Medicare and Joint Commission compliance requirements. + Successful team facilitation and change management experience. +… more
- Alameda Health System (Oakland, CA)
- …each individual in the classification. + Lead and manage a team of utilization review professionals providing guidance, training, and performance ... Director, Utilization Management + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day + Nursing + Req #:40826-30155 +… more
- Tenet Healthcare (Detroit, MI)
- …national standards for case management scope of services including: Utilization Management services supporting medical necessity and denial prevention ... potentially avoidable days Other duties as assigned. POSITION SPECIFIC RESPONSIBILITIES: Utilization Management Balances clinical and financial requirements and… more
- Elevance Health (Washington, DC)
- …is located at 609 H. Street NE.** The **RN** **Manager - Utilization Management ** is responsible for managing a team of physical health practitioners in the ... acuity. + Provides direct oversight and is responsible for Utilization Management execution/decision making for managed member...+ Assists and provides back up coverage to Case Management team **Minimum Requirements:** + BA/BS in… more
- LifeCenter Northwest (Bellevue, WA)
- …General Responsibilities + Lead and engage daily with the Organ Utilization Coordinator (OUC) team in donor case operations, developing and implementing ... actions. + Contribute to LifeCenter Northwest's strategic planning efforts and the Organ Utilization Team 's operational plan. + Based on quality reviews of… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …on documentation and reimbursement requirements. Serves as a resource to the health care team for utilization and denial management . Liaises with provider ... review functions. Oversees daily operations, which include supervising staff performing utilization management activities. The goal is to achieve clinical,… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE** : Supervise the daily operations of the utilization management (UM) department functions to ensure appropriate coordination ... of business. **Knowledge, Skills and Abilities (KSAs)** + Oversight of Utilization Management clinicians while championing process improvement, change adoption… more
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