- Intermountain Health (Las Vegas, NV)
- …utilization management, care management, claims, network management, and finance. As the Medical Director for Utilization Management, you are responsible, ... 1-3 are a must in order to be considered for the position.** Performs medical review activities pertaining to utilization review , claims review ,… more
- AnMed Health (Anderson, SC)
- The Utilization Review Medical Director supports operations and direction of the Care Coordination, Clinical Documentation, and Utilization ... Management programs at AnMed. The Medical Director ensures the program and associated physicians work collaboratively with and provide consultation to the… more
- Tenet Healthcare (Detroit, MI)
- Group Utilization Review Director - 2506000536 Description : The Detroit Medical Center (DMC) is a nationally recognized health care system that serves ... and most diverse employers in Southeast Michigan. Summary Description SUMMARY: The Group Director , Utilization Review will perform the functions necessary to… more
- BriteLife Recovery (Englewood, NJ)
- What you will be doing? The Director of Utilization Review is responsible for overseeing all utilization review activities to ensure that clients ... for each client. This individual leads a team of utilization review specialists and works closely with...departments to ensure that documentation and treatment plans support medical necessity for all levels of care provided. The… more
- Intermountain Health (Las Vegas, NV)
- **Job Description:** The Utilization Review Care Management Director is responsible for providing leadership and administrative direction for Utilization ... optimal patient level of care, and attainment of financial goals. Reporting to the Sr. Director /AVP/VP Utilization Management, the role of the Director for … more
- UPMC (Pittsburgh, PA)
- The Medical Director , Utilization Management is responsible for assuring physician commitment and delivery of comprehensive high-quality health care to UPMC ... Changing Medicine happen. **Responsibilities:** + Actively participates in the daily utilization management and quality improvement review processes, including… more
- Humana (Louisville, KY)
- …of medical services and/or benefit administration determinations. The Associate Director , Utilization Management Nursing requires a solid understanding of ... utilization management staff; direct performance regarding prior authorization, medical necessity determinations, concurrent review , retrospective review… more
- AmeriHealth Caritas (Newtown Square, PA)
- …services. Discover more about us at www.amerihealthcaritas.com. **Responsibilities:** The Medical Director , Utilization Management provides organizational ... leadership in the operational areas of care management, utilization review , appeals, quality improvement and related...policy and practice initiatives in collaboration with the Corporate Medical Director (s), Utilization Management and… more
- Mount Sinai Health System (New York, NY)
- …influence other services by focusing on patient processes. 9. Develops and implements Utilization Review (UR) based on internal data collection, data received ... from external agencies, Physician Advisors and the Medical Director . 10. Works collaboratively with Admitting, Transfer Services and Finance to ensure… more
- Prime Healthcare (Inglewood, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/200257/ director -of-case-management utilization ... Overview AtCentinela Hospital Medical Center, our dedicated team of professionals are...case managers, social workers and case management coordinators/discharge planners, utilization review coordinators and utilization … more