- Memorial Hermann Health System (Houston, TX)
- …of the following: Care Facilitation, Utilization Management , Case Management and Discharge Planning.The Director is responsible for developing systems ... Health System is seeking a Registered Nurse (RN) Case Management Director for a nursing job in...financial and quality data related to utilization management , quality improvement and performance improvement. The Director… more
- Pathways Vermont (Burlington, VT)
- …House Program Manager Supervisor: Alternative Mental Health Services Director Location: Burlington, Vermont Responsibilities:Oversight of Service ProvisionEnsure ... residents receive excellent services, including: Individualized Service Plans Monitoring utilization of services, including duration, medication, incidents, external connections,… more
- Tower Water (Somerset, NJ)
- Tower Water Management is seeking an experienced Water Treatment Sales Manager to oversee existing territory and manage the sales team in the Northeast Region. This ... growing a small territory and report directly to the Director of Sales and Marketing. Tower Water is in...tools to streamline sales processes. Implement a customer relationship management (CRM) system for efficient tracking and management… more
- Comhar Inc. (Philadelphia, PA)
- …8:30AM-5:00PMBilingual Blended Case Manager Supervisor Position SummaryCOMHAR's Targeted Case Management (TCM) program provides blended case management services ... needs and work to achieve their goals. Our case management unit also has 2 specialty teams that provide...a chart review should be completed using the updated Utilization Review sheet with particular attention paid to whether… more
- Marion County (Salem, OR)
- …SUPERVISION RECEIVEDWorks under the general supervision of a Health Department Division Director who assigns and oversees work, establishes goals and reviews results ... to the following Program Development & ManagementProvide program development and management /oversight of a diverse group of programs and teams. Program oversight… more
- Saint Francis Health System (Tulsa, OK)
- …and support decision-making. Working knowledge of general disease state management processes, bio-psychosocial model, and clinical pathways. Ability to receive ... toward goals. Facilitates patient discharge through timely, appropriate referrals and utilization of patient education resources, suitable to patient age and… more
- Universal Health Services (Streamwood, IL)
- Responsibilities Director of Utilization Management Full-Time The Director of Utilization Management is responsible for the oversight of the ... utilization management department. Responsibilities include monitoring team members to initiate...and implementation of discharge planning and customer service. The Director will analyze data to track trends including length… more
- Prime Healthcare (Ontario, CA)
- …Responsibilities The Corporate Director of Clinical ... individual and Company performance. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/160505/corporate- director -of-clinical- utilization - management /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilityPrime Healthcare… more
- Virginia Mason Franciscan Health (Bremerton, WA)
- …annual bonus eligibility, and more! **Responsibilities** **Job Summary / Purpose** The Utilization Management (UM) Director is responsible for the ... market(s) development, implementation, evaluation and direction of the Utilization Management Program and staff in support of the CommonSpirit Health Care… more
- Ascension Health (Baltimore, MD)
- …Ascension Saint Agnes is seeking a dynamic and experienced Director of Case Management & Utilization Management . In this position you will play a ... **Details** + **Department:** Case Management & Utilization Management + **Schedule:** Monday - Friday. 40 hours a week. + **Hospital:** Ascension Saint… more
- Geisinger (Harrisburg, PA)
- …Establishes and leads execution of a strategic plan for the provision of Utilization Management services across the organization, fostering a spirit of ... provide effective and meaningful educational programs across the department. Responsible for management of the Utilization Review policy and observation … more
- Ascension Health (Austin, TX)
- …Provide strategic direction and oversight of the day-to-day operations of utilization management function within the insurance plan. + Ensure ... integration of utilization management functions with network strategy and claims processing. + Oversee work with provider relations on resolving issues. + Manage… more
- Elevance Health (Columbus, OH)
- **Clinical Operations Medical Director ** ** Utilization Management of Medical Oncology Benefits** **Carelon Benefits Management ** **$20,000 Sign On ... proud member of the Elevance Health family of companies, Carelon Medical Benefits Management , formerly AIM Specialty Health, is a benefit- management leader in… more
- Universal Health Services (San Antonio, TX)
- …Standards, providing on-site education to manage difficult cases, and assisting the Director of Utilization Management with department processes and ... procedures. Key Responsibilities: + Maintains knowledge of all facets of Utilization Management + Supports Director and performs management duties when … more
- Mirror (Newton, KS)
- Job Summary: Under the administrative supervision of the Director of Utilization Management , the URC is responsible for the implementation, and maintenance ... and departmental guidelines. + Other duties as requested by the Director of Utilization Management . Qualifications + High School diploma or equivalent… more
- AdventHealth (Maitland, FL)
- …The Medical Director is responsible for providing physician review of utilization , claims management , and quality assurance related to inpatient care, ... assigned by the Division CFO/SrVP, Vice President of Revenue Cycle Operations and/or Director , Utilization Review Management ..Reviews data and trends to… more
- CVS Health (Springfield, IL)
- …to Account Management in support of Key Clients as assigned.The Medical Director transacts Utilization Management UM activities (prior authorization and ... Management in support of Key Clients as assigned.The Medical Director transacts Utilization Management UM activities (prior authorization and appeals) and… more
- Humana (Columbus, OH)
- … 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
- Humana (Columbus, OH)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... with prior experience participating in teams focusing on quality management , utilization management , case ...management operational improvements, including those within the medical director area + Participate in call rotation + Develop… more
- Dignity Health (Rancho Cordova, CA)
- …home.** **Position Summary:** Under the guidance and supervision of the department Manager/ Director , the Supervisor of Utilization Management is responsible ... (Medicare Guidelines, InterQual, Health Plan Benefit Interpretation Guidelines and Medical Management Policies, and DHMF Utilization Management guidelines… more
