- Elevance Health (Louisville, KY)
- …must live within 50 miles of one of our Elevance Health locations.** The Medical Director is responsible for the administration of physical and/or behavioral ... cost of care opportunities. May serve as a resource to staff including Medical Director Associates. May be responsible for an entire clinical program. How you… more
- Elevance Health (Atlanta, GA)
- …within 50 miles of one of our Elevance Health office locations.** The Medical Director is responsible for the administration of physical and/or behavioral ... cost of care opportunities. May serve as a resource to staff including Medical Director Associates. May be responsible for an entire clinical program. How you… more
- Elevance Health (Rancho Cordova, CA)
- …disability plans, and are flexible enough to fit any size business. The ** Medical Director ** is responsible for the administration of physical and/or behavioral ... Additional experience may be required by State contracts or regulations if the Medical Director is filing a role required by a State agency. Preferred Skills,… more
- City and County of San Francisco (San Francisco, CA)
- …specifically in the Mental Health Service Center + Supervises medical staff, including UM Medical Director , OCC Nurse Practitioner, and the medical ... health services, including psychiatric services. The Behavioral Health Services (BHS) Deputy Medical Director of Managed Care provides effective leadership and… more
- Nuvance Health (Norwalk, CT)
- …cost-effective utilization of Hospital Resources and optimize financial performance. Collaborates with UM Medical Director and Vice President of Medicine. ... Care Coordination Director Location: Norwalk, CT, United States Requisition ID:...Northern Dutchess Hospital, Putnam Hospital Center and Vassar Brothers Medical Center in New York - plus multiple primary… more
- YesCare Corp (Bartow, FL)
- … UM + Reviews requests for outpatient services, codes, and forwards to Corporate UM Medical Director + Performs monthly audit of Inpatient, ER and ... + Minimum of two (2) years prior experience with UM preferred + Minimum of one (1) year prior...each site and participates in Utilization Review with Clinical Director and other personnel as required + Provides assistance… more
- University of Maryland, Baltimore (Baltimore, MD)
- The University of Maryland School of Medicine is seeking a Chair and Medical Director of Critical Care for the UM Capital Region Health Medical Center ... Associates, PA They will work closely and in collaboration with the Trauma Medical Director , Chief of Cardiac Surgery, Surgery, Medicine, Neurocritical Care. The… more
- BlueCross BlueShield of North Carolina (NC)
- …according to regulatory requirements. * Assess appropriateness for secondary case review by the Medical Director (MD) for denials and coordinate as needed. * May ... coordinate the delivery of health care services for members based on medical necessity and contractual benefits. Effectively coordinate with providers, members, and… more
- UCLA Health (Los Angeles, CA)
- …state and federal laws/regulations. You will extrapolate and summarize essential information for the UM Manager and Medical Director and regularly meet with ... MSO, IPA, or health plan) + In-depth knowledge of medical terminology + Understanding of the HMO referral process,...records + Ability to thrive within a complex academic medical center + Ability to develop, implement, and evaluate… more
- Healthfirst (NY)
- …and medical departments + Conduct ad hoc medical condition research per Medical Director and/or UM Clinical Director requests. + Collaborate with ... **Duties/Responsibilities:** + Support the Medical Policy and Clinical Utilization Management ( UM...the Medical Policy and Clinical Utilization Management ( UM ) Governance Committee Chairs, committee members, and related workgroups… more
- CVS Health (Springfield, IL)
- …clinical support to Account Management in support of Key Clients as assigned.The Medical Director transacts Utilization Management UM activities (prior ... to Account Management in support of Key Clients as assigned.The Medical Director transacts Utilization Management UM activities (prior authorization and… more
- Virginia Mason Franciscan Health (Bremerton, WA)
- …necessity determinations; processes appeals and reconsiderations. In collaboration with the Division Director Care Coordination, the UM Director develops ... highest quality of care provided by our expert, compassionate medical care team at 11 hospitals and nearly 300...more! **Responsibilities** **Job Summary / Purpose** The Utilization Management ( UM ) Director is responsible for the market(s)… more
- Magellan Health Services (Dallas, TX)
- …quality improvement activity (QIA) in collaboration with the clinical lead senior medical director , and quality improvement staff. May participate in various ... day to day physician oversight to an assigned interdisciplinary UM team, including regular involvement in the case management...committees or project teams as directed by the senior medical director or vice-president. + Supports senior… more
- YesCare Corp (Hagerstown, MD)
- …disabled Veteran status. EOE including Disability/Protected Veterans._ **Responsibilities** Regional Medical Director (RMD) is primarily accountable for quality ... is a list of your responsibilities as a **Regional Medical Director ** **(RMD)** with YesCare located in...safety and chart and site audits. + Adherence to UM programs specific to the contract requirements and corporate's… more
- University of Miami (Coral Gables, FL)
- …. The University of Miami has a great opportunity for an Assistant Director , Academic Advising to work at the Coral Gables Campus. The Assistant ... Director of Transitional Advising works with undergraduate students to...and outreach to ensure students are completing Road to UM tasks, Road to UM modules, and… more
- University of Maryland, Baltimore (Baltimore, MD)
- …physician-scientist with expertise in clinical trial design and execution to serve as Director of Clinical Trial Innovation.* The UM -IHC is a large-scale ... life and longevity of the citizens of Maryland. The UM -IHC, located in North Bethesda, MD, is a collaborative...of Maryland College Park, and the University of Maryland Medical System, funded with initial grants from the State… more
- ChenMed (Louisville, KY)
- …for the foundational business unit of our care model - the center. The Senior Medical Director (SMD) will partner with the Center Director /Center Executive ... The SMD is an earned title where the Center Medical Director completes all necessary primary care...conjunction with the transitional care team; hospital, SNF, post-acute, UM , and home-based services for the division. + Assists… more
- CVS Health (Hartford, CT)
- …members' health care and social determinant needs. The Duals Care Management (CM) Medical Director will participate in designing, developing and deploying our ... physical, behavioral and socioeconomic needs.* Partner closely with the Executive Director of Duals and other Duals Care Management leadership to collaborate… more
- University of Miami (Miami, FL)
- …OPO certification to all LAORA staff within 2 years of hire. + Work closely with Medical Director , Director of Operations, and the Executive Director to ... areas of organ donation. + Work closely with the Medical Director , Director of Operations...in an effort to help other members of the medical community learn from the UM OPO… more
- CVS Health (Hartford, CT)
- …personal, convenient and affordable. Job Purpose and Summary: The LTSS/SAI National Senior Medical Director , reporting to a Regional CMO of Medicaid, will ... LTSS line of business including but not limited to UM , Quality, care management, and network growth as listed...team and develops specific actions to manage LTSS related medical cost trends* Develops benchmarks for LTSS clinical staff… more