- Ascension Health (Nashville, TN)
- …. Must be located with in the TN market . We're looking for an experienced Director of Utilization Management to join our team! In this pivotal role, ... **Details** + **Department:** Utilization Management + **Schedule:** Monday -...root-cause analysis to enhance our processes. You'll collaborate with Market Care Management , Finance, CDI, and Physician… more
- Humana (Louisville, KY)
- …a part of our caring community and help us put health first** The Associate Director , Utilization Management utilizes clinical nursing skills to support the ... and communication of medical services and/or benefit administration determinations. The Associate Director , Utilization Management Nursing requires a solid… more
- CommonSpirit Health Mountain Region (Centennial, CO)
- …care about your success. 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...processes appeals and reconsiderations. In collaboration with the Division Director Care Coordination, the UM Director develops… more
- Rady Children's Hospital San Diego (San Diego, CA)
- …team of physicians and nurses working with the Rady Children's Health Network. The Utilization Management Medical Director will collaborate closely with the ... ideal candidate will have a strong pediatric clinical background. Utilization management experience is a plus. This...full benefits with a remote work option. The Medical Director , UM is a clinical subject-matter expert for the… more
- LA Care Health Plan (Los Angeles, CA)
- Supervisor, Utilization Management RN Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full ... safety net required to achieve that purpose. Job Summary The Supervisor of Utilization Management (UM) RN is responsible for executing the day-to-day operations… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position ... support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and approves… more
- Rady Children's Hospital San Diego (San Diego, CA)
- JOB SUMMARY: Under the supervision of the Director , Utilization Management (UM) Operations & Member Services, the UM Operations Specialist will provide ... meetings as needed, and documents meeting minutes Under the supervision of the Director , Utilization Management (UM) Operations & Member Services, the… more
- Rady Children's Hospital San Diego (San Diego, CA)
- …phone calls. As part of the managed care insurance process the Manager of Utilization Management Operations is responsible for oversight of teams that process ... JOB SUMMARY: Under the supervision of the Director , UM Operations, the Manager, UM Operations oversees...internally equitable. We demonstrate this commitment by conducting regular market reviews to remain competitive with organizations of similar… more
- ChenMed (Houston, TX)
- …expanding and we need great people to join our team. The Associate Market Clinical Director will directly supervise, performance manage and train Clinical ... workplace concerns. + Reviews/approves center-level referrals and provides back-up for market referral and delegated utilization authorizations. Other duties as… more
- Organon & Co. (Boston, MA)
- …to help the team be more effective? Then this role may be for you. The Associate Director Market Access Insights & Planning will report to the Director of US ... Planning and Contract Operations and support the Organon US Market Access and Account Management (MA&AM) team....performance and provide insights for optimization based on current market access and utilization trends. This assignment… more