- Point32Health (Canton, MA)
- …we are at Point32Health, click here (https://youtu.be/S5I\_HgoecJQ) . **Job Summary** The Director , Utilization Management is responsible for directing, ... the business processes and operations for all levels of utilization management review (ie, Precertification and Intake...leadership. The Director oversees and leads medical management activities related to precertification utilization … more
- Commonwealth Care Alliance (Boston, MA)
- **Why This Role is Important to Us:** The Director of Utilization Management leads and manages all utilization management (UM) functions for physical ... state and federal regulatory requirements and all applicable accreditation standards. The Director of Utilization Management is responsible for setting… more
- CareFirst (Baltimore, MD)
- …location based on business needs and work activities/deliverables that week. The Director , Utilization Management provides strategic leadership of the ... utilization management team and is responsible for the design, assessment,...responsible for the design, assessment, implementation and outcomes of utilization management strategies using a multidisciplinary approach… more
- WellSpan Health (York, PA)
- …Utilization Management Review Committees. Co-chair's System Utilization Management Committee. + Works closely with Medical Director to identify trends ... Committee Meetings with payers. + Organizes and assists Medical Director with System Utilization Management Committee (URC) meetings. Prepares reports for… more
- Prime Healthcare (Ontario, CA)
- …Responsibilities The Corporate Director of Clinical ... individual and Company performance. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/172723/corporate- director -of-clinical- utilization - management /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilityPrime Healthcare… more
- Catholic Health Initiatives (Lexington, KY)
- …can happen both inside our hospitals and out in the community. **Responsibilities** 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 Coordination… more
- CommonSpirit Health Mountain Region (Centennial, CO)
- …resources to help you flourish and leaders who 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 Health Care Coordination… more
- Dignity Health (Bakersfield, CA)
- …practice, capitation, HMO regulations, managed healthcare systems, quality improvement, medical utilization management , risk management , risk adjustment, ... work within PST business hours.** **Position Summary:** The Medical Director of UM reports to the Chief Physician Executive...Minimum of 10 years+ of clinical experience in a Utilization Management setting preferred - Board Certified… more
- Fallon Health (Worcester, MA)
- …MA (or licensable). Board certified in medical or surgical specialty. **Experience:** Utilization management ; network management ; medical policy and ... This position works with both inpatient and outpatient Care Management nurses to monitor appropriate care and services in...review + Pharmacy issues and referral requests + Medical director on-call coverage + Support the benefits and technology… more
- UTMB Health (Galveston, TX)
- …and reports trends of inappropriate resource utilization to Director /Assistant Director of Utilization Management . + Maintains a documentation system ... the use of medical services, procedures, and facilities. Supports the UTMB Utilization Management Program utilizing clinical knowledge, expertise, and criteria… more