Associate director cm um operations jobs

Description: Under the supervision of the Director, Utilization Management, the manager is responsible for the daily clinical operations of the centralized UM department including Appeals, Prior Authorization, Medical Claim Review and Telephonic Inpatient Case Management. Daily coordination with Medical Directors, UM Nurses, UM Coordinators, Network Management and other various PHC departments and...
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The San Francisco Health Plan is a progressive managed care health plan designed by and for the people of San Francisco. Our goal is to provide affordable, quality health care to all residents of San Francisco. We are a fast-paced, team-oriented organization that is rapidly growing and we are ambitious in our pursuits, passionate about our mission, and creative in our execution. This is a fantasti...
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Medical Director Number of Positions: 1 Description · Provides leadership to the operation on all medical aspects relating to the peer review process, case management, and other activities requiring medical/clinical leadership, consultation and oversight. · Provides clinical oversight of the utilization management process and serves as a resource to clinical staff. · Recruits, trains, monitors and...
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Director of Manufacturing The Role: · Oversee the planning, directing and coordinating the manufacturing of products · Oversee the management of the total production departments · Oversee the responsibility for managing multi-shift production operations to meet delivery schedules · Oversee the maximization and efficiency of production lines and ensure the effective employment utilization. · Manage...
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Description Description Responsible for day-to-day operations and supervision of Case Management and Social Services departments, to include divisions and committee functions, in accordance with, Administrative and Departmental Policies and Procedures, Joint Commission on Accreditation of Healthcare Organizations (Joint Commission) Standards and applicable federal and state guidelines. Plans, dire...
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DIRECTOR OF CASE MANAGEMENT Responsible for day-to-day operations and supervision of Case Management and Social Services departments, to include divisions and committee functions, in accordance with, Administrative and Departmental Policies and Procedures, Joint Commission on Accreditation of Healthcare Organizations (Joint Commission) Standards and applicable federal and state guidelines. Plans, ...
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Description: Position Description: Primary responsibilities are performed in a TRICARE Service Center (TSC) located in a Military Treatment Facility (MTF), most often on a military installation. Manages the activities of the TSC to ensure compliance with contractual requirements and maintenance of customer service standards. Serves as the primary liaison between the MTF regarding TSC operations, n...
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RN Case Manager - Inpatient Monday- Friday; 40 Hours a Week The Job: Manage a caseload of patients by (re)assessing the individual's needs made by the PCP/​Specialist.​ Level of care, length of stay, continued stay review. SI/IS. Discharge planning for transition of care planning Reviews, verifies and processes requests for referrals/authorizations of services. Strong problem solving and organizat...
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Description: SUMMARY: The Medical Director of Ambulatory Care interacts with physicians, staff, health plan staff, Associate Medical Directors, and health plan members when a physicianâs input is needed or required. The Medical Director of Ambulatory Care is responsible for the Medical Management functions that include Utilization Management, Case Management, and Disease Management Programs, as re...
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Description Description As a part of the Tenet and Catholic Health Initiatives family, Conifer Health Solutions is a leading healthcare business process management services provider working to improve operational performance for more than 600 clients so they can support financial improvement, enhance the patient experience, and drive value-based performance. Through our revenue cycle management , ...
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Description: The Associate Director of Clinical Operations (MLTC) is responsible for clinical and medical management activities necessary to support successful operation and continued expansion of United Healthcareâs Long Term Care programs including assessing, planning, implementing, coordinating, monitoring and evaluation activities. This position provides leadership to, and is accountable for, ...
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Digital Advertising Operations Associate Director Our client, a fast-growing digital advertising technology company who works with some of the world’s most successful and iconic brands is seeking an experienced associate ad operations director to join its NY team. The Associate Director role is responsible for managing a team of Operations Analysts/Campaign Managers. Working closely with the Direc...
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Position Description: APS Healthcare provides health services to our member populations, with the goal of improving the health of those we serve. We have an exciting opportunity for a Director, Operations based in our Oklahoma City office. We are seeking an experienced, senior-level individual to lead, direct and supervise the clinical and non-clinical operations of the OK service center(s) suppor...
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Case Manager I - UM Registered Nurse (RN) highly desired Location: Columbus, OH; this is a non-remote position JOB SUMMARY Responsible for health care management and coordination of Molina Healthcare members in order to achieve optimal clinical, financial and quality of life outcomes. Works with members to create and implement an integrated collaborative plan of care. Coordinates and monitors Moli...
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The Public Health Institute (PHI) is an independent, nonprofit organization dedicated to promoting health, well-being and quality of life for people throughout California, across the nation and around the world. As one of the largest and most comprehensive public health organizations in the nation, we are at the forefront of research and innovations to improve the efficacy of public health statewi...
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Harvard Business Publishing is an idea-driven company with a commitment to improving the practice of management. We're a wholly owned subsidiary of Harvard University serving customers across three primary markets: educational institutions, corporations, and individual managers. Working in our Corporate Learning (CL) business unit and reporting to the CL Business Director, the Associate Director o...
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Job Title: Job ID: 14171 Location: Berkeley Heights, NJ Offsite Territory: Full/Part Time: Full-Time Regular/Temporary: Regular Category: Information Technology Department: IT - Global Business Partner - 4168 Celgene Corporation is committed to delivering innovative therapies designed to improve the lives of patients worldwide. We are a global biopharmaceutical company with operations in more than...
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Job Title: Director, Operations Job ID: 17535 Location: Columbus,OH, US Full/Part Time: Regular/Temporary: Regular Line of Business:Alliance Data Responsibilities Job Summary: This position is accountable for developing, executing and maturing the Customer Care Center’s planning process. The functions reporting to this position are Workforce Management, Business Analysis, and SLA Management. In ad...
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DIRECTOR OF TECHNOLOGY, INFORMATION AND OPERATIONS Position Number: 931044 The Director of Technology, Information and Operations reports to the Associate Dean and assumes responsibility for assignments that support the teaching, research, service, planning, and assessment functions of the College of Business. The Director of Technology, Information and Operations will manage the operations, infor...
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Description: This position works under the direction of the director of accreditation. Primary responsibility is to coordinate and conduct accreditation activities for standards related to UM, DM, and CM. You will assist the director of accreditation with establishing cross-functional accreditation teams. Actively participates in meetings and leads work groups as needed. You will prepare applicati...
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Sales Operations builds and executes the strategy to assist the sales and relationship management teams in the distribution of RPS products. The Director of Sales Operations is the chief advocate for maintaining and strengthening the company's choice to distribute products to employers via intermediaries. Two key teams, connected by a single focus and core messaging, comprise sales operations: 1. ...
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DIRECTOR OF HOUSING OPERATIONS Recruitment No. 50582 Administrative Grade Level Administrative Grade Level II Collective Bargaining Unit N/A College/Department University Housing Services Timebase Full-time Type of Appointment Management Personnel Plan (MPP II) Application Materials Required University Application, Resume, Letter of Interest, and References Required Anticipated Hiring Range Commen...
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I believe that better care begins at home. Compassionate care, uncompromising service and clinical excellence – that’s what Gentiva® patients have come to expect from our clinicians for nearly 40 years. Gentiva, America’s homecare leader, has set the clinical standard for today’s fastest-growing segment of healthcare – homecare. By creating innovative solutions that lead to high-quality patient ou...
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This position works under the direction of the director of accreditation. Primary responsibility is to coordinate and conduct accreditation activities for standards related to UM, DM, and CM. You will assist the director of accreditation with establishing cross-functional accreditation teams. Actively participates in meetings and leads work groups as needed. You will prepare application documents ...
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Excellent organization seeking a Sr. Facilities/Environmental Manager reponsible for planning,organizing, coordinatring, directirng and controlling all functions of facility,not limited to building maintenance, utility contract negotiations, plant budget, facility repair. 13 direct reports. Growing organization, excellent pay, OT/Bonus, Paid relocation. Responsibilities Performance of general buil...
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