11 medical director utilization management jobs found

POSITION SUMMARY/RESPONSIBILITIES This position provides clinical leadership and oversight of the population health management program including utilization management, case management, preventive health/disease management, and quality management while supporting the multidisciplinary member-centric approach to care management. Actively participates with staff across the organization - this is essential to facilitate integrated service delivery, planning, quality assurance, and risk management and to address the needs of members and their families to protect and promote the healthcare of members. EDUCATION/EXPERIENCE A medical degree as Doctor of Medicine (MD) or Osteopathy (DO) and an active and unrestricted Texas Medical License, free of sanctions from Medicaid or Medicare is required. Minimum of five year of direct clinical patient care experience post-residency is required. Minimum two years' experience in a medical leadership role is preferred. Previous experience...

About this role: As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical operations. As the facility leader, you will be part of a close-knit, collaborative team responsible for delivering unique care plans and providing dialysis treatment to patients facing end stage renal disease or chronic kidney disease. Training and advancement: You will enter our Clinical Leadership Program that creates and supports a culture of continuous learning for our managers. The curriculum will cover onboarding, essential functions, leading your business, and advanced leadership. As a Clinical Manager, you may advance your career into an Area Team Lead or Director of Operations role. Our culture: We believe our employees are our most important asset - we value, care about, and support our people. We are there when you may need us most, from tuition reimbursement to support your education goals, granting scholarships...

About this role: As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical operations. As the facility leader, you will be part of a close-knit, collaborative team responsible for delivering unique care plans and providing dialysis treatment to patients facing end stage renal disease or chronic kidney disease. Training and advancement: You will enter our Clinical Leadership Program that creates and supports a culture of continuous learning for our managers. The curriculum will cover onboarding, essential functions, leading your business, and advanced leadership. As a Clinical Manager, you may advance your career into an Area Team Lead or Director of Operations role. Our culture: We believe our employees are our most important asset - we value, care about, and support our people. We are there when you may need us most, from tuition reimbursement to support your education goals, granting scholarships...

About this role: As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical operations. As the facility leader, you will be part of a close-knit, collaborative team responsible for delivering unique care plans and providing dialysis treatment to patients facing end stage renal disease or chronic kidney disease. Training and advancement: You will enter our Clinical Leadership Program that creates and supports a culture of continuous learning for our managers. The curriculum will cover onboarding, essential functions, leading your business, and advanced leadership. As a Clinical Manager, you may advance your career into an Area Team Lead or Director of Operations role. Our culture: We believe our employees are our most important asset - we value, care about, and support our people. We are there when you may need us most, from tuition reimbursement to support your education goals, granting scholarships...

AVP Associate Chief Medical Officer-Texas Health Dallas   Texas Health Dallas Texas Health Presbyterian Hospital Dallas is one of North Texas's most established hospitals. As an 875 bed, full service hospital, we've served the Dallas community and surrounding areas including Lakewood, White Rock, and Highland Park since 1966 with a commitment to high quality, compassionate care.  We specialize in cancer care, cardiology, neurosciences, women's services, and emergency medicine. Our hospital is home to a renowned Level III Neonatal Intensive Care Unit (NICU), a Comprehensive Stroke Center, and a Bariatric Surgery Center of Excellence. We also offer a wide range of outpatient services, including surgery, wellness programs, and advanced women's imaging. Our Women's Robotic Surgery program holds accreditation as a Center of Excellence in Robotic Surgery by the Surgical Review Corporation (SRC), reflecting our commitment to innovation in women's health and patient safety in...

Description Roles and Responsibilities Overview The Physician Advisor is a full-time administrative physician role serving CHRISTUS St. Michael hospital and its affiliates through teaching, consulting, and advising both the Care Management Department and the medical staff on matters regarding physician practice patterns, documentation, over- and under-utilization of resources, medical necessity, compliance rules and regulations, collaboration and relationships with payers, and the community. The PA also ensures physician support and execution for the Care Management and CDI Departments' initiatives by promoting effective and efficient physician documentation to support the patient's Level of Care (LOC), billing status, and appropriateness of Medicare Severity-Diagnosis Related Group (MS-DRG)/DRG assignment. The PA will submit monthly time records documenting time actually spent in the provision of the responsibilities outlined below. M-F, no call responsibilities! Reporting...

Location: Jail Main Clinic Primary Purpose Responsible for supporting, facilitating and participating in clinical and administrative activities, which will enhance the attainment of Correctional Health clinical goals and objectives. Provides medical expertise, administrative, medical and nursing support as well as professional liaison functions which enhance high quality, timely and safe patient centered, patient valued services, best practice and compliance. Minimum Specifications Education Must have successfully completed an Accreditation Council for Graduate Medical Education (ACGME) or American Medical Association (AMA) approved residency for appropriate specialty. Experience Must have five years management experience in clinical medicine programs. Prefer experience in a correctional health environment. Certification/Registration/Licensure Must meet and maintain licensing and registration requirements as delineated by the Medical Staff Bylaws, Medical...

  Nurse Manager II-Operating Room   Are you looking for a rewarding career with family-friendly hours and top-notch benefits? We’re looking for qualified candidates like you to join our Texas Health family.   Texas Health Denton Since 1987, Texas Health Denton has served the Denton community and surrounding areas including Corinth, Lake Dallas, Argyle, Sanger, Aubrey, and communities throughout North Texas and southern Oklahoma. As a 255-bed, full-service hospital with more than 1,100 employees and 486 physicians on our medical staff, we're one of the largest employers in Denton County.  We offer advanced care in robotic and endovascular surgery, general surgery, orthopedics and sports medicine, spine and back services, emergency medicine, and bariatric surgery. Additional services include cancer treatment, critical care, neonatology, cardiac CT imaging, neurology, electrophysiology, stroke care, vascular care, women's and infants' services,...

For the quickest response, please apply directly via CorroHealth's website. Click Company>Careers>USA>search Medical Director >Apply. Thank you. About CorroHealth: At CorroHealth our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals. We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success. JOB SUMMARY: As a Medical Director, Denials Management you will have the unique opportunity to evaluate hospitalizations across the country while utilizing your medical knowledge and gaining experience as an expert advisor to client hospitals. You will perform clinical case reviews and provide...

For the quickest response, please apply directly via CorroHealth's website. Click Company>Careers>USA>search Medical Director >Apply. Thank you. About CorroHealth: At CorroHealth our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals. We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success. JOB SUMMARY: As a Medical Director, Denials Management you will have the unique opportunity to evaluate hospitalizations across the country while utilizing your medical knowledge and gaining experience as an expert advisor to client hospitals. You will perform clinical case reviews and provide...

Director of Nursing Behavioral Health   Are you looking for a rewarding career with top-notch benefits? We are looking for a qualified Manager   like you to join our Texas Health family.   Position Highlights Work location:  Texas Health Dallas Core Work hours: Monday – Friday; 8:00a-5:00p   Texas Health Presbyterian Hospital Dallas is one of North Texas's most established hospitals. As an 875 bed, full service hospital, we've served the Dallas community and surrounding areas including Lakewood, White Rock, and Highland Park since 1966 with a commitment to high quality, compassionate care.  We specialize in cancer care, cardiology, neurosciences, women's services, and emergency medicine. Our hospital is home to a renowned Level III Neonatal Intensive Care Unit (NICU), a Comprehensive Stroke Center, and a Bariatric Surgery Center of Excellence. We also offer a wide range of outpatient services, including surgery, wellness programs, and...