Director Of Managed Care Jobs

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733 Director Of Managed Care jobs found on Monster.

Jobs 1 to 20 of 733
RN Director of Medical Management - Managed Care Springfield, Illinois Job Summary: The Director of Medical Management will be responsible for the work flows, procedures, and clinical tools used for integrated health medical management operations including utilization management, complex case management, disease management, and wellness activities. The Director of Medical Management will be respon...
Description: For those who believe in the power of data to help write the next chapter in the history of health care, here's your opportunity. Advancement, an elite group of peers, variety of product lines, and rewards for delivering on our mission ensures you will always be challenged at UnitedHealth Group to do your life's best work.(sm) The Associate Director, Managed Care Underwriting will man...
Experienced Medical Director needed for an innovative MCO Healthcare Management Services Organization -developer and vendor of nationally recognized best-in-class proprietary IT, data, infrastructure, and management solutions for healthcare providers, institutions, payors, and others in the healthcare industry. Company provides services and infrastructure solutions, including managing and partneri...
Responsible for contracting and negotiations for SJRMC with insurance companies, networks, and payors. Oversees dissemination of information and the implementation of contracts once contracts have been finalized. Acts as a managed care consultant for all SJRMC affiliates. JOB DUTIES 1. Actively demonstrates the organization’s mission and core values, and conducts oneself at all times in a manner c...
Bilingual RN Manager of Utilization Management - Managed Care Los Angeles, CA * Candidates must be fully bilingual in English & Spanish. * Job Summary: The role of the RN Manager of Utilization Management is to promote the quality and cost effectiveness of prior authorization and concurrent review functions. This person is responsible for management and oversight of daily managerial operations per...
Company Confidential East Freehold, NJ, 07728
Responsibilities: Under the direction of the Director of Budget, Reimbursement and Managed Care, prepares financial analysis and conducts research in support of hospital, physician and ancillary provider contract negotiations. Identifies and models payor contract negotiating targets that permit the organization to achieve strategic and financial objectives. Leads the managed care rate negotiation...
RN Manager of Prior Authorizations - Managed Care Phoenix, AZ (East Valley) Job Summary: The Nurse Manager of Prior Authorizations will promote the quality and cost effectiveness of medical care by ensuring department staff are applying clinical acumen and the appropriate application of policies and guidelines to prior authorization specialty referral requests. Responsible for the day to day opera...
RN Manager of Case Management - Managed Care Stockton, CA Job Summary: Manager of Case Management provides clinical leadership for all Health Care Services programs by serving as an educator, role model, member advocate, and change agent to enhance member care and staff competency. The Manager collaborates with other departments (including Clinical Staff, Administration, Directors, Managers, and o...
RN Manager of Utilization Management - Managed Care Boston, MA Job Summary: The role of the RN Manager of Utilization Management is to promote the quality and cost effectiveness of prior authorization and concurrent review functions. This person is responsible for management and oversight of daily managerial operations pertaining to utilization management; including but not limited to training, de...
PSYCHIATRISTS NEEDED Texas Tech University Health Sciences Center has openings for Board Certified or Eligible Psychiatrists in Lubbock and Amarillo. These positions are full time positions with benefits to include retirement, health insurance and professional liability. We offer competitive salaries and flexible work hours. Contact Nick Blythe at 806-791-4433 or ***** for informa...
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 due to the Affordable Care Act. Our culture is one of serving with respect, striving for excellence and teamwork. Thi...
Job Description: Prominent key player within the medical/healthcare sector (Managed Care) is actively seeking a Compliance Audit Analyst that can assist in driving this Co. to the next level of success. As the selected Analyst you will be responsible in assisting with the audit of compliance programs, and related educational and training materials throughout. This key role will provide ideas in pl...
Job Description: Prominent key player in the medical/health care sector is actively hiring a UM Coordinator. Seeking an expert that will gladly offer least one year to eight years of experience in Medi-Cal managed care authorization processes and/or as a Medical Assistant; UM expert will assist with the handling all administrative and technical functions of the authorization process including inta...
PSYCHIATRISTS NEEDED Texas Tech University Health Sciences Center has openings for Board Certified or Eligible Psychiatrists in Lubbock and Amarillo. These positions are full time positions with benefits to include retirement, health insurance and professional liability. We offer competitive salaries and flexible work hours. Contact Nick Blythe at 806-791-4433 or ***** for informa...
Inpatient Case Management Nurse (RN or LVN) – Managed Care Simi Valley, CA Job Summary: As a member of the medical management team, the Nurse Inpatient Case Manager plays an integral part in the coordination of care assessing the member’s condition and providing them the necessary resources, options, and coordination for a healthy care outcome. The primary responsibility of the Nurse Case Manager...
CONTRACT Complex Case Management RN - Managed Care Ontario, CA * This is a full-time CONTRACT opportunity, currently scheduled to last AT LEAST 60-90 days! * Job Summary: As a member of the medical management team, Complex Case Manager works with members, providers and caregivers to provide intensive, comprehensive case management and increase efficient utilization of services; identifies chronic...
Health Quest is the Hudson Valley’s largest integrated family of hospitals and health care providers, delivering the highest quality care across a variety of service lines, including Cancer Care, Cardiac Care, Orthopedics, Neurosciences, Women’s and Children’s Services and Surgical Services. Our family includes three awarding-winning hospitals—Northern Dutchess Hospital in Rhinebeck, Putnam Hospit...
Utilization Review RN - Managed Care San Francisco, CA Job Summary: The Utilization Management Nurse is responsible for utilization management, utilization review, or concurrent review (telephonic inpatient care management). The UM Nurse will performs reviews of current inpatient services, and determine medical appropriateness of inpatient and outpatient services following evaluation of medical gu...
VP Management Supervisor/VP Account Supervisor - Managed Care/Managed Markets My client an excellent Healthcare Communications company specializing in Managed Care/Managed Markets/Payer Marketing in the local Northern NJ area is actively seeking an experienced Vice President of Account Services (VP Management Sup/VP Account Group Sup as titles don't translate well from company to company). Descrip...
Field Case Manager (RN) - Managed Care Columbus, OH Job Summary: As a member of the medical management team, the Case Manager plays an integral part in the coordination of care assessing the member’s condition and providing them the necessary resources, options, and coordination for a healthy care outcome. The primary responsibility of the Case Manager is to coordinate and monitor the care of Heal...

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