/ IPA practice, capitation, HMO regulations, managed healthcare systems, quality improvement, medical utilization management... to work within PST business hours. Position Summary: The Medical Director of UM reports to the Chief Physician Executive...
/ IPA practice, capitation, HMO regulations, managed healthcare systems, quality improvement, medical utilization management... to work within PST business hours. Position Summary: The Medical Director of UM reports to the Chief Physician Executive...
hospitals across Bakersfield, Delano, Hanford, Selma, Reedley, Tehachapi, and Tulare, along with more than 130 medical offices.... Supports new and existing providers, medical offices and services through development, execution, monitoring and measurement...
management experience: Preferred Essential Functions: Works with site medical expense team to provide direction for actions... improvement, utilization and reducing medical costs while incorporating the skills of provider partners...
of Utilization Management (UM) ensuring partnership with the Managed Care Medical Director of UM for the implementation... with the Managed Care Medical Director of UM for the medical necessity reviews, denials management, and utilization management...
of Utilization Management (UM) ensuring partnership with the Managed Care Medical Director of UM for the implementation... with the Managed Care Medical Director of UM for the medical necessity reviews, denials management, and utilization management...
to the Program Director and is responsible for providing direct services to Participants including but not limited... to individual case management and groups. ESSENTIAL JOB RESPONSIBILITIES * Must be able to maintain a caseload. Make written case...