Top 22 Idr Internal Data Resources Jobs

Medical Director of Case Management and Utilization Review - FT Days - MHM
Memorial Healthcare System —Miramar, FL
- Full-time
- Acute care
- Medicine
- Surgery
Director of Stakeholder Engagement
PROVIDER RESOURCES INC —Remote
- $165,000 - $215,000 a year
- Full-time
- Remote
- Analysis skills
- Senior level
- Communication skills
- Health savings account
- Health insurance
Quick Apply
IDR Nurse Reviewer
Commence —Virginia Beach, VA
- $45 - $55 an hour
- Part-time
- Remote
- Microsoft Word
- Microsoft Outlook
- RN License
Director of Dispute Resolution
Claritev —Remote
- $140,000 - $160,000 a year
- Full-time
- Remote
- Sales
- 5 years
- HIPAA
- Paid parental leave
- Employee stock purchase plan
Research Data Scientist
USC —Los Angeles, CA
- $106,012.83 - $125,000.00 a year
- Full-time
- Hybrid work
- 3 years
- SQL
- AWS
Claims Audit Analyst - Denver Health Medical Plan (Must Live in Colorado. Weekly On-Site Requirement)
Denver Health —Denver, CO
- $60,500 - $87,700 a year
- Full-time
- Hybrid work
- Microsoft Access
- Word processing
- Pass drug screening
- Paid parental leave
- Paid holidays
Office Coordinator
Augusta University —Augusta, GA
- $17.88 an hour
- Full-time
- Background check
- Microsoft Excel
- Management
- Paid holidays
- Health insurance
Enforcement Compliance Reviewer
Health & Human Services Comm —Austin, TX
- $4,523.16 - $7,253.83 a month
- Online Application
- Writing skills
- Office
- Analysis skills
- Health insurance
- Opportunities for advancement
Quick Apply
4d
International Disaster Response Program Manager
World Renew —Byron Center, MI
- $80,649 - $90,730 a year
- Contract
- Remote
- Background check
- Microsoft Excel
- 5 years
Quick Apply
4d
Financial Analyst (FINANCIAL ANL 3 CX)
University of California, Davis —Davis, CA
- $77,100 - $139,900 a year
- Full-time
- Hybrid work
- Background check
- Pass drug screening
- Mid-level
- Continuing education credits
- Paid holidays
Claims Compliance Manager
Centivo —Buffalo, NY
- $115,000 - $125,000 a year
- Full-time
- 5 years
- HIPAA
- Presentation skills
- Health insurance
Scientist, mRNA Sequence Engineering & Computational Biology
Moderna, Inc. —Cambridge, MA
- $121,600 - $194,500 a year
- Full-time
- Bachelor of Science
- Office
- Bachelor's degree
- Paid time off
- Adoption assistance
Program Area Director, NORC Health Data Lab
NORC at the University of Chicago —Washington, DC
- $180,000 - $205,000 a year
- Full-time
- Hybrid work
- Doctoral degree
- 11+ years
- Office
- Paid parental leave
- Paid holidays
Senior Finance Manager
Commence —Virginia Beach, VA
- $150,000 - $160,000 a year
- Online Application
- Remote
- 7 years
- Office
- Finance
Quick Apply
3d
Director, Accounts Payable
Sunrun Inc —Lehi, UT
- $131,796 - $175,728 a year
- Full-time
- Oracle
- 5 years
- Residential
Quick Apply
4d
Pharmacy Program Manager
Booz Allen Hamilton —Bethesda, MD
- $99,000 - $225,000 a year
- Full-time
- 7 years
- Doctoral degree
- Office
- Health insurance
- Flexible spending account
11d
Associate Director - Market Risk
Royal Bank of Canada —New York, NY
- $120,000 - $200,000 a year
- Full-time
- Computer Science
- 5 years
- Engineering
- Disability insurance
- Health insurance
3d
Operations Manager, Retail Services
UT Southwestern —Dallas, TX
- Full-time
- Clean driving record
- Marketing
- 5 years
- Paid parental leave
- Paid holidays
3d
Director, Oracle Cloud Applications
Michael Baker International —United States
- $180,000 - $200,000 a year
- Full-time
- Remote
- Oracle
- Computer Science
- 5 years
- Health savings account
- AD&D insurance

Other jobs to consider

Find your next job by exploring related positions.

Graphic Designer III
IDR Healthcare, LLC. —Centennial, CO
Support the design and configuration of SharePoint sites, including building site information architecture, content, and permissions.
$33.09 - $39.33 an hour
Quick Apply
6d
AWS Solutions Architect
IDR Healthcare, LLC. —Suwanee, GA
Active AWS Associate-level certification (required): AWS Certified Solutions Architect – Associate OR AWS Certified CloudOps Engineer (active/valid at time of…
$90 an hour
Quick Apply
11d

I want to receive the latest job alert for Idr Internal Data Resources

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Explore jobs in more locations

Idr Internal Data Resources jobs near

Medical Director of Case Management and Utilization Review - FT Days - MHM

Memorial Healthcare System -
Miramar, FL

Apply Now

Job Details

Full-time

Qualifications

Doctor of Medicine
Customer service
Administrative experience
Medical License
Acute care experience

Full Job Description

Location:

Miramar, Florida

At Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience.

Summary:

The Medical Director of Case Management and Utilization Review leads the hospital specific execution of the Case Management (CM) and Utilization Management (UR) and related activities. The Medical Director functions as the primary physician advisor for the hospital and supervises other Physician Advisors for that hospital. As an active member of the UR Committee and in collaboration with it, identifies opportunities to improve utilization of hospital resources and the quality of patient care. Assists the Case Management staff in resolving patient care issues for referred cases, provides physician education, and assists the hospital and medical staff in developing and promoting resource management goals and objectives. This position reports to the Senior Medical Director of Case Management and Utilization Management.

Responsibilities:

Education and Clinical Documentation Improvement:Supports education and clinical documentation improvement. This includes, but not limited to:At least annually, educates and communicates to the medical staff the role and benefits of case management. Assists in conducting medical necessity education in collaboration with the Senior Medical Director and Physician Advisors. Provides ad hoc education and discussion regarding resource management cases with physicians. Assists physicians in improving the quality of documentation and serves as a liaison between Health Information Management (HIM) Department and the medical staff.Complex Care Management:Leads Complex Care Management. This includes, but not limited to: Leads hospital initiatives to reduce complex patient length of stay, in conjunction with nursing director of case management. Leads hospital complex care meeting in collaboration with case management leadership. Responds proactively to escalation of care delays, particularly related to clinical care, physician decision making, and patient and family related discharge barriers. Works with physicians on efficient care of observation patients and serves as liaison to insurance companies for prior authorizations creating discharge delay.Case Management and Utilization Review:Supports the overall enterprise of the Case Management and Utilization Review. This includes, but not limited to:Makes decisions on referred individual patient cases regarding pre-admission authorization, medical necessity and services/setting, appropriateness of admission, and continuation stay. Provides peer review services for medical necessity of admission or continued stay, conformance to professional standards for quality patient care, and for other cases referred by CE staff. Supports the Senior Medical Director in Medical Staff Education. Assists physicians in improving the quality of their medical necessity documentation and works with MDs on efficient care of observation patients. Serves as liaison to insurance companies for prior authorizations and removes barriers to discharge. Supports case management by attending interdisciplinary rounds (IDR) and provides feedback and suggestions to physicians and CMs. Serves as liaison to case management, social workers, nursing staff, individual physicians, and the medical staff. Communicates with Centralized UR staff and serves as support and back-up for case management escalations during and outside of IDRs.Annual Initiatives:Develops UM/resource management studies and projects including fiscal data to improve utilization and patient flow in collaboration with the URC and CM leadership. May include single DRG studies and different physician practice patterns and utilization; works with physicians to change practices and improve outcomes.Utilization Review Committees:Co-leads hospital specific UR Committee and is a member of the system UR Committee. Makes decisions on referred individual patient cases regarding pre-admission authorization, medical necessity and services/setting, appropriateness of admission, and continuation of stay.

Competencies:

Education and Certification Requirements:

Medical Doctor (Required)Medical Doctor License (ME LICENSE) - State of Florida (FL), Osteopathic Physician License (OS LICENSE) - State of Florida (FL)

Additional Job Information:

Complexity of Work: Essential Competencies and Skills: Excellent customer service and interpersonal skills. Able to effectively present information, both formal and informal. Strong written and verbal communications skills with all levels of internal and external customers. Strong analytical skills. Strong organizational skills and the ability to set priorities and multi-task. Demonstrated flexibility, teamwork, and accommodation to change in the healthcare environment.· Ability to drive results and produce outcomes.Required Work Experience: Extensive experience in one or more branches of medicine or surgery; at least, five (5) post-training years of medical staff organization/administrative experience in a large acute care hospital.Other Information: Additional Education Info: Graduate of a medical school approved by the Council on Medical Education of the American Medical Association.

Working Conditions and Physical Requirements:

Bending and Stooping = 80%
Climbing = 40%
Keyboard Entry = 80%
Kneeling = 40%
Lifting/Carrying Patients 35 Pounds or Greater = 40%
Lifting or Carrying 0 - 25 lbs Non-Patient = 60%
Lifting or Carrying 2501 lbs - 75 lbs Non-Patient = 0%
Lifting or Carrying > 75 lbs Non-Patient = 0%
Pushing or Pulling 0 - 25 lbs Non-Patient = 60%
Pushing or Pulling 26 - 75 lbs Non-Patient = 0%
Pushing or Pulling > 75 lbs Non-Patient = 0%
Reaching = 80%
Repetitive Movement Foot/Leg = 0%
Repetitive Movement Hand/Arm = 0%
Running = 40%
Sitting = 80%
Squatting = 40%
Standing = 80%
Walking = 80%
Audible Speech = 80%
Hearing Acuity = 80%
Smelling Acuity = 0%
Taste Discrimination = 0%
Depth Perception = 80%
Distinguish Color = 80%
Seeing - Far = 80%
Seeing - Near = 80%
Bio hazardous Waste = 40%
Biological Hazards - Respiratory = 40%
Biological Hazards - Skin or Ingestion = 40%
Blood and/or Bodily Fluids = 40%
Communicable Diseases and/or Pathogens = 40%
Asbestos = 40%
Cytotoxic Chemicals = 40%
Dust = 40%
Gas/Vapors/Fumes = 40%
Hazardous Chemicals = 40%
Hazardous Medication = 40%
Latex = 40%
Computer Monitor = 80%
Domestic Animals = 0%
Extreme Heat/Cold = 0%
Fire Risk = 0%
Hazardous Noise = 0%
Heating Devices = 0%
Hypoxia = 0%
Laser/High Intensity Lights = 0%
Magnetic Fields = 0%
Moving Mechanical Parts = 0%
Needles/Sharp Objects = 40%
Potential Electric Shock = 0%
Potential for Physical Assault = 40%
Radiation = 0%
Sudden Decompression During Flights = 0%
Unprotected Heights = 0%
Wet or Slippery Surfaces = 60%

Shift:

Days

Disclaimer: This job description is not intended, nor should it be construed to be an exhaustive list of all responsibilities, skills, efforts or working conditions associated with the job. It is intended to indicate the general nature and level of work performed by employees within this classification.

Wages shown on independent job boards reflect market averages, not specific to any employer. We encourage candidates to talk to their Memorial Healthcare System recruiter to discuss actual pay rates, during the hiring process.

Memorial Healthcare System is proud to be an equal opportunity employer committed to workplace diversity.

Memorial Healthcare System recruits, hires and promotes qualified candidates for employment opportunities without regard to race, color, age, religion, gender, gender identity or expression, sexual orientation, national origin, veteran status, disability, genetic information, or any factor prohibited by law.

We are proud to offer Veteran’s Preference to former military, reservists and military spouses (including widows and widowers). You must indicate your status on your application to take advantage of this program.

Employment is subject to post offer, pre-placement assessment, including drug testing.

If you need reasonable accommodation during the application process, please call 954-276-8340 (M-F, 8am-5pm) or email [email protected]

Apply Now

Refine Your Search

Idr Internal Data Resources jobs

Medical Director of Case Management and Utilization Review - FT Days - MHM

Director of Stakeholder Engagement

IDR Nurse Reviewer

Director of Dispute Resolution

Research Data Scientist

Claims Audit Analyst - Denver Health Medical Plan (Must Live in Colorado. Weekly On-Site Requirement)

Office Coordinator

Enforcement Compliance Reviewer

International Disaster Response Program Manager

Financial Analyst (FINANCIAL ANL 3 CX)

Claims Compliance Manager

Scientist, mRNA Sequence Engineering & Computational Biology

Program Area Director, NORC Health Data Lab

Senior Finance Manager

Director, Accounts Payable

Pharmacy Program Manager

Associate Director - Market Risk

Operations Manager, Retail Services

Director, Oracle Cloud Applications

Other jobs to consider

I want to receive the latest job alert for Idr Internal Data Resources

Explore jobs in more locations

Job Seeker Tools

Employer Tools

Browse

Stay Connected