- VNS Health (Manhattan, NY)
- …or care manager generated requests for medical services and renders clinical determinations in accordance with healthcare policies as well as applicable state ... and federal regulations. Delivers timely notification detailing clinical decisions. Coordinates with management, subject matter experts, physicians, member… more
- Independent Health (Buffalo, NY)
- …perks, benefits and commitment to diversity and inclusion. **Overview** The Program Manager - Utilization Management (UM) will be accountable for the management, ... IH associates on the use and implementation of new criteria. + Monitor utilization trends and clinical appropriateness and make changes (add/remove) in services… more
- Veterans Affairs, Veterans Health Administration (Hines, IL)
- Summary The Utilization Management (UM) Nurse Manager (NM) is a registered professional nurse responsible for the assessment, planning, provision and ... evaluation of UM Program. The UM NM serves as...the practice of utilization management. Responsibilities The Utilization Management (UM) Nurse Manager (NM) s… more
- VNS Health (Manhattan, NY)
- …or care manager generated requests for medical services and renders clinical determinations in accordance with healthcare policies as well as applicable state ... and federal regulations. Delivers timely notification detailing clinical decisions. Coordinates with management, subject matter experts, physicians, member… more
- Stanford Health Care (Palo Alto, CA)
- …to delivering evidence-based and patient-centered care. We are seeking a results-driven manager to further develop the framework for clinical , operational, and ... Here, your leadership, coaching, and mentoring would further develop our robust, Utilization Management team. Are you driven by health care innovation, partnerships,… more
- Veterans Affairs, Veterans Health Administration (Washington, DC)
- …practice, including access to care and discharge planning. Using advanced clinical knowledge judgment to promote staff involvement in planning, decision-making, and ... evaluating outcomes. Functioning as an expert in clinical practice and/or areas related to the assigned roles and responsibilities. Systematically evaluating current… more
- Covenant Health Inc. (Louisville, TN)
- Overview Utilization Review Coordinator, Quality Management Full Time, 80 Hours Per Pay Period, Day Shift Peninsula Overview: Peninsula, a division of Parkwest ... to end of approved number of authorized days, reviews clinical justification for continued stay and assigns further days,...Hospital to identify and address problems related to the utilization process and to monitor and track the resolution… more
- Behavioral Center of Michigan (Warren, MI)
- …to help educate the staff and physicians regarding charting. REPORTS TO: Utilization Review Lead/ Manager QUALIFICATIONS: + High School Diploma or equivalent. ... the level of nursing care and collaborates with other departments in evaluation of projects affecting discharge plans. Supports clinical improvement activities… more
- AdventHealth (Altamonte Springs, FL)
- …893 Hope Way Altamonte Springs, FL 32714 **The role you'll contribute:** The Clinical Resource Manager provides leadership and consultation to company facilities ... in the clinical review, evaluation and procurement of products...**The value you'll bring to the team:** + Facilitates clinical teams to review utilization and options… more
- AdventHealth (Hinsdale, IL)
- …- Friday **Location:** Chicago, IL area **The role you'll contribute:** **The Clinical Resource Manager provides leadership and consultation to company ... facilities in the clinical review, evaluation and procurement of products...**The value you'll bring to the team:** + **Facilitates clinical teams to review utilization and options… more
- VNS Health (NY)
- …OASIS, and Evaluation visits. Ensures clear and appropriate visit utilization using evidence-based practices to provide positive clinical outcomes and ... OverviewOversees the completion and approval of all clinical utilization documentation, including Start of Care, Re-certification, Resumption of Care, Follow up… more
- Trinity Health (Grand Rapids, MI)
- …and appropriate medication use recommendations to appropriate stakeholders/committees. Oversees evaluation of drug products, medication utilization and ... and standardization for acute care, ambulatory, infusion, and community Clinical Pharmacy services. Implements strategic and operational initiatives including new… more
- Mount Sinai Health System (New York, NY)
- …in the NY/NJ region. MSHS, World Trade Center Health Program (WTCHP) seeks a Clinical Pharmacy Manager that reports to Senior Manager , Pharmacy Benefits ... under the direction of the WTCH medical leadership. The Clinical Pharmacy Manager will have direct patient...support staff at the practices assigned to this role. Manager will lead the design, implementation and evaluation… more
- Guthrie (PA)
- …support staff, exhibiting the Core Values in all activities. Mentors under the Clinical Manager / Director and pursues management and leadership training within ... the Guthrie Robert Packer Hospital. May be assigned to special projects per Clinical Manager / Director consistent with strategic, fiscal, and operational… more
- Guthrie (Sayre, PA)
- …support staff, exhibiting the Core Values in all activities. Mentors under the Clinical Manager / Director and pursues management and leadership training within ... the Guthrie Robert Packer Hospital. May be assigned to special projects per Clinical Manager / Director consistent with strategic, fiscal, and operational… more
- CVS Health (Baton Rouge, LA)
- …the power of our people to transform health care. **Position Summary:** The Clinical Case Manager Behavioral Health (CM-BH) utilizes advanced clinical ... of available resources and optimal, cost-effective outcomes. The Clinical Case Manager BH is a full...with their provider in healthcare decision-making. + Analyzes all utilization , self-report, and clinical data available to… more
- CenterWell (Wilkesboro, NC)
- …our caring community and help us put health first** Wilkesboro, NC The RN Clinical Manager coordinates and oversees all direct care patient services provided by ... clinical personnel. This role is a focused on both...specific location. Responsible for the overall direction, coordination, and evaluation of the location. Carries out supervisory responsibilities in… more
- HCA Healthcare (Nashville, TN)
- …purpose and integrity. We care like family! Jump-start your career as a Clinical Resources Manager today with HealthTrust Supply Chain. **Benefits** HealthTrust ... vary by location._** Come join our team as a Clinical Resources Manager . We care for our...of supply expense opportunities to improve product standardization and utilization . This process includes product selection, evaluation … more
- Centene Corporation (Jefferson City, MO)
- …and present performance reviews in conjunction with client account team * Perform clinical data and drug utilization review analysis to meet client requirements ... and requests * Collaborate with Clinical Pharmacists to enhance drug utilization review... business plans appropriate for each client, including the evaluation of current client program and restrictions (prior authorization,… more
- Erickson Living (Tinton Falls, NJ)
- Location: Seabrook Village by Erickson Senior Living Join our team as the Clinical Manager is an active member of the clinical leadership team who is ... delivery of safe and effective person-centered care in their assigned neighborhood. The Clinical Manager will also facilitate, precept, and mentor staff to grow… more