- Community Health Plan of Washington (Eugene, OR)
- …organization. * Create an equitable work environment. About the Role The Level I Utilization Management Clinician performs utilization review for medical or ... behavioral health requests using utilization review criteria, technologies, and tools. Identifies, coordinates, and implements...do not meet medical necessity or criteria for medical director review . * Communicate effectively with medical… more
- Pathways Vermont (Burlington, VT)
- …House Program Manager Supervisor: Alternative Mental Health Services Director Location: Burlington, Vermont Responsibilities:Oversight of Service ProvisionEnsure ... Practice Registered Nurse (APRN). Meet weekly for individual supervision, to review role expectations and provide feedbackProvide ongoing support for job completion… more
- Saint Francis Health System (Tulsa, OK)
- …an on-site office location (not a remote position)Will perform admit, discharge chart review and other patient care duties from an office location via secure virtual ... toward goals. Facilitates patient discharge through timely, appropriate referrals and utilization of patient education resources, suitable to patient age and… more
- Saint Francis Health System (Tulsa, OK)
- …toward goals. Facilitates patient discharge through timely, appropriate referrals and utilization of patient education resources, suitable to patient age and ... decisions from many diversified alternatives that are subject to general review in final stages only.Working Relationship: Coordinates activities of others (does… more
- AdventHealth (Maitland, FL)
- …assigned by the Division CFO/SrVP, Vice President of Revenue Cycle Operations and/or Director , Utilization Review Management..Reviews data and trends to ... in review of long stay patients, in conjunction with the Director of Utilization Review Management to facilitate the use of the most appropriate… more
- St. Luke's University Health Network (Allentown, PA)
- …registrations and/or physician queries + Serves as liaison between Physician Advisor/Medical Director , Finance, Utilization Review Department and CDCI. ... of cases lost with feedback to respective departments + Conduct concurrent review with utilization review department for post op surgical cases with… more
- BrightSpring Health Services (Mishawaka, IN)
- …days of death and submit to State Health Services Director and Assigned Director , Clinical Practice* Review utilization report at least monthly to ensure ... are coordinated with behavioral and programmatic staff in partnership with the Executive Director . The Director of Nursing is accountable for overseeing the… more
- YesCare Corp (Bartow, FL)
- …for ensuring the monthly report is sent to each site and participates in Utilization Review with Clinical Director and other personnel as required ... Below is a list of your responsibilities as a ** Utilization Management Coordinator** with YesCare: + Confirms admissions with...outpatient services, codes, and forwards to Corporate UM Medical Director + Performs monthly audit of Inpatient, ER and… more
- CareFirst (Baltimore, MD)
- …& Qualifications** **PURPOSE:** The Medical Director oversees all activities of utilization review , care management and quality to determine the medical ... of members. We are looking for an experienced Medical Director in the greater Baltimore / Washington DC metropolitan...post-acute care, and appeals. + Oversees all activities of utilization review , care management and quality to… more
- UCLA Health (Los Angeles, CA)
- Description Under the direction of the RN Asst. Director for Utilization Review , Intensive Case Management, you will support and perform duties to provide ... discharge planning/ UM concurrent review of the complex cases admitted in Non Domestic...aim to foster continuity of care and reduce unnecessary utilization of healthcare services by coordinating and providing health… more
- Virginia Mason Franciscan Health (Bremerton, WA)
- …performance and facilitates educational training for medical staff on issues related to utilization management. 1. Implements utilization review policies and ... coaching, mentoring, training and development. Educates and trains staff on utilization review processes and guidelines. 3. Promotes collaborative practice… more
- Trinity Health (Boise, ID)
- …level reviews for patients not meeting inpatient criteria. C. Participates in local Utilization Review Committee and be a member of appropriate committees and ... is seeking a physician leader to become our Medical Director of Documentation and Utilization Excellence. This...accurate reporting of bed status. F. Assist case managers, utilization review nurses and social workers to… more
- Arms Acres (Bronx, NY)
- …life skills) as identified in patient treatment plans and requested by program director . Performs utilization review , provides progress reports and develop ... implementation of the multidisciplinary treatment plan; coordinates treatment plan review ; performs these activities within established time frames. Documents… more
- Prime Healthcare (Ontario, CA)
- …Clinical Utilization Management (UM) provides comprehensive oversight of the Utilization Review process for the self-insured Employee Health Plans, according ... needs. + Provides strategic leadership, development, and supervision to utilization review department, provides interprofessional collaboration with… more
- Office of Personnel Management (Washington, DC)
- Summary The Director , Small and Disadvantaged Business Utilization (SDBU) promotes opportunities for small, minority, disadvantaged, and women-owned businesses ... owned and disabled veteran businesses in Agency programs. Responsibilities The Director SDBU ensures that small businesses participate equitably in OPM programs… more
- Molina Healthcare (CA)
- This is a fully remote role. The Director of Healthcare Services position will be overseeing the Outpatient Utilization Management Team. Candidates must have an ... following key Healthcare Services functions: case management/disease management/care transitions; utilization management (Position oversees PA authorizations and manages the… more
- Geisinger (Harrisburg, PA)
- …educational programs across the department. Responsible for management of the Utilization Review policy and observation management performance including outcomes ... Establishes and leads execution of a strategic plan for the provision of Utilization Management services across the organization, fostering a spirit of innovation in… more
- Arms Acres (Carmel, NY)
- …life skills) as identified in patient treatment plans and requested by program director + Performs utilization review , provides progress reports and ... and implementation of the multidisciplinary treatment plan; coordinates treatment plan review ; performs these activities within established time frames + Documents… more
- Arms Acres (Carmel, NY)
- …life skills) as identified in patient treatment plans and requested by program director + Performs utilization review , provides progress reports and ... and implementation of the multidisciplinary treatment plan; coordinates treatment plan review ; performs these activities within established time frames + Documents… more
- Arms Acres (Carmel, NY)
- …life skills) as identified in patient treatment plans and requested by program director + Performs utilization review , provides progress reports and ... and implementation of the multidisciplinary treatment plan; coordinates treatment plan review ; performs these activities within established time frames + Documents… more
