- Stanford Health Care (Palo Alto, CA)
- …and Abilities** + Knowledge of principles and best practices of case management, utilization review, social work, care coordination and discharge planning. ... while honoring its commitment to delivering evidence-based and patient-centered care . We are seeking a results-driven manager ...service lines and departments related to the provision of care coordination services to Stanford Hospital and… more
- UNC Health Care (Raleigh, NC)
- …through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management staff to ... met and care delivery is coordinated across the continuum. The Utilization Manager completes admission, continued stay, and discharge reviews in accordance… more
- Community Health Systems (Franklin, TN)
- …and enhancing the overall utilization review process to optimize patient care and manage resources effectively. The manager supports and coordinates the ... Director, and Payor Relations Manager to facilitate coordination of services related to utilization review....a nurse required + 1-3 years work experience in Care Management or Utilization Review required +… more
- VNS Health (Manhattan, NY)
- … utilization management processes are followed by the service operations staff, utilization staff, and the interdisciplinary care team to ensure cost ... home and community-based settings. + Manages and evaluates staff in delivery and coordination of utilization management review services in compliance with CMS… more
- McLaren Health Care (Detroit, MI)
- **Position Summary:** Responsible for providing assistance to the Utilization Manager (UM) RN in the coordination of patient admission and continued stay ... based on medical necessity. 2. Performs concurrent and retrospective utilization management-related activities and functions to ensure that appropriate data… more
- VNS Health (Manhattan, NY)
- …management, subject matter experts, physicians, member representatives, and discharge planners in utilization tracking, care coordination , and monitoring to ... and regulatory requirements. + Evaluates and analyzes care and utilization trends/issues and identifies opportunities for better coordination of members'… more
- Helio Health Inc. (Syracuse, NY)
- …to track, review, and analyze data relating to continuous quality improvement. The Utilization Case Manager will work on a Full-Timebasis supporting our ... as appropriate. + Assist in developing and administering policies and procedures for utilization . + Negotiating access to care for individuals seeking services… more
- UCLA Health (Los Angeles, CA)
- …with patients and their families to ensure safe and effective coordination of care . In this role you will perform utilization review while assuring the ... skills, you will be responsible for assessing and coordinating care for a diverse group of patients. This in-patient... for a diverse group of patients. This in-patient utilization review case manager position will work… more
- Healthfirst (NY)
- …identifying alternative care options, and discharge planning + Certified Case Manager + Interqual and/or Milliman knowledge + Knowledge of Centers for Medicare & ... - identifying medical, psychological, and social issues that need intervention. + Coordination - partnering with PCP and other medical providers to coordinate… more
- Elevance Health (Tampa, FL)
- …II GBD Special Program** is responsible for supporting the development, implementation, and coordination of a comprehensive health care program in which members' ... communicates, and monitors program schedule, budget, and resources plan. + Manages resource utilization to ensure appropriate delivery of care to members and… more
- ERP International (Nellis AFB, NV)
- …team meetings, designated facility meetings, discharge planning meetings/rounds and Care Coordination meetings. Shares knowledge and experiences gained ... and present medical care practices for patterns; trends incidents of under-or over- utilization of resources incidental to providing medical care . * Acts as… more
- Hackensack Meridian Health (Hackensack, NJ)
- …or Comorbidities + (CC) categories documentation and identification a. Tools to assist with care coordination decision making b. Liaison with 3rd party payers as ... Staff Management and Organizational Strategy a. Development & implementation of Utilization Management strategies to assure appropriate health care delivery… more
- Hackensack Meridian Health (Hackensack, NJ)
- …**5. (CC) categories documentation and identification** **a. Tools to assist with care coordination decision making** **b. Liaison with 3rd party payers ... Staff Management and Organizational Strategy** **a. Development & implementation of Utilization Management strategies to assure appropriate** **health** ** care … more
- Actalent (Santa Barbara, CA)
- …management of Utilization Management, Case Management, Disease Management, Population Health, Care Coordination , and Care Transition activities + As ... These units include, but are not limited to, the Utilization Management, Case Management, Enhanced Care Management,...telephonic or onsite clinical review; case or disease management, care coordination or transition, or population health… more
- Behavioral Center of Michigan (Warren, MI)
- …the Utilization Review Coordinator provides professional assessment, planning, coordination , implementation and reporting of complex clinical data and supports ... to help educate the staff and physicians regarding charting. REPORTS TO: Utilization Review Lead/ Manager QUALIFICATIONS: + High School Diploma or equivalent.… more
- Scottish Rite for Children (Dallas, TX)
- …promoting appropriate length of stay, readmission prevention and patient satisfaction + Care Coordination by demonstrating throughput efficiency while assuring ... back their childhood! Job Posting Title: Director of Case Management and Utilization Management Location: Dallas - Hospital Additional Posting Details: Monday -… more
- Banner Health (Sun City, AZ)
- …, you will contribute your expertise and enthusiasm for healthcare to our Care Coordination team. You'll have the chance to forge meaningful relationships ... weekend shift differential. POSITION SUMMARY This position provides comprehensive care coordination for patients as assigned. The...Travel positions require a minimum of one year Case Manager experience in an acute care hospital.… more
- Banner Health (Mesa, AZ)
- …As the RN Case Manager , you will bring your experience and passion for health care to our Care Coordination team! You will have the opportunity to build ... weekend shift differential. POSITION SUMMARY This position provides comprehensive care coordination for patients as assigned. The...Travel positions require a minimum of one year Case Manager experience in an acute care hospital.… more
- Pacific Medical Centers (Renton, WA)
- …assure cost effective, appropriate utilization of health care resource. Utilization Nurse / Case Manager manages, directs, and coordinates the entire ... and outpatient. This position assists physicians (internal and external) with management and coordination of care . Works primarily at Renton or at other provider… more
- Crouse Hospital (Syracuse, NY)
- Care Coordination is a collaborative practice model including the multidisciplinary health care team, the patient and family, and community services and ... resources. The Care Coordination process encompasses analysis of information,... care discharge planning. + Preferred: + Acute care utilization review experience. + Previous leadership… more