- Cipla (Fall River, MA)
- …Safety, Health, and Environmental policies. Other duties assigned as required by Reporting management / Dept. Head. Education QualificationsBachelor's degree in ... new technologies and automation in production workflows. Collaborate with Team, Quality , Supply Chain, Project Management , Engineering, and R&D teams… more
- University of New Mexico - Hospitals (Corrales, NM)
- …short-term and long-term patient responses to interventions in collaboration with quality assurance and utilization review, maintaining interdependent follow-up ... an organized, multidisciplinary, patient centered care team approach, and assure quality , cost-effective care for the identified patient population. Manage the… more
- Harbor Health Services, Inc. (Mattapan, MA)
- …cares for more than 580 participants. We are currently seeking a Director of Utilization Management & Quality Programs. Harbor Health offers an excellent, ... Off plus 11 additional Holidays and much more! Role: Reporting to the Senior Director of Health Plan Operations,...Senior Director of Health Plan Operations, the Director of Utilization Management and Quality Programs… more
- University of New Mexico - Hospitals (Corrales, NM)
- …and facilitate communication, problem solving, decision-making, crisis intervention, resource utilization , and conflict management * SUPERVISION - Develop ... role model to promote a positive work environment and quality patient care. Ensure adherence to Hospitals and departmental...participate in their own care by asking questions and reporting treatment or situations that they don't understand or… more
- Christus Health (San Antonio, TX)
- …and workload planning. Maintains project issues and reports to Information System management and local steering teams on the progress of critical path items. ... Expected to manage multiple projects by maintaining the high level of quality in terms of deliverables, implementation, and customer experience. Responsible to… more
- FM (Johnston, RI)
- …future IT procurement needs, and ensure these needs will be met through high- quality strategic relationships with key vendors. Knowledge Management Ensure there ... research capability and engineering expertise are solely dedicated to property risk management and the resilience of its policyholder-owners. These owners, who share… more
- MCKESSON (Irving, TX)
- …healthcare. We are known for delivering insights, products, and services that make quality care more accessible and affordable. Here, we focus on the health, ... Life Science companies and their drugs. Your responsibilities include lifecycle management , sales & marketing initiatives and support, and pricing, while delivering… more
- Christus Health (San Antonio, TX)
- …KWKT appropriately. Quality /Outcomes Management : Identify and assist outcomes management process by referring and reporting variances in standards of ... Impacts Medicare GMLOS by managing per Milliman/Interqual Care Guidelines. Resource/ Utilization Management /appropriateness: Assess assigned patient population for… more
- Christus Health (La Luz, NM)
- …of healthcare operations, proven communication, problem-solving, critical thinking, and management skills to guide design, development, and deployment of critical ... to the System Director to support efficient and effective planning for resource utilization and prioritization of the body of work for which is accountable and… more
- Fresenius Medical Care (Albany, OR)
- …Accountable for outstanding quality of patient care, as defined by the quality goals, by working with management to ensure that policies and procedures ... to coordinate the facility operations and patient procedures to ensure provision of quality patient care on a daily basis in accordance with policies, procedures and… more
- Fresenius Medical Care (Fayetteville, NC)
- …following all regulatory and FMS policy requirements. Ensure provision of quality patient care while maintaining cost-effective clinical operations in accordance ... larger range within the department. Responsible for supporting and driving FMS quality standards through meeting all ESRD regulatory requirements and the practice of… more
- Fresenius Medical Care (Hayward, WI)
- …As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical operations. As the facility ... the operations of the clinic, including costs, processes, staffing, and quality standards. Provides leadership, coaching, and development plans for all direct… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Quality Reporting and Auditing Specialist I Job Category: Clinical Department: Utilization Management Location: Los ... required to achieve that purpose. Job Summary The Utilization Management (UM) Quality Reporting and Auditing Specialist I is responsible for dynamically… more
- State of Indiana (Indianapolis, IN)
- … management subject-matter expert in health care delivery, develops utilization management reporting requirements for all Medicaid programs, ... utilization review, clinically appropriate care and risk management for the purpose of quality assurance...including managed care and analyzes and evaluates the reporting to determine impact on members and providers as… more
- UNC Health Care (Morrisville, NC)
- …the unique communities we serve. **Summary** : The **Executive System Director of Utilization Management (UM)** is a strategic and operational leader responsible ... for designing, implementing, and standardizing utilization management functions across a large healthcare...management . + Advanced skills in data analysis and reporting and strategic planning. + Experience in clinical system… more
- George C. Grape Community Hospital (Hamburg, IA)
- …years of clinical nursing experience (acute care preferred). o Prior experience in utilization review, case management , quality improvement, and infection ... Quality / Utilization Review Nurse Position Summary: The...& Collaboration: o Educate clinical staff on documentation requirements, utilization management processes, and infection control standards.… more
- Tenet Healthcare (Detroit, MI)
- …national standards for case management scope of services including: Utilization Management services supporting medical necessity and denial prevention ... potentially avoidable days Other duties as assigned. POSITION SPECIFIC RESPONSIBILITIES: Utilization Management Balances clinical and financial requirements and… more
- McLaren Health Care (Port Huron, MI)
- …hospital **Preferred:** ⦁ Experience in utilization management /case management , critical care, clinical documentation, or patient outcomes/ quality ... as Assigned:** 1. Performs a variety of concurrent and retrospective utilization management -related reviews and functions to ensure that appropriate… more
- Beth Israel Lahey Health (Plymouth, MA)
- …Management Certification required + Minimum of 3 years of progressive experience in utilization management and appeal/denial management . + Holds a strong ... a difference in people's lives.** Full Time **Job Description:** ** Utilization Review & Denials management manager -...proud to be a trusted healthcare provider, offering personalized, high- quality care to the South Shore of Massachusetts. As… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …of or ability to learn financial management related to UR function and reporting , quality improvement processes, and human resources management * Able to ... review functions. Oversees daily operations, which include supervising staff performing utilization management activities. The goal is to achieve clinical,… more
