- Prime Healthcare (Ontario, CA)
- …(https://careers-primehealthcare.icims.com/jobs/172723/corporate- director -of-clinical- utilization - management ... Notice for California Applicants: https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf Responsibilities The Corporate Director of Clinical Utilization Management… more
- Ascension Health (Nashville, TN)
- …to Ascension Saint Thomas hospitals throughout the TN market. We're looking for an experienced Director of Utilization Management to join our team! In this ... **Details** + **Department:** Utilization Management + **Schedule:** Monday -...optimize patient care, and partner with the National Senior Director of UM to align on organizational goals. Ready… more
- Scottish Rite for Children (Dallas, TX)
- …giving children back their childhood! Job Posting Title: Director of Case Management and Utilization Management Location: Dallas - Hospital Additional ... Details: Monday - Friday 8:00am to 4:30pm Job Description: Duties/Responsibilities: + Utilization Management supporting medical necessity and denial prevention +… more
- Ascension Health (Tulsa, OK)
- **Details** + **Department:** Utilization Management + **Schedule:** FT, Monday-Friday, 8am-5pm + **Hospital:** Ascension St. John Medical Center + **Location:** ... strategic direction and oversight of the day-to-day operations of utilization management function within the insurance plan....Join more than 7,000 associates and find a rewarding healthcare career at one of our 6 hospitals and… more
- Henry Ford Health System (Detroit, MI)
- …DNB numbers 2. Ensure correct patient status for hospitalized patients 3. Chair Utilization Management Committee: a. Reviewing outlier data, observation LOS b. ... The Medical Director of Utilization Review is responsible...updates, and LOS initiatives 13. Ensure compliance with CMS Utilization Management Conditions of Participation (COP) 14.… more
- Sharp HealthCare (San Diego, CA)
- …competency and individual development planning process.Maintain current knowledge of case management , utilization management , and discharge planning, as ... as Allscripts.Identify opportunities for cost reduction and participate in appropriate utilization management venues.Escalate and refers cases for consultation… more
- HCA Healthcare (Campbell, CA)
- …midpoint of the range. **Introduction** Do you have the career opportunities as a(an) ** Utilization Management RN** you want with your current employer? We have ... an exciting opportunity for you to join HCA Healthcare which is part of the nation's leading provider...of colleagues. Do you want to work as a(an) Utilization Management RN where your passion for… more
- ERP International (Nellis AFB, NV)
- … Management Society of America (CMSA); American Accreditation Healthcare Commission/ Utilization Review Accreditation Commission (URAC); Comprehensive ... No Call, No Weekends, No Holidays! **Job Specific Position Duties:** * Provides Utilization Management activities and functions by using MTF specific Quality… more
- Trinity Health (Silver Spring, MD)
- …experience in an acute healthcare setting required, preferably with case management , utilization review or closely related area. + Extensive knowledge of ... Director , is responsible and accountable for the operational management , leadership, professional development and quality assessment and improvement...payer mechanisms and clinical utilization management is required. + Knowledge of… more
- Reno Behavioral Healthcare Hospital (Reno, NV)
- …an interdisciplinary approach to support continuity of care. + Provides utilization management , transfer coordination, discharge planning, and issuance of ... The UR Specialist reviews and monitors patients' utilization of health care services with the goal...and quality of care. + Responsible for the proactive management of patients with the objective of improving quality… more
- Stanford Health Care (Palo Alto, CA)
- …practice. Here, your leadership, coaching, and mentoring would further develop our robust, Utilization Management team. Are you driven by health care innovation, ... Extended Care Facilities, Durable Medical Equipment vendors) in collaboration with Contract Management and Legal Affairs. + Assists Director in designing,… more
- HCA Healthcare (Brentwood, TN)
- **Description** This position is incentive eligible. **Introduction** The Director Knowledge Management and Scholarly Communications for Graduate Medical ... and promoting the library's scholarly communications and education initiatives. The GME Director of Knowledge Management and Scholarly Communications will assist… more
- Hackensack Meridian Health (Belle Mead, NJ)
- …third party payers and communicate potential or identified concerns to the treatment team, Director of Utilization Management , and the Medical Director . ... keep getting better - advancing our mission to transform healthcare and serve as a leader of positive change....and serve as a leader of positive change. The Utilization Management Coordinator utilizes clinical knowledge and… more
- Behavioral Center of Michigan (Warren, MI)
- …all state mandated regulations. Maintains compliancy with regulation changes affecting utilization management . Reviews patient recrods and evaluates patient ... programs and advises physicians and other departments of regulations affecting utilization management . Consults with Social Services Department regarding the… more
- Katmai (Usaf Academy, CO)
- …**DESIRED QUALIFICATIONS &** **SKILLS** + Certification by a Utilization Management -specific program such as Certified Professional in Healthcare ... precertification requests for medical necessity, referring to the Medical Director those that require additional expertise. + Review clinical...Minimum of two (2) years of prior experience in Utilization Management . + Must possess a current,… more
- Bassett Healthcare (Cooperstown, NY)
- …of risk management and patient safety initiatives within the Bassett Healthcare Network. The Director is responsible for identifying, planning, designing, ... the direction of the VP-Quality & Patient Experience, the Director of Patient Safety and Risk Management ...and the quality of services provided throughout the Bassett Healthcare Network. The Director develops processes to… more
- Sharp HealthCare (San Diego, CA)
- …to accrediting and regulatory agency feedback. + Supports pre-admission review, utilization management , and concurrent and retrospective review Process. Performs ... + Participates in risk management reviews. + Assists in pharmacy utilization management , catastrophic case review, outreach programs, HEDIS reporting, site… more
- Molina Healthcare (UT)
- …Active, unrestricted State Registered Nursing (RN) license in good standing. + Utilization Management Certification (CPHM) Certified Professional in Health Care ... lieu of Bachelor's Degree). **Required Experience** + 7+ years managed healthcare experience with line management responsibility including clinical operations.… more
- Molina Healthcare (FL)
- …Active, unrestricted State Registered Nursing (RN) license in good standing. + Utilization Management Certification (CPHM) Certified Professional in Health Care ... lieu of Bachelor's Degree). **Required Experience** + 7+ years managed healthcare experience with line management responsibility including clinical operations.… more
- Atrius Health (Newton, MA)
- *SUMMARY* Under executive direction, the Associate Director Medex/DW Healthcare Economics Optum Massachusetts is responsible for all aspects of assessing, ... management , collaborates on the annual hospital and outside utilization budgets and year-end/multi-year projections, including managing complex provider discounts… more
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