- CHRISTUS Health (Tyler, TX)
- …in matters related to nursing service and strategies Standard I: Financial Management Recognizes the impact of reimbursement on revenue Understands the relationship ... capital appropriations and project authorizations Standard II. Human Resources Management Evaluates and specifies the critical resources required to accomplish… more
- CHRISTUS Health (Tenneryville, TX)
- …care experience in a relevant setting . Minimum of 5-10 years of healthcare management experience C. Licenses, Registrations, or Certifications . RN License ... in matters related to nursing service and strategies Standard I: Financial Management . Recognizes the impact of reimbursement on revenue . Understands the… more
- CHRISTUS Health (Tenneryville, TX)
- …Supervisor experience overseeing work of assigned units, preferred. Previous healthcare management experience preferred. Licenses, Registrations, or ... high-quality, cost-effective care to patients. Responsible in assisting the Director for analyzing, planning, implementing, evaluating, and communicating processes… more
- 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
- Commonwealth Care Alliance (Boston, MA)
- **Why This Role is Important to Us:** The Director of Utilization Management leads and manages all utilization management (UM) functions for physical ... state and federal regulatory requirements and all applicable accreditation standards. The Director of Utilization Management is responsible for setting… 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
- 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
- Sharp HealthCare (San Diego, CA)
- …The UM Care Coordinator, under the direct supervision of the Supervisor, Utilization Management Care Coordinators, prepares referral requests for outpatient ... care, as it related to the position.Bring to attention of the Supervisor, Utilization Management Care Coordinators, and UM Manager, areas of UM non-compliance… more
- Hartford HealthCare (Torrington, CT)
- …Nurse Director & Social Work Supervisor, the Inpatient Psychiatric Utilization Review Social Worker will work collaboratively with the IP Psychiatry Patient ... Social Work * Active LCSW required * Two years with behavioral health utilization review As a Hartford HealthCare entity, Charlotte Hungerford Hospital provides… 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
- Sharp HealthCare (San Diego, CA)
- …Knowledge of medical terminology, healthcare finances, alternative care options, utilization management , health plan criteria, established criteria such as ... time for routine, urgent and expedited referrals as outlined in SCMG's Utilization Management Plan.Decisions will be communicated to the appropriate persons… 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
- Elevance Health (FL)
- **JR133557 Manager II Behavioral Health Services ( Utilization Management for Behavior Analysis Services)** Responsible for Behavioral Health Utilization ... lower cost of care. + Candidate will be responsible for the oversight of the utilization management team. + Responsible for a team of clinicians who conduct… more
- LA Care Health Plan (Los Angeles, CA)
- …observation) admission in the acute setting. Works with UM leadership, including the Utilization Management Medical Director , on requests where determination ... Utilization Management Admissions Liaison RN II...data presented and established criteria/guidelines, escalating to the medical director if needed. Triages and assesses members for admission… more
- Providence (Mission Hills, CA)
- … program in the Southern California Region. The Manager assists the Regional Director of Utilization Management , Appeals & Clinical Training through ... **Description** The Manager of Utilization Management provides a key role...Registered Nurse License + 5 years Healthcare management experience related to acute care utilization … more
- UCLA Health (Los Angeles, CA)
- …timely communication is provided to all stakeholders. + Working closely with medical director , utilization management and quality review team to ensure ... Description As the Utilization Management & Quality Review Specialist,...a detail-oriented individual with: * Bachelor's degree in a healthcare -related field or equivalent experience * Two or more… more
- Covenant Health Inc. (Louisville, TN)
- …budgeted targets. + Provides medical/psychiatric leadership/consultation to Provider Relations, Medical Utilization Management , and Quality Management Staff ... and adults, Peninsula is a leader in the changing healthcare environment. The hospital is located in Blount County,...updated utilization review guidelines. + Participates in Utilization Management Committee. + Performs other related… more
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