- Alameda Health System (San Leandro, CA)
- Clinical Nurse III, Acute Inpatient Behavioral Health Utilization Management + San Leandro, CA + John George Psychiatric Hospital + JGP Care Coordination + ... Program required; Bachelor's degree in Nursing preferred. Minimum Experience: Previous Behavioral Health Utilization Management or Care Management … more
- Katmai (Fort Carson, CO)
- **SUMMARY** Provide a comprehensive utilization review (UR) and utilization management (UM) program for all TRICARE eligible beneficiaries within the CMHS. ... management concepts. + Establish and maintain referral management practices to monitor and evaluate health ...Operations Manual (TOM) access to care standards for appropriate utilization of services. Perform utilization management… more
- Commonwealth Care Alliance (Boston, MA)
- 013650 CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management , the Nurse Utilization Management (UM) ... clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring CCA… more
- Katmai (Fort Carson, CO)
- …(BSN) is required. + Minimum of two (2) years of prior experience in Utilization Management . + Must possess a current, active, full, and unrestricted Registered ... background checks. **DESIRED QUALIFICATIONS & SKILLS** + Certification by a Utilization Management -specific program such as Certified Professional in Healthcare… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …an experienced **MD** to join our team as an **Assistant Medical Director ( Utilization Management - Oncology)** . The AMD will leverage their specialization ... to Fortune 100 companies. Our services include innovative programs focused on health management , wellness, prevention, and patient safety. We deliver these… more
- Stanford Health Care (Palo Alto, CA)
- …planning process and applicable regulatory requirements; educates the staff on case management ; and provides specific information related to case types. + ... of America) Why work at Stanford Medicine | Stanford Health Care (SHC)? Are you a seasoned RN Case...your bedside RN experience to great use in case management working in conjunction with the medical teams, third-party… more
- Stanford Health Care (Palo Alto, CA)
- …with electronic medical record systems (eg, Epic, Lawson) and materials management information systems (MMIS). **Required Knowledge, Skills and Abilities** ... - 08 Hour (United States of America) At Stanford Health Care, you'll have the opportunity to work at...care and academic medical centers that may impact product/service utilization or Value Based Management processes. +… more
- Stanford Health Care (Palo Alto, CA)
- …planning process and applicable regulatoryrequirements; educates the staff on case management ; and provides specific information related to casetypes. + ... with revieworganizations / payers to provide requested clinical and psychosocial information to assurereimbursement. + Utilization Review -- Reviews… more
- ERP International (Luke AFB, AZ)
- … Management Society of America (CMSA); American Accreditation Healthcare Commission/ Utilization Review Accreditation Commission (URAC); CAMH; (AAAHC); Health ... algorithms, CM software, and databases for community resources. - Integrate CM and utilization management (UM) and integrating nursing case management with… more
- Stanford Health Care (Palo Alto, CA)
- …Stanford Health Care **What you will do** + Inpatient & SNF Utilization Management & Care Coordination: + Support proactive hospital discharge planning, ... , if appropriate. + High Risk Member Complex Case Management : + Proactively review Health Risk Assessments...Provide regular feedback to providers, inpatient case managers, and utilization management coordinators on the appropriateness of… more
- Luke Staffing (Yigo, GU)
- …peers, and other health team members. + Submits all concerns through Utilization Management Director; be able to identify, analyze, and make recommendations ... experience is required. One year of previous experience in Utilization Management is required. Full time employment...providers in routine or STAT situations. Routinely monitors referral management Composite Health Care System (CHCS) queue… more
- Stanford Health Care (Pleasanton, CA)
- …of America) The Manager of Advanced Practice Providers (APPs) for Cardiovascular Health oversees clinical operations and team management across the Tri-Valley ... dotted-line reporting relationship to Rose Geronimo, Senior Director of Nursing for Cardiovascular Health . **This is a Stanford Health Care job.** **A Brief… more
- Novo Nordisk Inc. (New Orleans, LA)
- …d) supports and assists representatives and managers in answering questions from health care providers and IHNs Combines account management skills, business ... and demonstrates the benefits of key products to HCPs. Provides medical information and coordinates educational workshops, round tables, medical forums, etc.. May… more
- ASRC Industrial Services (Tempe, AZ)
- …adhere to recordkeeping standards. + Advise teams on the application of information management policies and procedures, including creation, use, retention and ... + Provide advice and guidance on the organization and utilization of information assets, while ensuring practices...of content. + Respond to ad hoc queries regarding information management within standard or negotiated timelines,… more
- ASRC Industrial Services (Tempe, AZ)
- …Provide input and support in the development and maintenance of enterprise information management policies and procedures. + Provides superior professionalism ... + Provides advice and guidance on the organization and utilization of information assets, while ensuring practices...customer service. + Responds to ad hoc queries regarding information management within standard or negotiated timelines,… more
- Children's Hospital Los Angeles (Los Angeles, CA)
- …years nursing experience with advanced level pediatric clinical experience and utilization management and/or discharge planning experience. Thorough knowledge of ... every patient. And together, CHLA team members will turn health care into health transformation. Join a...managed care, utilization management , discharges planning, and continuous quality… more
- ASRC Industrial Services (Tempe, AZ)
- …required to travel. **Essential Duties and Responsibilities** + Maintain the Legacy Management information architecture to include the thesaurus, taxonomies, and ... management , information governance, and records and information management . + Protect and identify sensitive...+ Provide advice and guidance on the organization and utilization of information assets, while ensuring practices… more
- Christus Health (Cibolo, TX)
- …excellence in patient care, patient experience and patient outcomes. Effectively manages utilization of staff and material resources so that the most therapeutically ... enhances performance and facilitates professional development. Provides HR with information to maintain associate files with current licensure, credentialing… more
- Christus Health (Cibolo, TX)
- …excellence in patient care, patient experience and patient outcomes. Effectively manages utilization of staff and material resources so that the most therapeutically ... enhances performance and facilitates professional development. Provides HR with information to maintain associate files with current licensure, credentialing… more
- Baptist Memorial Health (Southaven, MS)
- Interested in this role You can find all the relevant information in the description below. Summary Manages the care for a specific population; facilitates the safe ... of patients throughout the continuum of care for appropriate utilization of resources, service delivery and compliance with federal...RN with 3 years of clinical experience with Case Management experience in a hospital or payer setting Minimum… more
