- Staffing Now (Carson City, NV)
- …for Applied Behavioral Analysis (ABA) services only, and there is licensed staff supervision. Previous experience in case management/ utilization management ... expertise to ensure our members are directed to the appropriate level of care . Will be Responsible for managing psychiatric and substance abuse or substance abuse… more
- Accounting Now (Carson City, NV)
- …for Applied Behavioral Analysis (ABA) services only, and there is licensed staff supervisionPrevious experience in case management/ utilization management with ... of experience with complex psychiatric/substance abuse cases requiredPrior managed care experience requiredFor URAC accredited areas, the following professional… more
- Blanchard Valley Hospital (Findlay, OH)
- …ancillary staff to optimize communication and effective utilization of health care resources. REQUIRED QUALIFICATIONS Licensed by the Ohio Board of Nursing ... committees and meetings to contribute information regarding transitions of care and utilization of care ...care and outcomes. Duty 4: The RN Case Manager addresses the safety of patients by reporting suspicions… more
- Tris Pharma (GA)
- …- and several marketed branded and generic products in the US We have licensed our products in the US and international markets and have a robust pipeline ... and team success.We have an immediate opening for a Regional Sales Manager for our Georgia/Florida territory (including Puerto Rico). Qualified candidates must live… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …the case management and interdisciplinary healthcare team in facilitating patient care through the continuum. Monitors department activities to ensure optimum case ... management, including education, competency and accountability of the licensed staff who provide services to patients. Provides clinical oversight and training in… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …of individual patient needs; Works collaborate with the Physicians, patient/family, nursing, utilization review and other members of the healthcare team to assure ... patient outcomes with appropriate transitions to the next level of care ; Responsible for length of stay management, regulatory compliance, and… more
- Northeast Georgia Health System, Inc (Braselton, GA)
- …of Excellence in Minimally Invasive Surgery and Robotic Job SummaryThe Nurse Manager (NM) functions as the first-line administrative nursing leader, with 24-hour ... accountability for care delivery including budget of a nursing unit(s). The Nurse Manager must be able to navigate proficiently within the EHR. He/She must be… more
- Pacer Staffing (Atlanta, GA)
- …to quality care in a cost-effective manner. Coordinates with the Primary Care Manager (PCM) or specialty health providers for information and input into ... Shift - Standard | Mon to Fri Location - Remote (Case Manager - serious diagnoses. Children/Pediatric with down syndrome, serious disabilities, physical… more
- Northeast Georgia Health System, Inc (Oakwood, GA)
- …of system-wide opportunities as they relate to Value Analysis standardization, utilization and implementation. Facilitate Value Analysis Teams (VAT) to most ... projects. Integrates accepted practice changes and assures that standards of care are achieved when standardization opportunities are implemented. Meets with vendors… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …Minimum Job QualificationsLicensure or other certifications: Georgia licensure as Licensed Professional Counselor (LPC), Licensed Clinical Social Worker ... skills Essential Tasks and ResponsibilitiesWorks with the Clinical Coordinator and Nurse Manager to develop patient schedules for inpatient, DPH and IOP levels of… more
- Elevance Health (Tampa, FL)
- …health plans for people enrolled in Medicaid and/or Medicare programs in Florida. ** Licensed Utilization Review II** **Location:** This is a remote position. The ... be required based on operational needs (holiday rotation). The ** Licensed Utilization Review II** is responsible for...of Florida. + Minimum of 2 years of Long-Term Care clinical or Long-Term Care utilization… more
- WellSpan Health (York, PA)
- Utilization Care Manager Location: York Hospital, York, PA Schedule: Part Time Hours: M-F Days Part Time: 20 hours/week General Summary Performs a variety of ... clinical treatment administered by the provider. + Coordinates services with medical utilization / care management personnel of other health plans to ensure… more
- UNC Health Care (Hillsborough, 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
- UNC Health Care (Hendersonville, NC)
- …daily with the Care Manager to manage level of care transitions & appropriate utilization of services. Coordinates with the appropriate staff/payers ... the health and well-being of the unique communities we serve. Summary: The Utilization Manager (UM) assesses new admissions, continued stay and discharge review… more
- UNC Health Care (Hendersonville, NC)
- …daily with the Care Manager to manage level of care transitions & appropriate utilization of services. Coordinates with the appropriate staff/payers ... **Description** Job Summary The Utilization Manager (UM) assesses new admissions,...complex patients and identify trends. Formulates potential solutions with Care Manager and Social Worker and continuously… more
- Molina Healthcare (NV)
- …Nevada is not a compact state at this time.** **Prior experience with managed care (Medicaid, Medicare) Utilization Management processes and 3 + years in ... integrated) performing one or more of the following activities: care review/ utilization management (prior authorizations, inpatient/outpatient medical necessity,… more
- Lucile Packard Children's Hospital Stanford (Palo Alto, CA)
- …are licensed nursing professionals responsible for coordinating continuum of care and discharge planning activities for a caseload of assigned patients. Major ... outcomes. A Case Manager differs from other roles in professional nursing/health care practice in that it is not intended to provide direct patient care… more
- The Mount Sinai Health System (New York, NY)
- …in Nursing or health-related field preferred. + 5 years minimum of progressive acute care leadership and acute care utilization review experience. + ... **JOB DESCRIPTION** The Utilization Review Manager for the Selikoff...area of nursing practice assigned; in this case, acute care utilization review. + Previous experience making… more
- LA Care Health Plan (Los Angeles, CA)
- …Degree Experience Required: At least 4 years of experience in a patient care setting and/or combination in utilization management, appeals and grievances, ... Utilization Management Nurse Specialist LVN II Job Category:...$87,342.00 (Mid.) - $107,498.00 (Max.) Established in 1997, LA Care Health Plan is an independent public agency created… more
- Trinity Health (Mason City, IA)
- …Monday-Friday 0630-1430; no weekends or holidays **About The Job** The Utilization Review Case Manager responsibilities include case screening, insurance ... experience as a registered nurse involving community contact, knowledge of managed care , resource utilization criteria, Medicaid, insurance coverage for acute … more
Related Job Searches:
Care,
Care Manager,
Licensed,
Licensed Care Manager,
Manager,
Utilization,
Utilization Manager