- PIH Health Careers (Los Angeles, CA)
- …patients from PHWH to the patient's contracted facilities. The RN Access Case Manager performs utilization review with a high level of expertise by ... the right level of care. The RN Access Case Manager works to ensure appropriate utilization of...with ICU or ED background Previous experience in case management . Knowledge of payer requirements and previous… more
- PIH Health Careers (Downey, CA)
- …from PIH Health Hospitals to the patient's contracted facility. The RN ED Access Case Manager performs utilization review with a high level of expertise by using ... right level of care. The RN ED Access Case Manager works to ensure appropriate utilization of...Critical Care or Emergency Department Previous experience in case management . Knowledge of payer requirements and previous… more
- Exact Sciences Careers (Harrisburg, PA)
- …Liaison II (ROL II) will develop and implement a plan to maximize the utilization of our products in targeted accounts, while staying within budget and compliance ... and driving depth within existing accounts. * Demonstrate elevated territory management , planning, and implementation. * Deep and actionable understanding of… more
- University Of Maryland Medical System Careers (Largo, MD)
- …5 years Experience (describe required & preferred):Progressive experience in nursing management . Knowledge of regulatory standards, health care environment and ... to nursing unit professional and support staff in order to maximize utilization of their time and abilities.Principal Duties:1. Provides departmental leadership for… more
- Nashville Nissan Careers (Nashville, TN)
- …and customer engagement metrics, ensuring goals are met. * *Collaborate with Sales Management :* Work closely with the *Internet Sales Manager * and sales managers ... *Job Title: Automotive Sales BDC Manager ** **Location: Downtown Nashville Nissan** **Compensation: Starting at $20.00/hour + Commission Based on Department… more
- Cella Careers (San Diego, CA)
- …Range: $50 - 58 per hourWe are looking for a Sr. Staff Product Marketing Manager to define and execute strategies that drive adoption and utilization of our ... platforms. The ideal candidate will have strong domain knowledge , technical acumen, and the ability to develop compelling product positioning, messaging, and… more
- Butterball (Mount Olive, NC)
- …the table to contribute to our successJob Summary: The Sanitation Operations Manager is responsible for overseeing the Sanitation department and managing Sanitation ... in audits, facility inspections and coordinate pre-operational inspection with QA Management . Set clear development plan, training and performance targets for… more
- MEDSTAR HEALTH (Washington, DC)
- …; management of safety recalls in conjunction with the Pharmacy Benefit Manager ; creation, implementation, and management of projects related to quality and ... requests for medications requiring prior authorization or other exception; management of the content of the formulary for appropriateness...safety, including Drug Utilization Review (DUR) initiatives; and attendance and participation in… more
- McKesson (Juneau, AK)
- …of customer initiatives, quarterly business review, industry knowledge Consistent utilization of Customer Relationship Management (CRM) software as outlined ... on McKesson technology & applicable programs (ie QBR, McKesson Connect, Mobile Manager , CSOS). Customer pre-call planning to include but not limited to report… more
- Houston Methodist The Woodlands Hospital (The Woodlands, TX)
- …through medication use evaluations, drug policy development, and continuous quality management activities related to his/her specialty focus area designed to improve ... and participating in staff development and coordinating intradepartmental quality management and performance improvement initiatives related to the respective… more
- Beth Israel Lahey Health (Plymouth, MA)
- …a job, you're making a difference in people's lives.** Full Time **Job Description:** ** Utilization Review & Denials management manager - Full Time** **Who ... and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager...in utilization management and appeal/denial management . + Holds a strong working knowledge … more
- VNS Health (Manhattan, NY)
- …and updates through on-going training, coaching and educational materials. + For Utilization Management Only: + Issues Determinations, Notices of Action, and ... health care services. Manages providers, members, team, or care manager generated requests for medical services and renders clinical...by state or federal regulations are saved in the Utilization Management System. + Reviews, evaluates and… more
- Humana (Columbus, OH)
- …and determines approach, resources, schedules and goals. The Manager , Utilization Management Nursing uses clinical knowledge , communication skills, ... a part of our caring community and help us put health first** The Manager , Utilization Management Nursing utilizes clinical nursing skills to support… more
- UCLA Health (Los Angeles, CA)
- …the next level. You can do all this and more at UCLA Health. As a Manager for Medicare Advantage Utilization Management , you'll provide direct management ... + Thorough knowledge of health care industry, utilization review, utilization management , and...off-site meetings and conferences + ACM - Accredited Case Manager preferred + CCM - Certified Case Manager… more
- Humana (Columbus, OH)
- …and help us put health first** The Manager , Utilization Management Behavioral Health utilizes behavioral health knowledge and skills to support the ... resources, schedules and goals. The Manager , Utilization Management Behavioral Health uses clinical knowledge , communication skills, and independent… more
- Elevance Health (Washington, DC)
- Manager ll HCMS - Utilization and Case Management (JR142403) **Location:** This position requires travel to our Washington, DC office 4 days each week. The ... with varying degrees of medical complexity and acuity. + Participates in Case Management **and** Utilization Management execution/decision making for managed… more
- UNC Health Care (Chapel Hill, NC)
- …through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management staff to ... & the Hospitals? Utilization Management Plan. In addition, the Utilization Manager is responsible for revenue protection by reconciling physician orders,… more
- Stanford Health Care (Palo Alto, CA)
- …and Abilities** + Knowledge of principles and best practices of case management , utilization review, social work, care coordination and discharge planning. + ... practice. Here, your leadership, coaching, and mentoring would further develop our robust, Utilization Management team. Are you driven by health care innovation,… more
- Beth Israel Lahey Health (Burlington, MA)
- …of three years of medical/surgical nursing care experience. -Two years of Case Management or Utilization Management experience desirable. - Demonstrated ... a difference in people's lives.** Joint role of Case Manager and Utilization Review Nurse **Job Description:**...to ensure a timely process. Registered Nurses (RNs) with utilization review experience, case management experience, and… more
- Trinity Health (Silver Spring, MD)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** **Position Purpose:** As a Case Manager in Utilization Management , you will be the key ... care plans to align with clinical and regulatory standards. By optimizing resource utilization and maintaining the highest standards of care, you will contribute to… more
Related Job Searches:
Knowledge,
Knowledge Management,
Knowledge Management Manager,
Management,
Manager,
Utilization