- 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 ... using resources to meet quality, clinical and cost effective outcomes . Coordinates a team approach designed to facilitate the...to ensure services will be covered.Coordinate and communicate with Utilization Review Nurse on a daily, consistent… more
- Blanchard Valley Health System (Findlay, OH)
- …Care Transitions Team, including the disciplines of Social Work, Case Management, Utilization Review , and Emergency Department Care Navigation to support ... utilization of available resources to ensure best possible outcomes for patients and their caregiver transitioning from Care...during acute care stay. Duty 9: Maintains position as Utilization Review committee chair. Works in collaboration… more
- Pacer Staffing (Atlanta, GA)
- …with providers, patients, families as appropriate and assesses the effectiveness and outcomes to improve individual health status. Working Conditions . Ability to ... or worsening chronic conditions. . Manage activities necessary to ensure appropriate utilization and access to resources while maintaining optimal standards of care.… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …at all campuses operated by NGHS. Collaborates with the physicians, patients, families, nursing, utilization review and other members of the health care team to ... with patient needs using resources to meet quality, clinical, and cost-effective outcomes . Coordinates a team approach designed to facilitate the achievement of… more
- Pacer Staffing (Atlanta, GA)
- Shift - Standard | Mon to Fri Location - Remote (Case Manager - serious diagnoses. Children/Pediatric with down syndrome, serious disabilities, physical ... services as clinically appropriate and according to TRICARE policy. Conducts clinical review for requested services particular to the ECHO according to policy,… more
- Lennar Homes (Irving, TX)
- …the United States. Join a Company that Empowers you to Build your FutureThe Sr. Manager of Data Quality will oversee our Data Quality portfolio within the data and ... and ensuring that quality metrics are systematically monitored and reported.The Sr. Manager will lead a team in creating data quality operational reporting, driving… more
- Rose International (Atlanta, GA)
- Summary:Working with the program manager , you will define, plan, manage and deliver large global cyber security projects in data security to ensure that results are ... increase efficiency and effectiveness Perform analysis to identify innovative utilization of existing resources and potential solutions that facilitate… more
- Neil & Laura Clark Women & Children's Center (Findlay, OH)
- …OF THIS POSITION The purpose of the BVMP Behavioral Health Therapist/Case Manager is to provide a range of psychological assessment, diagnostic, therapeutic, and/or ... 3: Participates in various committees and meetings to contribute information regarding utilization of services and quality of healthcare for the purpose of improving… more
- VNS Health (Manhattan, NY)
- …understanding of the community's needs.Oversees the implementation and monitoring of utilization review and quality management procedures, while also conducting ... service delivery. Executes strategies with aim to improve member outcomes and operational efficiency. Continuously develop, implements, monitors, and assesses… more
- Accounting Now (Carson City, NV)
- …and outpatient professional treatment health benefits through telephonic or written review Will use appropriate screening criteria knowledge and clinical judgment to ... implementation case planning monitoring and evaluating to promote quality member outcomes to optimize member health benefits and to promote effective use… more
- Staffing Now (Carson City, NV)
- …and outpatient professional treatment health benefits through telephonic or written review . Will use appropriate screening criteria knowledge and clinical judgment ... implementation case planning monitoring and evaluating to promote quality member outcomes to optimize member health benefits and to promote effective use… more
- Northeast Georgia Health System, Inc (Oakwood, GA)
- …to ensure appropriate feedback is received before product decisions are made. Utilization Review of necessity, quality, effectiveness and efficiency of medical ... of system-wide opportunities as they relate to Value Analysis standardization, utilization and implementation. Facilitate Value Analysis Teams (VAT) to most… more
- Northeast Georgia Health System, Inc (Braselton, GA)
- …effective team work and interdisciplinary team building skills as evidenced by Manager observation, peer review , and other departments feedback, ie nursing. ... compliance with department and third party payors guidelines. Accomplishes good clinical outcomes (using national benchmarks and comparing to others in the same… more
- Concorde Career Colleges, Inc. (San Antonio, TX)
- …and rewarding place to work.Position Summary:The Financial Aid Director (FAD) is the Manager of the Financial Aid Department and is responsible for the oversight and ... that is compliance oriented, customer service heavy, and accountable for specific outcomes related to the administration of Title IV programs and packaging of… more
- The Mount Sinai Health System (New York, NY)
- **JOB DESCRIPTION** The Utilization Review Manager for the Selikoff Centers for Occupational Health is responsible for the management of program operations ... medical records, and internal and external regulatory and survey requirements. + The Utilization Review Manager collaborates with multiple professionals to… more
- Trinity Health (Silver Spring, MD)
- …physician advisor and external review organizations to ensure quality outcomes , patient throughput, and appropriate resource utilization while supporting the ... Type:** Full time **Shift:** Day Shift **Description:** **Job Title:** Manager Care Mgt & Util Review **Employment...RN Case Managers for in inpatient care coordination and utilization review . Oversees interactions of staff with… more
- Hartford HealthCare (Torrington, CT)
- …*your moment*. **Job:** **Professional Clinical* **Organization:** **Charlotte Hungerford Hospital* **Title:** * Utilization Review Social Work Care Manager ... Nurse Director & Social Work Supervisor, the Inpatient Psychiatric Utilization Review Social Worker will work collaboratively...activities on a 17 bed Adult unit. The Care Manager will liaison with insurance companies and other referral… more
- Trinity Health (Mason City, IA)
- …**Hours:** Monday-Friday 0630-1430; no weekends or holidays **About The Job** The Utilization Review Case Manager responsibilities include case screening, ... commercial payer specific guidelines to prevent denials and revenue loss. Patient outcomes are achieved through effective application of care plans, managed care… more
- Hackensack Meridian Health (Hackensack, NJ)
- **Overview** The Senior Utilization Review Specialist collaborates with the healthcare team in the management and resolution of activities that assure the ... patient population and HackensackUMC. These include but are not limited to utilization review , hospital reimbursement, clinical compliance, case management, and… more
- Billings Clinic (Billings, MT)
- …starting. Click here (https://billingsclinic.csod.com/ats/careersite/search.aspx?site=15&c=billingsclinic) to learn more! Utilization Review RN Billings Clinic ... Wage DOE: $35.34 - 44.18 Under the direction of department leadership, the Utilization Review / Management RN. This position is to conduct initial, concurrent,… more
