- Alameda Health System (Oakland, CA)
- …off plans Role Overview: Alameda Health System is hiring! The Director of Utilization Management holds a critical role encompassing operational oversight, ... background. Required Licenses/Certifications : Valid license to practice as a Registered Nurse in the State of California. Preferred Licenses/Certifications… more
- Harbor Health Services, Inc. (Mattapan, MA)
- …care and ensure efficient and cost-effective operations. The Director of Utilization Management and Quality Programs develops systems , processes and best ... MA and cares for more than 580 participants. We are currently seeking a Director of Utilization Management & Quality Programs. Harbor Health offers an excellent,… more
- Fresenius Medical Care (Fayetteville, NC)
- …Develops action plans for unexcused and missed treatments in collaboration with the Director . Plans, coordinates and acts as the liaison for patient care as per ... management company. Maintains current knowledge of disease management software and systems as pertinent. STAFF: Responsible for implementation of FMS staffing, and… more
- Luke Staffing (Yigo, GU)
- …+ **Licensure:** Current, full, active, and unrestricted license to practice as a Practical OR Registered Nurse in any one of the 50 States, the District of ... ** NURSE - REFERRAL MANAGEMENT** **SITE OF SERVICE:** Andersen...other health team members. + Submits all concerns through Utilization Management Director ; be able to identify,… more
- Alameda Health System (Oakland, CA)
- …or related fields. Required Licenses/Certifications: Valid license to practice as a Registered Nurse in the State ofCalifornia RequiredExperience:Seven years of ... Director , Service Line Administration + Oakland, CA +...development, revenue generation, and expenditure control to optimize the utilization of resource at greatest value. + Represents the… more
- UnitedHealthcare (New Orleans, LA)
- …RN licensure in the state of Louisiana 3+ years of experience as a Registered Nurse in a hospital setting, acute care, direct care experience, community ... the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a… more
- Organon & Co. (Columbus, OH)
- **Job Description** **The Position** The Regional Payer Account Director (RPAD) reports directly to the Executive Director , Regional Payer Accounts. The RPAD ... generating potential solutions that enhance partnership. Collaborating with the National Account Director , the RPAD participates in the development of, as well as… more
- Commonwealth Care Alliance (Boston, MA)
- 011230 CA-Provider Engagement & Performance Position Summary: The Director of Provider Relations leads the strategic vision and operational execution of provider ... network performance, and ensuring compliance with regulatory standards. The Director drives initiatives that enhance operational engagement, member access, provider… more
- Katmai (Usaf Academy, CO)
- …with military and civilian healthcare providers and staff and uses Utilization Management (UM) systems support to identify high-risk/high-cost patients ... upon request. + Reports monthly summary of care to Director , Medical Management (MM) or designee. + Conducts monthly...States or jurisdiction, be able to practice using a nurse compact state license or Enhanced Nurse … more
- Commonwealth Care Alliance (Boston, MA)
- …manager, and performance partner - using data, provider feedback, and system collaboration to enhance provider engagement, improve outcomes, and strengthen ... quality care. The BH Provider Engagement Program Manager reports to the Director of Delegation Partnerships and Provider Engagement. Supervision Exercised: - No,… more
- Alameda Health System (Oakland, CA)
- …off plans **Role Overview:** Alameda Health System is hiring! The Director of Utilization Management holds a critical role encompassing operational ... Director , Utilization Management + Oakland, CA...background. Required Licenses/Certifications: Valid license to practice as a Registered Nurse in the State of California.… more
- UNC Health Care (Morrisville, NC)
- …health and well-being of the unique communities we serve. **Summary** : The **Executive System Director of Utilization Management (UM)** is a strategic and ... operational leader responsible for designing, implementing, and standardizing utilization management functions across a large healthcare system , including a… more
- Huron Consulting Group (Chicago, IL)
- …Support: Leads and manages the utilization review staff and function for the system , reporting to the Director of Utilization Management within Revenue ... agencies, and hospital contractual payor agreements. This position reports to the Director of Utilization Management and works with hospital leadership to… more
- Sacramento Behavioral Healthcare Hospital (Santa Rosa, CA)
- …LVN/LPT $35.00-44.19 Per Hour RN /LCSW/LMFT/LPCC $54.00-68.18 Per Hour REPORTS TO: Director of Utilization Review DESCRIPTION OF POSITION: Work as member of ... the greater Santa Rosa and Northern California mental health system of care. Conveniently located in the North Bay,...substance abuse conditions. POSITION TITLE: Utilization Review Clinician PAY RANGE:… more
- Prime Healthcare (Inglewood, CA)
- …outcomes and reducing readmissions. #LI-CC2 Qualifications Required qualifications: 1. CA Registered Nurse 2. Bachelor's of Science in Nursing3. Grandfathered ... As a member of Prime Healthcare, a Top-15 hospital system in the United States, Centinela Hospital Medical Center...part-time. Responsibilities We are seeking a strategic and compassionate Director of Case Management to lead our dynamic Case… more
- Houston Methodist (Houston, TX)
- …leading multi-site or enterprise-level programs preferred **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure -- ... for all hospital-based Case Management Directors and the Central Utilization Review Director across the system...approach in the optimization of safe outcomes and information systems by monitoring and improving the system -wide… more
- RWJBarnabas Health (Newark, NJ)
- Asst Director Patient Care Registered Nurse ( RN ) Full Time Days CTICUReq #:0000204650 Category:Nursing Management / Leadership Status:Full-Time Shift:Day ... Location: 201 LYONS AVENUE, NEWARK, NJ 07112-2027 Job Title:Asst Director Patient Care Location:Newark Beth Israel Medical Ctr Department...you need. Required Certifications and Licenses: + Active NJ RN License or Multistate RN License with… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …policy and procedure, identifies and refers potential quality of care and utilization issues to Medical Director . + Utilizes appropriate communication techniques ... and accreditation entities. Refers appropriate cases to the Medical Director for review. Refer to and work closely with...is required to know multiple functional areas and supporting systems . + Expert in Utilization Management and… more
- Banner Health (Torrington, WY)
- …of recreational opportunities. Torrington Community Hospital is looking for a full-time RN Associate Director to lead the Emergency department in Torrington, ... a state-of-the-art emergency department, electronic medical records and a computerized OB system designed to reduce the chances of complications during labor and… more
- St. Luke's University Health Network (Lehighton, PA)
- …including but not limited to: RN care managers, assistants, coordinators, utilization management staff, and director . . Facilitates communication among all ... we serve, regardless of a patient's ability to pay for health care. The Registered Nurse or Social Worker Care Manager is responsible for coordinating the… more
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