- HCA Healthcare (Nashville, TN)
- …to join an organization that invests in you as a(an) Director Regulatory and Accreditation ? At HCA Healthcare, you come first. HCA Healthcare has committed up to ... to make a difference. We are looking for a dedicated Director Regulatory and Accreditation like you to be a part of our team. **Job Summary and Qualifications**… more
- Centene Corporation (Tallahassee, FL)
- …ensure appropriate and effective utilization of healthcare services + Works with utilization management senior management team to provide updates ... accreditation standards, and industry best practices related to utilization management + Educates and provides resources...ensure adherence to quality and performance standards + Assists utilization management senior leadership with… more
- Centene Corporation (Raleigh, NC)
- …knowledge of regulations, accreditation standards, and industry best practices related to utilization management + Works with utilization management ... ensure appropriate care to members. Supervises day-to-day activities of utilization management team. + Monitors and tracks...applicable guidelines, policies, and procedures + Works with the senior management to develop and implement UM… more
- Veterans Affairs, Veterans Health Administration (Hines, IL)
- Summary The Utilization Management (UM) Nurse Manager (NM) is a registered professional nurse responsible for the assessment, planning, provision and evaluation ... client cases as it relates to the practice of utilization management . Responsibilities The Utilization ...education and experience to provide direct staff support to Senior Leadership, Service Line Leaders, and others in the… more
- Sharp HealthCare (San Diego, CA)
- …to accrediting and regulatory agency feedback. + Supports pre-admission review, utilization management , and concurrent and retrospective review Process. Performs ... risk management reviews. + Assists in pharmacy utilization management , catastrophic case review, outreach programs,...CMO CPTAC and Peer Review Committees. + Partners with Senior Management including CMO and COO to… more
- Magellan Health Services (Albuquerque, NM)
- …the delivery of appropriate health care by overseeing the service coordination, utilization management , care/case management , population health/disease ... all health plans overseen by the assigned position which includes metrics for utilization and quality management . Develops mitigating strategies to ensure goals… more
- Houston Methodist (Houston, TX)
- …of the clinic network, assist in the development of regional strategic direction with Senior leadership, serve as the primary liaison with physicians in SPG and PCG ... secure compliance with ethical and legal business practices and accreditation /regulatory/government regulations. **PEOPLE ESSENTIAL FUNCTIONS** + Directs, develops and… more
- Veterans Affairs, Veterans Health Administration (Albuquerque, NM)
- …admitted and discharged within the medical center, and to review utilization of laboratory, pharmacy, inpatient, and outpatient resources. Establishes performance ... policy and procedures to ensure compliance with Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and other accrediting bodies and regulatory… more
- CVS Health (Trenton, NJ)
- …Matter Expert (SME) for the plan and works across various departments including Care Management , Utilization Management , Quality Management , and Medical ... with demonstrated outcomes + 4+ years demonstrated experience in managed care Utilization Management to include prior authorization, concurrent review OR… more
- UPMC (Pittsburgh, PA)
- …+ Provide innovative ideas for new and existing clinical program development, utilization management , formulary management , provider education, and ... pharmacy expertise to develop, implement, and manage the pharmacy benefit. The Senior Clinical Pharmacist assists in managing pharmacy utilization and provides… more
- Veterans Affairs, Veterans Health Administration (Long Beach, CA)
- … Senior Social Worker's primary responsibilities include providing case management services for clinically complex Veterans and providing consultation and support ... the EDRP application. Former EDRP participants ineligible to apply. Responsibilities The Senior Social Worker practices within the Housing and Urban Development / VA… more
- Veterans Affairs, Veterans Health Administration (San Antonio, TX)
- …similar role or with population served Clinical supervision certification Quality or utilization management experience Former VA Trainee Reference: For more ... Summary The Senior Social Worker (Emergency Department [ED]) works independently...be experienced in making rapid assessments and developing crisis management plans for admission to Mental Health inpatient/outpatient programs.… more
- Veterans Affairs, Veterans Health Administration (Huntington, WV)
- …the Hershel "Woody" Williams VAMC Outpatient Mental Health Clinic and serves as the Senior Social Worker in BHIP at the medical center and its Community Based ... Outpatient Clinics. This position serves as the senior clinician on the team and helps to manage consults, admissions and care assignments. Responsibilities VA… more
- Sharp HealthCare (San Diego, CA)
- …Start Time** **Shift End Time** Six Sigma Yellow Belt Certification - Various-No accreditation board **Hours** **:** **Shift Start Time:** 8 AM **Shift End Time:** ... subject matter experience. + 3 Years system analyst role. + Project Management experience. + Six Sigma Yellow Belt Certification - Various-No accreditation… more
- Veterans Affairs, Veterans Health Administration (Huntington, WV)
- …Hershel "Woody" Williams VAMC Outpatient Mental Health Clinic and serves as the Senior Licensed Professional Mental Health Counselor (LPMHC) in BHIP at the medical ... center and its Community Based Outpatient Clinics. This position serves as the senior clinician on the team and helps to manage consults, admissions and care… more
- Houston Methodist (Houston, TX)
- …/regulatory/ government regulations. **PEOPLE ESSENTIAL FUNCTIONS** + Performs management responsibilities of selection, scheduling, supervision, retention, and ... At Houston Methodist, the Senior Practice Manager position is responsible for independently managing and/or coordinating complex delivery of care within a large,… more
- Battelle Memorial Institute (Crystal City, VA)
- …commercial clients. The Cyber Architecture & Advisory Services is seeking a ** Senior Information System Security Officer (ISSO)** to lead the Security Architecture ... and Security Authorization Process (Certification & Accreditation ) effort for the Department of Homeland Security's Transportation Security Administration (TSA), TSA… more
- Spectrum Health Services (Philadelphia, PA)
- …for identifying said population via provider/external health facility referral, utilization management referral, disease registry reporting mechanisms and ... in nursing care and practice in accordance with all regulatory requirements and accreditation standards. The Senior Clinical Director is responsible for building… more
- Tufts Medicine (Burlington, MA)
- …the Clinical Documentation Improvement, HB/PB Coding, HIM Operations, and Utilization Review (UR) departments while implementing enterprise-wide vision. The leader ... guide, and direct standardization of activities across localized CDI, Coding, and Utilization Review departments. They will provide input and direction to strategic… more
- The County of Los Angeles (Los Angeles, CA)
- SENIOR DISASTER SERVICES ANALYST Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4320334) Apply SENIOR DISASTER SERVICES ANALYST Salary ... efficiency. Analyzes and interprets legislative proposals relating to emergency/disaster management systems and recommends amendments as needed. Provides assistance… more