- Katmai (Fort Carson, CO)
- **SUMMARY** Provide a comprehensive utilization review (UR) and utilization management (UM) program for all TRICARE eligible beneficiaries within the CMHS. ... analyze data, and develop recommendations to resolve problems related to the appropriate utilization of patient care services at the appropriate level of care. +… more
- Commonwealth Care Alliance (Boston, MA)
- 013650 CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management (UM) Reviewer is ... and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring CCA meets CMS… more
- Rady Children's Hospital San Diego (San Diego, CA)
- …Manager, the UM Operations Trainer's primary job function is to support Utilization Management operations by training non-clinical staff on how to successfully ... perform any non-clinical tasks. This includes, but is not limited to, initial authorization processing (data entry, eligibility verification, benefits verification, and requesting required supporting documents from submitting provider offices), answering the… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …an experienced **MD** to join our team as an **Assistant Medical Director ( Utilization Management - Oncology)** . The AMD will leverage their specialization in ... Oncology to provide benefit coverage determinations based on medical necessity and contract language for health plan members, including review of clinical documentation using medical policy criteria, guidelines, and member contracts. In addition, they will… more
- ERP International (Macdill AFB, FL)
- …is seeking a **Registered** **Nurse (RN)** for a Full-Time position in ** Utilization Management** at MacDill AFB, FL. Apply online today and discover more ... about this exceptional employment opportunity. www.erpinternational.com **Be the Best!** Join our team of exceptional health care professionals across the nation. Come discover the immense pride and job satisfaction ERP Employees experience in providing care… more
- ERP International (Vandenberg AFB, CA)
- **Overview** ERP International is seeking a full-time **Registered Nurse (RN) Utilization Management** for a temporary contract position in support of the30th ... Medical Group at Vandenberg AFB, CA (https://www.airforcemedicine.af.mil/MTF/Vandenberg/About-Us/) . **NOTE: This is NOT a Tele-Health/Remote Practice Opportunity.** **Be the Best!** Join our team of exceptional health care professionals across the nation.… more
- Stanford Health Care (Palo Alto, CA)
- …include coordinating all facets of a patient's admission/discharge; performing utilization review activities, including review of patient charts for timeliness ... of services as well as appropriate utilization of services; and ensuring optimum use of resources, service delivery, and compliance with external review agencies'… more
- Stanford Health Care (Palo Alto, CA)
- …include coordinating all facets of a patient's admission/discharge; performing utilization review activities, including review of patient charts for timeliness ... of services as well as appropriate utilization of services; and ensuring optimum use of resources,...records as required; collects, analyzes and reports ondata for utilization , quality improvement, compliance, and other areas as assigned.… more
- DHL Express, Inc. (Erlanger, KY)
- …The Business Analyst prepares, analyzes, and reports data to improve the utilization of the DHL Express Air Network movements. **Key Accountabilities:** **Capacity ... Planning:** -Develop and implement capacity plans to ensure optimal utilization of transportation resources. Align capacity with demand forecasts and operational… more
- Bluestone Child & Adolescent Psychiatric Hospital (University Heights, OH)
- …experience as a psychiatric nurse. 1-2 years-experience in behavioral health utilization review preferred. AGENCY SUMMARY: Bluestone is seeking dynamic healthcare ... the avenues for advocacy on behalf of patients with insurance for utilization of insurance benefits throughout the patient's treatment. Further, the Intake Nurse… more
- Greenspring Village by Erickson Senior Living (Springfield, VA)
- …such as Falls, Pressure Ulcers, Medication Errors, Restraint Utilization , Re-hospitalization, Anti-psychotic utilization , ADL splits/documentation, etc. ... leadership meetings such as Wound Rounds, Clinical Operations Meeting, Utilization Review, and Performance Improvement/Risk Management/Safety (PI/RM/S) Committee Provides… more
- Valley Health System Consolidated Services (Las Vegas, NV)
- …by establishing a safe, individualized discharge and providing proficient timely utilization management services to ensure that maximum reimbursement is achieved for ... three years experience in varied clinical settings. Two years experience in Utilization Review, Utilization Management or Case Management preferred. Applicant… more
- Valley Health System Consolidated Services (Las Vegas, NV)
- …by establishing a safe, individualized discharge and providing proficient timely utilization management services to ensure that maximum reimbursement is achieved for ... three years experience in varied clinical settings. Two years experience in Utilization Review, Utilization Management or Case Management preferred. Applicant… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …procedure and diagnosis codes, and support business decisions regarding utilization management activities and guidelines. + Support medical policy development ... and diagnosis codes for company medical policies and UM ( Utilization Management) guidelines that reflect medical necessity, experimental/investigational or other… more
- Houston Methodist Clear Lake Hospital (Nassau Bay, TX)
- …productivity in accordance with staffing grid. Provides input into unit resource utilization including unit capital and operational budget needs. Oversees shift by ... shift resource utilization through the allocation of staff, supplies and contributions to the patient throughput. GROWTH/INNOVATION ESSENTIAL FUNCTIONS Fosters… more
- Carle Health (Peoria, IL)
- …for coordination of the surgical schedule to assure the most efficient utilization of the operating rooms. Monitor case progression to identify potential schedule ... changes. Assigns, coordinates and monitors utilization of personnel and facilities. Provides for the assignment of lunch and break relief for intraoperative staff.… more
- Houston Methodist Cypress Hospital (Cypress, TX)
- …for services provided, as applicable. Uses resources efficiently to maximize utilization of time and equipment. Self-motivated to independently manage time ... Demonstrates professional and technical competence in the selection, evaluation, utilization of treatment plans for increasingly complex patient populations… more
- Mercy (Fort Smith, AR)
- …and cost-effective care provided by competent co-workers. They ensure efficient utilization of available resources to meet productivity and financial goals. Clinical ... and cost-effective care provided by competent co-workers. They ensure efficient utilization of available resources to meet productivity and financial goals. Clinical… more
- Xcel Energy (Denver, CO)
- …that minimize total cost while meeting user requirements. Enhance asset utilization through rental options, maintain adequate equipment pool and redeployment of ... to share fleet assets, optimally balancing functional, emergency availability, utilization , and cost considerations. Leverage reporting tools, identifying high and… more
- Washington Metropolitan Area Transit Authority (New Carrollton, MD)
- …space planning and interior design and addresses space needs by conducting utilization analysis and programming. The incumbent will lead the space allocation ... Manages the development and maintenance of WMATA Master Plan for Space Utilization (Non-Operations) and database of current space allocation by department. +… more
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