- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Admissions Liaison RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 ... required to achieve that purpose. Job Summary The Utilization Management (UM) Admissions Liaison RN II is primarily responsible for receiving/reviewing… more
- Cedars-Sinai (CA)
- …Assists with investigation and follow-up regarding customer complaints. + Serves as liaison with other units in the Admissions department. \#Jobs-Indeed ... of service cash collections and cash flow, and provide efficient and appropriate utilization of resources. Acts as a resource for team members by assisting with… more
- Ochsner Health (New Orleans, LA)
- …(CCM), Certified Professional Utilization Review (CPUR), Certified Professional in Utilization Management (CPUM) or Certified Professional in Healthcare ... in the delivery of patient care. Preferred - Experience in case management or utilization review. **Certifications** Required - Current Registered Nurse… more
- Fairview Health Services (St. Paul, MN)
- **Overview** M Health Fairview has an immediate opening for a Utilization Management Supervisor. This is a 1.0 FTE (80 hours per two week pay period), ... salaried/exempt role. This position is benefits-eligible. The Utilization Management Supervisor is responsible for the...and various other responsibilities to support the nursing and liaison UM staff. He/she will work closely with the… more
- Trinity Health (Albany, NY)
- …is to provide on-site support and assistance to hospital case management and hospitalist team to ensure timely identification of inpatients appropriate ... members, referral sources, and external payers regarding the effective and efficient utilization of program services and available resources. + Screening of clients… more
- Ochsner Health (New Orleans, LA)
- …at Ochsner Health and discover your future today!** The Physician Advisor (PA- Utilization Management ) serves as the physician leader in matters relating ... Post-Acute teams, Payors, Administration and Revenue Cycle) to improve utilization management , sustain quality goals, and act...quality control, and patient safety + Act as a liaison with payers to facilitate approvals and prevent denials… more
- Genesis Healthcare (NM)
- …the communities we serve. Responsibilities Join the Genesis team as a Clinical Liaison -- LPN where your marketing/sales and clinical skills will be fully engaged.to ... recent clinical experience. 3. Valid driver's license. 4. Preferred case management experience. 5. Experience in business/development preferred. 6. Prior experience… more
- Sharp HealthCare (San Diego, CA)
- …The UM Care Coordinator, under the direct supervision of the Supervisor, Utilization Management Care Coordinators, prepares referral requests for outpatient ... Us emails, Customer Service emails and CSRs, and Network Management referral requests.Serve as a liaison to...related to the position.Bring to attention of the Supervisor, Utilization Management Care Coordinators, and UM Manager,… more
- Kelsey-Seybold Clinic (Houston, TX)
- …Title: Utilization Review Specialist (LVN)** **Location: Remote** **Department:** ** Utilization Management ** **Job Type: Full Time** **Salary Range: $60,306 ... care services requiring authorization prior to services being rendered for members. The Utilization Review Specialist (LVN) serves as a liaison in reviewing… more
- Sutter Health (Berkeley, CA)
- …systems for the appeal/denial process, tracks and trends data, and coordinates utilization management activities for the assigned area. Collaborates with ... of services and appropriate service reimbursement. Monitors and acts as a liaison between external payers, internal business office, admissions staff, and… more
- Ochsner Health (New Orleans, LA)
- …as well as efficiently in high pressure situations. Preferred- Experience in Case Management or Utilization Review Business and Financial Knowledge as well as ... and applies hospital approved medical necessity criteria to review appropriate admissions , levels of care and continued stay. Documents completed reviews in… more
- Ochsner Health (New Orleans, LA)
- …as well as efficiently in high pressure situations. Preferred- Experience in Case Management or Utilization Review Business and Financial Knowledge as well as ... and applies hospital approved medical necessity criteria to review appropriate admissions , levels of care and continued stay. Documents completed reviews in… more
- OLV Human Services (Lackawanna, NY)
- Foster Care and 29I Liaison 790 Ridge Rd, Lackawanna, NY 14218, USAReq #497 Friday, January 3, 2025 **Are you looking for a rewarding career?** The Foster Care & 29I ... Liaison will work in collaboration with applicable OLV Human...attend all meetings with OCFS to discuss enrollment numbers, utilization of services, denials and issues with managed care… more
- VNS Health (Manhattan, NY)
- …to develop a high-quality safe discharge plan. Works with the authorization and utilization management teams to generate timely requests for medical services and ... or a skilled nursing facility stay. + Coordinates with the Authorization and Utilization Management teams to ensure all required authorizations are complete and… more
- Beth Israel Lahey Health (Plymouth, MA)
- …4) reducing readmissions. **Functions and Responsibilities:** **A. Utilization Management ** + Performs review of anticipated admissions utilizing InterQual ... This role is structured around four major functions + Utilization Management + Care Coordination + Discharge...admissions for social reasons + Functions as a liaison between the DEM and community-based resources on an… more
- TEKsystems (Century City, CA)
- …are appropriate, cost-effective, and beneficial to the patient - Coordinates with Pre- Admissions , Admissions , Patient Accounts, Utilization Review, PPS ... Coordinator, etc., to assure positive fiscal management outcomes for the patient - Develops and maintains...- 20 cases - Coordinates with other departments, ie: Pre- Admissions , Admissions , Patient Accounts, Utilization … more
- Ventura County (Ventura, CA)
- …medical policy with the Health Care Agency Director and Insurance Administrator, Utilization Management staff and Quality Assurance Staff. + Participates, as ... surgical procedures, referrals, tests, medication approvals requiring authorization.) + Develops utilization management standards and guidelines for approval by… more
- Louisiana Department of State Civil Service (Baton Rouge, LA)
- …of quality services, the development and stimulation of services of others, and the utilization of available resources in the most effective manner. LDH serves as a ... or Promotional appointment. Statewide Program Manager 1: (Nursing Facility Clinical Liaison ) This position is in the Louisiana Department of Health, Office… more
- Mount Sinai Health System (New York, NY)
- …limited to: a. Reviews all new admissions to identify patients where utilization review, discharge planning, and/or case management will be needed using ... **Job Description** **RN/Case Manager MSH Case Management FT Days** The Case Manager (CM) will...length of stay (LOS), improved efficiency, quality and resource utilization . Assignment will be by units/clinical areas of practice… more
- Community Health Systems (Milton, FL)
- … Review/Case Management meetings. Provides input in such meetings 6regarding utilization management and discharge planning. + Responsible for evaluating and ... our fundamental mission.** **Position Requirements** + Florida RN License-active + Case Management experience 2+ years + Utilization review experience 2+ years… more
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