- AmerisourceBergen Drug Corporation (Conshohocken, PA)
- …people and animals everywhere. Apply today!Job Details Summary: Secure Supply Chain Manager will have three main responsibilities: 1) manage the overall vendor DSCSA ... resolution with 400+ pharmaceutical manufacturing partners, enterprise IT, category management , regulatory assurance, and other various cross-functional teamsEstablish and… more
- Humana (Jefferson City, MO)
- …a part of our caring community and help us put health first** The Manager , Utilization Management Nursing utilizes clinical nursing skills to support ... and communication of medical services and/or benefit administration determinations. The Manager , Utilization Management Nursing works within specific… more
- Dartmouth Health (Lebanon, NH)
- Overview The Manager of Utilization Management is responsible for day to day operations of the utilization review program at multiple Dartmouth Health ... system hospitals covering a range of settings from the Academic Medical Center to Critical Access Hospitals. This role involves collaborating with program medical directors, care teams and health plans to ensure regulatory compliance and appropriate financial… more
- UCLA Health (Los Angeles, CA)
- …the next level. You can do all this and more at UCLA Health. As a Manager for Medicare Advantage Utilization Management , you'll provide direct management ... (BSN) degree required + Five or more years of utilization management required + Four or more...off-site meetings and conferences + ACM - Accredited Case Manager preferred + CCM - Certified Case Manager… more
- Huron Consulting Group (Chicago, IL)
- …as the expert you are now and create your future. **Qualifications** The Utilization Management Specialist is responsible for ensuring the appropriate ... to facilitate optimal patient outcomes while managing healthcare costs. The Utilization Management Specialist ensures compliance with regulatory requirements and… more
- Healthfirst (NY)
- **Duties/Responsibilities:** + Provides case management services for assigned member caseloads which includes: + Pre-certification performing risk-identification, ... Negotiates rates with non-partner providers, where applicable. Ensures appropriate access and utilization of a full continuum of network and community resources to… more
- Lucile Packard Children's Hospital Stanford (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,...delivery and quality of patient care. A hospital-based case management system has as its primary goal to ensure… more
- Elevance Health (Topeka, KS)
- …is a hybrid role.** The ** Manager of Behavioral Health - Kansas - Utilization Management (BH UM)** will manage a team of licensed clinicians and non-clinical ... or federal requirements that may apply; provided that the manager 's director has one of the types of licensure...and/or outpatient psychiatric and chemical dependency treatment and prior utilization management experience; or any combination of… more
- Prime Healthcare (National City, CA)
- …and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/175861/**case- manager -rn utilization - management ... https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf Responsibilities Responsible for the quality and resource management of all patients that are admitted to… more
- Prime Healthcare (Montclair, CA)
- …and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/175009/case- manager -%28rn%29 utilization - management ... https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf Responsibilities Responsible for the quality and resource management of all patients that are admitted to… more
- Prime Healthcare (North Las Vegas, NV)
- …computer skills. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/174491/case- manager -%28rn%29 utilization - management ... Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC\_KnowYourRights\_screen\_reader\_10\_20.pdf Responsibilities Responsible for the quality and resource management of all patients that are admitted to the… more
- Molina Healthcare (NV)
- …not a compact state at this time.** **Prior experience with managed care (Medicaid, Medicare) Utilization Management processes and 3 + years in management / ... performing one or more of the following activities: care review/ utilization management (prior authorizations, inpatient/outpatient medical necessity, etc.),… more
- Amazon (Seattle, WA)
- …to completion. We're seeking an experienced Senior Technical Infrastructure Program Manager in Seattle, WA to oversee data center electrical infrastructure ... projects. You will lead cross-functional and technical teams identify sub-optimal utilization , determine root causes, design solutions and drive project delivery.… more
- Humana (Columbus, OH)
- …a part of our caring community and help us put health first** The Senior Project Manager manages all aspects of a project, from start to finish, so that it is ... completed on time and within budget. The Senior Project Manager works on problems of diverse scope and complexity ranging from moderate to substantial in a… more
- Trinity Health (Silver Spring, MD)
- …acute healthcare setting required. + Extensive knowledge of payer mechanisms and clinical utilization management is required **Preferred:** + At least 5-7 years ... - 4:30pm + Reporting to the Director of Care Management + The RN Manager is responsible...RN Case Managers for in inpatient care coordination and utilization review. Oversees interactions of staff with outside activities… more
- AdventHealth (Altamonte Springs, FL)
- … will oversee ED, Inpatient, and Specialist utilization , and manage care management outcomes. The Senior Manager of Utilization will provide support, ... to the RN on care management duties/assignments. The Senior Manager of Utilization will be responsible for auditing the Transition of Care (TOC) process… more
- BronxCare Health System (Bronx, NY)
- …and implementation of educational programs for Denial Prevention and Management . Responsibilities - Establish and maintain positive relationships with patients, ... includes data collection, analysis, implementation of and compliance with risk management and claims activities, support of and participation in Continuous Quality… more
- AmeriHealth Caritas (Dublin, OH)
- ** Utilization Management Plan Oversight Manager ** Location: Dublin, OH Primary Job Function: Medical Management ID**: 37872 Your career starts now. We ... Chief Medical Officer for the Ohio Market, this position is representing Utilization Management (UM) in state interactions/audits, validation of regulatory… more
- UCLA Health (Los Angeles, CA)
- …You can do all this and more at UCLA Health. Under the direction of the Utilization Management , Assistant Manager , you will play a key role in processing ... role within a leading health organization. Help ensure smooth and efficient case management processes to support quality care. Take your expertise to the next level.… more
- LA Care Health Plan (Los Angeles, CA)
- …Certification in Certified Professional in Utilization Review (CPUR), Certified Case Manager (CCM), Utilization Management or Compliance Salary Range ... the coordination of member care with internal LA Care departments such as Care Management (CM), Utilization Management (UM), Managed Long Term Services and… more
