- ManpowerGroup (Columbia, SC)
- **Title:** **Managed Care Coordinator UM II ** **Location: Columbia SC (Onsite)** **Duration: 3 months** **Pay Range : $31/hr (On W2)** We are looking for a " ... **Managed Care Coordinator UM II ** "to join one of our...and makes referrals to appropriate staff (Medical Director, Case Manager , Preventive Services, Subrogation, Quality of care Referrals, etc.).… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist LVN II ...and implement a successful discharge plan. Works with the UM Manager and Physician Advisor on case ... net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist LVN II will...in the department's continuous quality improvement activities. Communicates to UM Manager and supervising RN, barriers to… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II ...and implement a successful discharge plan. Works with the UM Manager and Physician Advisor on case ... support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and approves… more
- Sharp HealthCare (San Diego, CA)
- …of the System Integrated Care Management (ICM) team the Transfer and Admissions Utilization Manager ( UM ) partners with the Centralized Patient Placement ... preferred.** + Experience and understanding of federal and state regulations governing utilization management. + Accredited Case Manager (ACM) - American Case… more
- Hackensack Meridian Health (Hackensack, NJ)
- …and provide assistance and support in overall medical management effectiveness, benchmarked utilization and cost management ( UM ) goals and clinical improvement ... **Overview** The Senior Utilization Review Specialist collaborates with the healthcare team...formal educational lectures and engage in frequent informal meetings ii . Retrospective Medical Record Documentation Review iii. Clarifying ambiguous… more
- Elevance Health (Grand Prairie, TX)
- …during regular business hours, 8:30 am - 5:00 pm.** **The Transplant Nurse II ** is responsible for providing case management and/or medical management ( UM /UR) ... with providers, claims or service issues. Assists with development of utilization /care management policies and procedures. + Within the medical management role… more
- Elevance Health (Topeka, KS)
- …necessary quality behavioral healthcare in a cost effective setting in accordance with UM Clinical Guidelines and contract. + Refers cases to Peer Reviewers as ... is also acceptable if all of the following criteria are met: performs UM approvals only, reviews requests for Applied Behavioral Analysis (ABA) services only, and… more
- LA Care Health Plan (Los Angeles, CA)
- …member care with internal LA Care departments such as Care Management (CM), Utilization Management ( UM ), Managed Long Term Services and Support (MLTSS), Social ... and unrestrited California License. Licenses/Certifications Preferred Certified Professional in Utilization Review (CPUR) Certified Case Manager (CCM) Required… more
- LA Care Health Plan (Los Angeles, CA)
- …health care auditing and monitoring (preferably in Appeals, Grievances, Quality Improvement, Utilization Management ( UM ) and so forth) and developing audit ... Compliance Advisor II Job Category: Administrative, HR, Business Professionals Department:...Compliance unit, the Advisor also advises and supports the Manager , Director, and Chief Compliance Officer on other duties… more
- Dignity Health (Los Angeles, CA)
- …years of nursing experience. + Certified Case Manager (CCM), Accredited Case Manager (ACM-RN), or UM Certification preferred + Knowledge of managed care and ... Los Angeles. The hospital offers a full complement of services including a Level II trauma center the Los Angeles Center for Womens Health obstetrics and pediatric… more
- ChenMed (Philadelphia, PA)
- …performance of the center, as the true dyad partner to the Center Manager /Center General Manager . Directly supervise, performance manage and train PCPs in ... Leads SH and Transforming Care Meeting (TCM) weekly, as well as supports Center Manager /Center General Manager in other center meetings. SMD partners with Center… more
- Queen's Health System (Kaunakakai, HI)
- …hospital-wide and Medical Staff Performance Improvement (PI), Utilization Management ( UM ), Infection Control (IC) and Employee Health. II . TYPICAL PHYSICAL ... setting. I. JOB SUMMARY/RESPONSIBILITIES Responsible to the Physical Therapy Manager . Provides inpatient and outpatient Physical Therapy services. Prepares all… more