- Hackensack Meridian Health (Brick, NJ)
- …to transform healthcare and serve as a leader of positive change. The ** Care Management , Care Coordinator, Utilization Management ** is a member of ... the patient's treatment. Accountable for a designated patient caseload; the Care Coordinator, Utilization Management plans effectively in order to manage… more
- CentraCare (St. Cloud, MN)
- …Support Job Schedule: Full time Responsible for providing administrative support to Care Management and Utilization Review departments. Functions as ... safety practices as appropriate. Supports and demonstrates family centered care principles when interacting with patients and their families,...including word processing required + 3 years of health care experience required + One to two years of… more
- UNC Health Care (Chapel Hill, NC)
- …designated Clinical Care Management Department team(s). Provides management direction to Case Managers, Utilization Managers, Clinical Social Workers, ... **Professional Experience Requirements:** * Five (5) years of experience in care management , utilization management , discharge planning, care… more
- Kaleida Health (Buffalo, NY)
- …related or Business field preferred. RN licensure required.** **Experience** **10 years of care management / utilization management experience required in ... **VP Care Management Post-Acute Care ...daily oversight of operations, the VP will partner with Utilization Review, Revenue Cycle, and Clinical leadership to create… more
- Health Care Service Corporation (Mobile, AL)
- …Three to Five (3-5) years recent experience in an acute- care environment, case- management , or utilization management position (experience can be a ... Responsible for coordinating the delivery of cost-effective, quality -based health care services for health plan customers by development and implementation of… more
- CVS Health (Columbus, OH)
- …Nurse, 1+ years of clinical experience in acute or post-acute setting, and 1+ years of Utilization Management / Care Management Experience + Must have ... on the telephone, and type on the computer. **Preferred Qualifications** Utilization Management experience preferred **Education** Diploma RN acceptable;… more
- CVS Health (Harrisburg, PA)
- …Nurse, 1+ years of clinical experience in acute or post-acute setting, and 1+ years of Utilization Management / Care Management Experience + Must have ... Nursing Licenses as business needs require. * **Preferred Qualifications** - Utilization Management experience preferred **Education** Associates Degree BSN… more
- CVS Health (Hartford, CT)
- …Nurse, 1+ years of clinical experience in acute or post-acute setting, and 1+ years of Utilization Management / Care Management Experience + Must have ... of clinical experience in acute or post-acute setting, and 1+ years of Utilization Management / Care Management Experience **Anticipated Weekly Hours**… more
- Molina Healthcare (Reno, NV)
- …team of healthcare services professionals in some or all of the following functions: care management , utilization management , behavioral health, care ... one or more of the following activities: care review, care management , utilization management (prior authorizations, inpatient/outpatient medical… more
- Providence (Olympia, WA)
- …Qualification:** + Bachelor's Degree Or Associate's Degree in Nursing + 3 years of Utilization Review, Care Management , Quality Management , and/or ... a strong clinical background blended with well-developed knowledge and skills in Utilization Management (UM), medical necessity and patient status determination.… more
- Commonwealth Care Alliance (Boston, MA)
- …of CCA's delegated partnerships programs, working with clinical community partners responsible for care management and utilization management across ... Desired Knowledge, Skills, Abilities & Language (nice to have): * Familiarity with care management and utilization management systems and workflows. *… more
- McLaren Health Care (Port Huron, MI)
- …timeliness, appropriateness and completeness as pertains to the utilization management process including level of care , medical necessity, and third-party ... ⦁ Three years of recent nursing or utilization management experience with an acute care hospital **Preferred:** ⦁ Experience in utilization management… more
- Molina Healthcare (MI)
- …team of healthcare services professionals in some or all of the following functions: care management , utilization management , behavioral health, care ... member care . Essential Job Duties * Assists in implementing health management , care management , utilization management , behavioral health and… more
- Rochester Regional Health (Rochester, NY)
- …care . ATTRIBUTES + Three (3) years of acute hospital care , case management or utilization management experience preferred + Excellent oral and written ... to ensure reimbursement for services are provided while maintaining quality of care + Patient Management . Collaborate with providers, patients and families… more
- Virginia Mason Franciscan Health (Tacoma, WA)
- …objectives related to quality care of patients, regulatory compliance, and utilization management (including LOS). 4. The Physician Advisor should discuss ... patient care reviews, decisions, and other pertinent information per Hospital/ Utilization Management policy **COLLABORATION** : * Establish and champion… more
- WellSpan Health (Waynesboro, PA)
- …needs of the department **General Summary** Performs a variety of duties and applies utilization and care management techniques to determine the most ... care transition needs. Provides leadership in the integration of utilization and care management principles throughout the hospital. **Duties and… more
- CVS Health (Baton Rouge, LA)
- …health plan medical directors. * Attend and actively participate in clinical meetings with care management and utilization management teams, offering ... members across Aetna. **Expectations and Responsibilities:** * Serve as the principal utilization management reviewer for cases related to Applied Behavior… more
- Baylor Scott & White Health (Dallas, TX)
- …FACTORS** Associate's degree in nursing. Specialty Certification strongly encouraged. Knowledge of care management , resource and utilization management . ... achieve optimal clinical and quality outcomes by effectively managing care and resources to reduce unnecessary utilization ....health care team to provide evidenced based care . Establishes patient care management … more
- Providence (Mission Hills, CA)
- …field (Acute, Ambulatory, or Post-Acute). + 2 years experience in Acute Care Management ( Care Coordination or Utilization Management ) or successful ... only 1% of US hospitals are four times designated. Care Management in Hospital/Health Care ... include the achievement of optimal health, access to care and appropriate utilization of resources, balanced… more
- Northwell Health (New York, NY)
- …throughout the entire continuum of health care delivery. Performs resource management , utilization management , discharge planning, care facilitation, ... a defined patient population, and as it relates to care management and the delivery of patient...care . 'Participates in the development, revision and effective utilization of the interdisciplinary clinical pathways for selected patient… more