- Magellan Health Services (Boise, ID)
- …and implement solutions that directly influence quality of care . General Job Information Title Care Manager ( UM / UR ) - Remote, Idaho Licensed Grade 24 ... + Maintains an active work load in accordance with National Care Manager performance standards. + Works with community agencies as appropriate. Proposes… more
- Apex Health Solutions (Houston, TX)
- …staff when benefit coverage or UR questions or issues arise. To support care management initiatives, the UM Reviewer should also identify enrollees in need ... a contact and resource person to Health Solutions' members for the utilization review ( UR ) of healthcare services. The UM Reviewer will be responsible for… more
- Stanford Health Care (Palo Alto, CA)
- …Stanford Health Care job.** **A Brief Overview** The Dir-Utilization Management ( UM ) leads and shapes the UM Strategy, while providing management oversight ... the Department's functions and overall business operations. Directs, manages, and supervises UM Department staff **Locations** Stanford Health Care (Palo Alto,… more
- Sharp HealthCare (San Diego, CA)
- …management process.Identify and refers situations needing immediate intervention to UR Manager , Physician Advisor, as appropriate.Participate in system ... Integrated Care Management (ICM) team the Transfer and Admissions Utilization Manager ( UM ) partners with the Centralized Patient Placement Center (CPPC) RN's… more
- Billings Clinic (Billings, MT)
- …in all organizational, departmental, and outside agency requirements. The responsibilities of the UR case manager are listed below, in order of priority and ... inpatient level of care to obtain inpatient order Communicate with Case Manager to understand discharge plan and barriers to discharge on OBS and Outpatient in… more
- CareFirst (Baltimore, MD)
- …management ( UM ) department functions to ensure appropriate coordination of health care services and compliance with UR policies/procedures, as well as, ... that week. **ESSENTIAL FUNCTIONS:** + Supervise the daily operations of the UM staff. Recruits, retains and develops a high performing team. Evaluates performance… more
- Texas Health Resources (Arlington, TX)
- …or other Utilization Management tool. Discusses working DRG issues as needed with Care Transition Manager 30% **Additional perks of being a Texas Health ... and/or the application of medical necessity criteria preferred + 1 year of UM experience in the last three years preferred **Licenses and Certifications** + RN… more