- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: ... support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and approves… more
- Elevance Health (Washington, DC)
- …preferred. + 3 years management experience with direct reports. + Managed Care Utilization Management experience, preferably in the District. + Working ... Manager ll HCMS - Utilization and... Manager ll HCMS - Utilization and Case Management (JR142403) **Location:** This position...a 1 hour commute of the above office. The ** Manager ll HCMS** is responsible for managing a team… more
- Elevance Health (Miami, FL)
- ** Utilization Management Representative II ** **Location: Onsite in Miami, FL** **Schedule: Monday-Friday 8:30am-5:30pm OR 9am-6pm** **Bilingual in Spanish ... Strongly Preferred** The ** Utilization Management Representative II ** is responsible for...to a nurse reviewer; and handles referrals for specialty care . + Processes incoming requests, collection of information needed… more
- Prime Healthcare (East Liverpool, OH)
- …With Us! (https://careers-primehealthcare.icims.com/jobs/201435/discharge-planner- ii - utilization -review/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) ... the Case Management Department under the direction of the assigned Case Manager /Social Worker assist with development and implementations of discharge plans. Assists… more
- BayCare Health System (Palm Harbor, FL)
- …Yes **Shift Hours:** 8:00 AM - 5:00 PM Equal Opportunity Employer Veterans/Disabled **Position** Manager Site II - Primary Care **Location** Palm Harbor | ... network consists of 16 community-based hospitals, a long-term acute care facility, home health services, outpatient centers and thousands...BayCare is currently in search of our newest **Site Manager II ** who is passionate about providing… more
- AmeriHealth Caritas (Jacksonville, NC)
- …administrative services. Discover more about us at; www.amerihealthcaritas.com .; **Responsibilities** The Care Manager II is responsible for managing and ... care and barriers to care . The Care Manager II develops a...care management platforms where applicable. + Monitor appropriate utilization and coordinate services with other payer sources, make… more
- Elevance Health (Indianapolis, IN)
- …and insightful analytics to improve the delivery of care ._ **Behavioral Health Care Manager II ** **Location** : **Indiana** . This position is ... 50 miles of our Elevance Health PulsePoint location in Indianapolis. The **Behavioral Health Care Manager II ** is responsible for managing psychiatric and… more
- AmeriHealth Caritas (Rock Hill, SC)
- …other administrative services. Discover more about us at www.amerihealthcaritas.com. **Responsibilities:** The Care Manager II is responsible for managing ... care and barriers to care . The Care Manager II develops a...care management platforms where applicable. 6. Monitor appropriate utilization and coordinate services with other payer sources, make… more
- AmeriHealth Caritas (Ann Arbor, MI)
- …and other administrative services. Discover more about us at; www.amerihealthcaritas.com .; The Care Manager II is responsible for managing and coordinating ... care and barriers to care . The Care Manager II develops a...care management platforms where applicable. + Monitor appropriate utilization and coordinate services with other payer sources, make… more
- Sharp HealthCare (San Diego, CA)
- …business practices. **What You Will Do** Supervisory responsibility for the acute care utilization management team. This position supervises, provides oversight ... + Collaboration and teamwork Provides consultation and direction for Case Manager Utilization Management, and non-clinical support team members regarding… more
- LA Care Health Plan (Los Angeles, CA)
- Enhanced Care Management Clinical Specialist II Job...such as a health insurance environment and/or experience as care manager in home health or hospice ... support the safety net required to achieve that purpose. Job Summary The Enhanced Care Management (ECM) Clinical Specialist II is responsible for the management… more
- Hackensack Meridian Health (Hackensack, NJ)
- …Staff Management and Organizational Strategy a. Development & implementation of Utilization Management strategies to assure appropriate health care delivery ... **Overview** The Senior Utilization Review Specialist collaborates with the healthcare team in the management and resolution of activities that assure the integrity… more
- Hackensack Meridian Health (Hackensack, NJ)
- …Staff Management and Organizational Strategy d. Development & implementation of Utilization Management strategies to assure appropriate health care delivery ... **Overview** The Utilization Review Physician collaborates with the healthcare team in the management and resolution of activities that assure the integrity of… more
- Elevance Health (Palo Alto, CA)
- …programs for autism and depression, and insightful analytics to improve the delivery of care . The ** Manager II Behavioral Health Services** will be ... ** Manager II Behavioral Health Services** **Location:**...staff responsible to ensure medical necessity and appropriateness of care for inpatient/outpatient BH services; ensures appropriate utilization… more
- Sutter Health (Modesto, CA)
- … care patient experience. This position works in collaboration with the Physician, Utilization Manager , Medical Social Worker and bedside RN to assure the ... are to include the achievement of optimal health, access to care , and appropriate utilization of resources balanced with the patients' self -determination while… more
- Sutter Health (Castro Valley, CA)
- … care patient experience. This position works in collaboration with the Physician, Utilization Manager , Medical Social Worker and bedside RN to assure the ... are to include the achievement of optimal health, access to care , and appropriate utilization of resources balanced with the patients' self -determination while… more
- Sharp HealthCare (La Mesa, CA)
- …considerations with regulatory/financial/ utilization review demands to assure patients are receiving care in the appropriate setting and level of care . The ... nursing experience or case management experience. + 3 Years case management, utilization review, care coordination experience. + California Registered Nurse (RN)… more
- The County of Los Angeles (Los Angeles, CA)
- MENTAL HEALTH PROGRAM MANAGER II / EMERGENCY APPOINTMENTS HOMELESSNESS Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4659662) Apply ... MENTAL HEALTH PROGRAM MANAGER II / EMERGENCY APPOINTMENTS HOMELESSNESS Salary...and implements reporting procedures to ensure that program services utilization and revenue data are reported accurately and in… more
- Chesapeake Regional Healthcare (Chesapeake, VA)
- …of clinical/financial resources as a facilitator and consultant to the multidisciplinary patient care team. The Care Manager predicts, facilitates, and ... Summary As part of the Care Management team, the Registered Nurse combines clinical...plans, implement and evaluates strategies that ensure the appropriate utilization of clinical resources and management of length of… more
- LA Care Health Plan (Los Angeles, CA)
- Care Management Specialist II - MCLA...such as a health insurance environment and/or experience as care manager in home health or hospice ... net required to achieve that purpose. Job Summary The Care Management Specialist II utilizes clinical skills...skills and judgement. Management of the caseload assigned by Manager includes: coordinating health care benefits, providing… more