- Overlake (Bellevue, WA)
- …required. Two years inpatient case management experience preferred Prior case management , utilization management , and/or payer experience ... Overlake has an outstanding opportunity for a Complex Nurse Case Manager to join our team. The position is...discharge dispositions, and working closely with Transitions of Care Director and Medical Director as well as… more
- Lee Health (Fort Myers, FL)
- …to Midpoint Pay Rate: $38.48 - $50.01 / hour (Salary/Exempt) Previous Supervisory/ Management of Staff preferred Three (3) years of Home Health experience, Two ... preferred. This is a leadership role. Summary Responsible for assisting the Director of Clinical Operations and Administrator in planning, organizing and directing… more
- Harbor Health Services, Inc. (Mattapan, MA)
- …Brockton, MA and cares for more than 580 participants. We are currently seeking a Director of Utilization Management & Quality Programs. Harbor Health offers ... Senior Director of Health Plan Operations, the Director of Utilization Management and...operating procedures for gaps in care that may affect utilization . Performs clinical case reviews of high… more
- Powerback Rehabilitation (Petoskey, MI)
- …of the rehab department, including oversight related to case management , quality improvement, care planning, clinical utilization , and patient identification ... for hiring therapy staff (in conjunction with the Clinical Operations Area Director ). Assumes responsibility for daily staffing and utilization with input… more
- MVP Health Care (Rochester, NY)
- …customers in every interaction Your key responsibilities: Utilize the essentials of an integrated utilization management and case management model that ... bring: Current New York State Licensure as a Registered Nurse required. Certification in Case Management required within 24 months after hire. At least 3 years… more
- Powerback Rehabilitation (Eau Claire, WI)
- …of the rehabilitation department, including oversight related to case management , quality improvement, care planning, clinical utilization , and patient ... of the rehab department, including oversight related to case management , quality improvement, care planning, clinical utilization , and patient identification… more
- Prime Healthcare (Inglewood, CA)
- …status, ie full-time or part-time. Responsibilities We are seeking a strategic and compassionate Director of Case Management to lead our dynamic Case ... of staff and systems to effectively operate a comprehensive Case Management Program. The Director ...supervision to case managers, social workers and case management coordinators/discharge planners, utilization … more
- UNC Health Care (Morrisville, NC)
- …and well-being of the unique communities we serve. **Summary** : The **Executive System Director of Utilization Management (UM)** is a strategic and ... The Executive Director works closely with leaders from various departments- case management , physician advisors, revenue cycle, medical staff, nursing, and… more
- Elevance Health (Durham, NC)
- ** Utilization Management Medical Director - NC...The **Medical Director ** will be responsible for utilization review case management for North ... May serve as a resource to staff including Medical Director Associates. **How you will make an impact:** +...and external physicians. + May conduct peer-to-peer clinical appeal case reviews with attending physicians or other ordering providers… more
- Integra Partners (Troy, MI)
- …Medicaid, and all federally funded programs; no OIG sanctions + 5+ years of utilization management experience, including complex case review + Prior ... (Senior MD) serves as the clinical and strategic leader for Integra's Utilization Management (UM) and Credentialing programs. This is a full-time, 40+… more
- Integra Partners (Troy, MI)
- …of Durable Medical Equipment (DME) and related requests to support Integra's Utilization Management (UM) operations. This full-time, salaried role functions ... The Utilization Review Medical Director is responsible...or past OIG or state sanctions + Experience performing utilization management or clinical review activities +… more
- Guthrie (Cortland, NY)
- Summary The LPN Utilization Management (UM) Reviewer, in collaboration with Care Coordination, Guthrie Clinic offices, other physician offices, and the Robert ... Hospital Business Office, is responsible for the coordination of Utilization Management (UM) processes and requirements of...with members of the healthcare team. + Proactively researches case findings related to payer audits of UM decisions… more
- Wellpath (Lemoyne, PA)
- …education, and point of care support. **How you make a difference** The Medical Director of Utilization Management leads and oversees utilization ... care and the appropriate utilization of medical services. The Medical Director of Utilization Management serves as a key liaison with external partners… more
- UTMB Health (Webster, TX)
- …efficient use of medically appropriate services. Integrates and coordinates utilization management activities, care coordination, discharge planning functions, ... UTMB TDCJ Hospital to specialty services hospitals. **_ESSENTIAL JOB FUNCTIONS_** **:** Utilization Management + Demonstrates thorough knowledge of Inter Qual… more
- Healthfirst (NY)
- …maintain and improve department performance** + **Collect, analyze, and report on utilization trends, patterns, and impacts to identify areas for improvement** + ... closely with other Operations leaders including but not limited to Care Management , Clinical Eligibility, Behavioral Health, and Appeals and Grievances teams to… more
- Houston Methodist (Houston, TX)
- …for all hospital-based Case Management Directors and the Central Utilization Review Director across the system. This position is responsible for the ... At Houston Methodist, the Sr Director Case Management position... initiatives. + Provides strategic vision and execution for case management and utilization review… more
- Brockton Hospital (Brockton, MA)
- PURPOSE OF POSITION: The Director of Case Management is responsible for planning, directing, and managing of the activities of the Case Management ... solves problems, referring exceptional issues to Vice President. The Director of Case Management is...resource utilization . Provides training to staff on case management methods and techniques. Establishes monitoring… more
- Tenet Healthcare (Detroit, MI)
- Director - Case Management -...Oversees hospital utilization performance improvement and operational management of the site Case Management ... services. Integrates national standards for case management scope of services including: * Utilization ... utilization of resources * Provides education to case management staff, physicians, and the healthcare… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Director Case Management & Social Services RN position is responsible for strategy, function and operations of the Case ... cost-effective utilization of the hospital's resources. The Director Case Mgmt Social Svcs position deploys...a voice for the department. + Sets direction for Case Management /Social Services which supports strategic and… more
- Select Medical (Gainesville, FL)
- **Overview** **Select Specialty Hospital** **Critical Illness Recovery Hospital (LTACH)** ** Director of Case Management ** **$10,000 Sign On Bonus** **Full ... doing well by doing what is right. As the Director of Case Management **,**...resource management . + Demonstrating compliance with facility-wide Utilization Management policies and procedures. + Coordinating… more
