- Scottish Rite for Children (Dallas, TX)
- …committed to giving children back their childhood! Job Posting Title: Director of Case Management and Utilization Management Location: Dallas - ... Details: Monday - Friday 8:00am to 4:30pm Job Description: Duties/Responsibilities: + Utilization Management supporting medical necessity and denial prevention +… more
- Trinity Health (Silver Spring, MD)
- …/supervision/leadership experience in an acute healthcare setting required, preferably with case management , utilization review or closely related ... RN with BSN or RN with > 10 years case management experience. Masters Degree preferred. **Minimum...area. + Extensive knowledge of payer mechanisms and clinical utilization management is required. + Knowledge of… more
- Sharp HealthCare (San Diego, CA)
- …experience or case management experience + 3 Years recent case management , utilization review, care coordination experience + California Registered ... performance planning, competency and individual development planning process.Maintain current knowledge of case management , utilization management , and… more
- Commonwealth Care Alliance (Boston, MA)
- **Why This Role is Important to Us:** The Director of Utilization Management leads and manages all utilization management (UM) functions for physical ... state and federal regulatory requirements and all applicable accreditation standards. The Director of Utilization Management is responsible for setting… more
- CareFirst (Baltimore, MD)
- …location based on business needs and work activities/deliverables that week. The Director , Utilization Management provides strategic leadership of the ... utilization management team and is responsible for the design, assessment,...of services and approved claims. + Oversees retrospective reviews, case appeals, billing coordination, and clinical support. + Ensure… more
- AnMed Health (Anderson, SC)
- …and direction of the Care Coordination, Clinical Documentation, and Utilization Management programs at AnMed. The Medical Director ensures the program and ... The Utilization Review Medical Director supports operations...the leadership and staff who perform the functions of Utilization Management (UM), Case … more
- Prime Healthcare (Ontario, CA)
- …Responsibilities The Corporate Director of Clinical ... or another relevant field + A minimum of seven (7) years' experience in Clinical Utilization Review or Case Management with a large Health Plan +… more
- Trinity Health (Boise, ID)
- …of two years' experience in hospital based medicine with exposure to utilization management and documentation initiatives. 3. Demonstrated teamwork, performance ... is seeking a physician leader to become our Medical Director of Documentation and Utilization Excellence. This...MDDUE will work in a dyad partnership with the Director of Clinical Resource Management . This position… more
- Covenant Health (Nashua, NH)
- …of the health care team. + Annual goals are achieved. + Attends pertinent case management / utilization review programs to maintain current knowledge of UR ... and quality of care and communicates findings to the director of the department. + Maintains current knowledge of...Minimum of five years broad clinical experience preferred + Case management and/or Utilization … more
- Henry Ford Health System (Detroit, MI)
- …DNB numbers 2. Ensure correct patient status for hospitalized patients 3. Chair Utilization Management Committee: a. Reviewing outlier data, observation LOS b. ... The Medical Director of Utilization Review is responsible...of Stay (LOS) escalations; a. Respond to escalations from case management , RNs, residents, staff, etc. b.… more
- Sharp HealthCare (San Diego, CA)
- …and refer members to case management or quality management as appropriate for utilization or quality issues while maintaining department ... of need for further management , communicates this to the appropriate Case Management Program per UM policy.Gathers pertinent information to provide … 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
- BronxCare Health System (Bronx, NY)
- …and implementation of educational programs for Denial Prevention and Management . Responsibilities - Establish and maintain positive relationships with patients, ... includes data collection, analysis, implementation of and compliance with risk management and claims activities, support of and participation in Continuous Quality… more
- Houston Methodist (Cypress, TX)
- …promoting the most cost-effective utilization of the hospital's resources. The Director Case Mgmt Social Svcs position deploys population-focused teams to ... At Houston Methodist, the Director Case Mgmt Social Svcs position...in the areas of care coordination, evidence- based practice, utilization management , and service excellence. Disseminates information… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Director of Case Management is responsible for the overall operation of the Case Management Department. This includes ... to patients. This involves the delivery of comprehensive front-line Case Management services, including utilization ... Management services, including utilization management , care facilitation and discharge planning. The Director… more
- LifePoint Health (Bullhead City, AZ)
- …promote continuity of care and cost effectiveness through the integrating and functions of case management , utilization review and management of ... years management experience, five (5) years of utilization review / case management ...AHA. **Job:** **Nursing* **Organization:** **Valley View Medical Center* **Title:** * Director , Case Management * **Location:** *Arizona-Ft.… more
- Select Medical (Gainesville, FL)
- **Overview** **Critical Illness Recovery Hospital** ** Director of Case Management ** **_Clinical license as a registered nurse or respiratory therapist or ... 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
- LifePoint Health (Rutherfordton, NC)
- …resources and knowledge and experience operating community hospitals and healthcare organizations. The Director of Case Management is responsible for the ... candidates for employment: Minority/Female/Disabled/Protected Veteran* **Job:** ** Case Management /Social Services* **Organization:** ** **Title:** * Director , … more
- Lakeview NeuroRehabilitation Center (Waterford, WI)
- The Director of Case Management is...coordination, discharge planning, and utilization review. The Director will manage a team of case managers ... responsible for the strategic and operational oversight of the case management department at a Long-Term Acute...patient-centered care and advocate for patient rights and needs. Utilization Review and Compliance + Monitor and evaluate the… more
- HCA Healthcare (Georgetown, TX)
- …position is incentive eligible. **Introduction** Do you have the career opportunities as a(an) Director Case Management you want with your current employer? ... of colleagues. Do you want to work as a(an) Director Case Management where your...to ensure continuity of care and optimal clinical resource utilization . The Director has oversight for all… more