- Stanford Health Care (Palo Alto, CA)
- …and Abilities** + Knowledge of principles and best practices of case management, utilization review, social work, care coordination and discharge planning. ... while honoring its commitment to delivering evidence-based and patient-centered care . We are seeking a results-driven manager ...service lines and departments related to the provision of care coordination services to Stanford Hospital and… more
- Trinity Health (Boise, ID)
- …innovative approaches to improve care . + Participates on teams regarding care coordination efforts as appropriate. + Fosters a collegial environment within ... of Clinical Resource Management/Case Management, Social Work, Bundled Payment for Care Improvement and Transition Support at Nampa. Responsible for lead management… more
- UNC Health Care (Chapel Hill, NC)
- …through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management staff to ... met and care delivery is coordinated across the continuum. The Utilization Manager completes admission, continued stay, and discharge reviews in accordance… more
- Sharp HealthCare (San Diego, CA)
- …As a member of the System Integrated Care Management (ICM) team the Utilization Manager (UM) II position supports utilization review functions to ensure ... while ensuring compliance with all local, state and federal regulations governing utilization review activities and/or care management. Expected outcomes include… more
- VNS Health (Manhattan, NY)
- … utilization management processes are followed by the service operations staff, utilization staff, and the interdisciplinary care team to ensure cost ... home and community-based settings. + Manages and evaluates staff in delivery and coordination of utilization management review services in compliance with CMS… more
- McLaren Health Care (Detroit, MI)
- **Position Summary:** Responsible for providing assistance to the Utilization Manager (UM) RN in the coordination of patient admission and continued stay ... based on medical necessity. 2. Performs concurrent and retrospective utilization management-related activities and functions to ensure that appropriate data… more
- Community Health Network (Indianapolis, IN)
- Registered Nurse (RN) Case Manager / Utilization Review - North Emergency Job Ref 2408203 Category Nursing Job Family Case Manager Department Case Management ... you. **Make a Difference** Community North has a part-time RN Case Manager / Utilization Review position available in the Emergency Department. The Registered… more
- VNS Health (Manhattan, NY)
- …management, subject matter experts, physicians, member representatives, and discharge planners in utilization tracking, care coordination , and monitoring to ... and regulatory requirements. + Evaluates and analyzes care and utilization trends/issues and identifies opportunities for better coordination of members'… more
- Helio Health Inc. (Syracuse, NY)
- …to track, review, and analyze data relating to continuous quality improvement. The Utilization Case Manager will work on a Full-Timebasis supporting our ... as appropriate. + Assist in developing and administering policies and procedures for utilization . + Negotiating access to care for individuals seeking services… more
- CVS Health (Austin, TX)
- …and lends expertise to other internal and external constituents in the coordination and administration of the utilization /benefit management function. **Required ... of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at… more
- UCLA Health (Los Angeles, CA)
- …with patients and their families to ensure safe and effective coordination of care . In this role you will perform utilization review while assuring the ... skills, you will be responsible for assessing and coordinating care for a diverse group of patients. This in-patient... for a diverse group of patients. This in-patient utilization review case manager position will work… more
- Lockheed Martin (Greenville, SC)
- **Description:** **Site Utilization and Proposal Management Asc Manager ** **Location: Greenville SC** **What You Will Be Doing** Lockheed Martin Aeronautics is ... hiring a Site Utilization and Business Development Proposal Manager in...Work closely with teams across the organization to ensure coordination and alignment on proposals, projects, and business development… more
- Healthfirst (NY)
- …identifying alternative care options, and discharge planning + Certified Case Manager + Interqual and/or Milliman knowledge + Knowledge of Centers for Medicare & ... - identifying medical, psychological, and social issues that need intervention. + Coordination - partnering with PCP and other medical providers to coordinate… more
- Sharp HealthCare (San Diego, CA)
- …System Integrated Care Management (ICM) team the Transfer and Admissions Utilization Manager (UM) partners with the Centralized Patient Placement Center ... while ensuring compliance with all local, state and federal regulations governing utilization review activities and/or care management. Expected outcomes include… more
- Hackensack Meridian Health (Hackensack, NJ)
- …or Comorbidities + (CC) categories documentation and identification a. Tools to assist with care coordination decision making b. Liaison with 3rd party payers as ... Staff Management and Organizational Strategy a. Development & implementation of Utilization Management strategies to assure appropriate health care delivery… more
- Hackensack Meridian Health (Hackensack, NJ)
- …**5. (CC) categories documentation and identification** **a. Tools to assist with care coordination decision making** **b. Liaison with 3rd party payers ... Staff Management and Organizational Strategy** **a. Development & implementation of Utilization Management strategies to assure appropriate** **health** ** care … more
- Behavioral Center of Michigan (Warren, MI)
- …the Utilization Review Coordinator provides professional assessment, planning, coordination , implementation and reporting of complex clinical data and supports ... to help educate the staff and physicians regarding charting. REPORTS TO: Utilization Review Lead/ Manager QUALIFICATIONS: + High School Diploma or equivalent.… more
- Fairview Health Services (St. Paul, MN)
- …tracks all work related to denials/appeals. + Educate internal members of the health care team on utilization management workflow and managed care concepts. ... secure reimbursement. This position assesses the patient's plan of care and progress of the patient throughout an acute...projects and assume other duties as assigned by the Utilization Review Manager or Supervisor. + Understand… more
- UCLA Health (Los Angeles, CA)
- …of equivalent education, experience, and training + Minimum three years of experience in utilization management, care coordination , or a similar role within ... Description Under the direction and supervision of the Utilization Management Manager , the Utilization Management Specialist is responsible for overseeing… more
- Scottish Rite for Children (Dallas, TX)
- …promoting appropriate length of stay, readmission prevention and patient satisfaction + Care Coordination by demonstrating throughput efficiency while assuring ... back their childhood! Job Posting Title: Director of Case Management and Utilization Management Location: Dallas - Hospital Additional Posting Details: Monday -… more