- Almost Family (Oshkosh, WI)
- The Clinical Manager is responsible for the coordination of high quality, cost-effective patient care. This position is responsible for the operations and ... and appropriateness for home care services and establishment of frequencies and utilization for new admissions. Works closely with the Agency Director regarding… more
- XPO (Reno, NV)
- …you're looking for a growth opportunity, join us at XPO. As the Shop Manager , you will be responsible for hiring, training, and supervising qualified employees to ... well as offering promotion, discipline and termination recommendations Support the Manager of Fleet Maintenance (MFM) in overseeing equipment maintenance and… more
- Central Missouri Home Health (Jefferson City, MO)
- We are hiring for a full-time Home Health Patient Care Manager RN to join our passionate team in Jefferson City, MO! This is an office position. At Capital Region ... a new level of caring. Apply today! The Home Health Patient Care Manager is responsible for the overall supervision and coordination of clinical services.… more
- Altru Health (Grand Forks, ND)
- …the processes to maintain them.Facilitates, in collaboration with the Supply Chain Manager , Altru's vendor management program.Performs other duties as assigned ... Value Analysis Committee, associated VA Teams, clinical staff and Supply Chain Management to achieve cost savings by focusing on appropriate supply standardization, … more
- Providence (Beaverton, OR)
- …the best people, we must empower them._** **Providence Health Plan is calling a Manager Utilization Management RN, Prior Authorization who will:** + Be ... responsible for Management and supervision of the PHP Utilization Management (UM) or Care Management (CM) clinical programs, outcomes and operations + Be… more
- UCLA Health (Los Angeles, CA)
- …the next level. You can do all this and more at UCLA Health. As a Manager for Medicare Advantage Utilization Management , you'll provide direct management ... (BSN) degree required + Five or more years of utilization management required + Four or more...off-site meetings and conferences + ACM - Accredited Case Manager preferred + CCM - Certified Case Manager… more
- Centene Corporation (NJ)
- …Review Clinical Review team to ensure appropriate care to members. Manages utilization management issues related to member care, provider interactions, and ... facilitates operations within utilization management . + Manages prior authorization, concurrent review, and retrospective clinical review team and ensures… more
- Huron Consulting Group (Chicago, IL)
- …as the expert you are now and create your future. **Qualifications** The Utilization Management Specialist is responsible for ensuring the appropriate ... to facilitate optimal patient outcomes while managing healthcare costs. The Utilization Management Specialist ensures compliance with regulatory requirements and… more
- Elevance Health (Washington, DC)
- …degrees of medical complexity and acuity. Participates in case and/or utilization management execution/decision making for managed member populations. Primary ... in the development, implementation, and coordination of a comprehensive integrated Medical Management program designed to manage health outcomes in a highly complex… more
- Prime Healthcare (Redding, CA)
- …#casemanager #rn Connect With Us! (https://careers-primehealthcare.icims.com/jobs/166207/case- manager utilization - management ... https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf Responsibilities Responsible for the quality and resource management of all patients that are admitted to… more
- Prime Healthcare (National City, CA)
- …and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/165000/case- manager utilization - management ... https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf Responsibilities Responsible for the quality and resource management of all patients that are admitted to… more
- Humana (Tallahassee, FL)
- **Become a part of our caring community and help us put health first** The Manager Utilization Management Nursing utilizes clinical nursing skills to support ... and communication of medical services and/or benefit administration determinations. The Manager , Utilization Management Nursing works within specific… 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 ... Hospitals? Utilization Management Plan. In addition, the Utilization Manager is responsible for revenue protection by reconciling physician orders, bed… more
- Molina Healthcare (Long Beach, CA)
- …and will need to work PACIFIC hours.** **This is a telephonic hybrid position for utilization management and case management . You can work 100% remote for ... **We are seeking a LVN CASE MANAGER (CALIFORNIA LICENSED VOCATIONAL NURSE), Bilingual Spanish with...(CALIFORNIA LICENSED VOCATIONAL NURSE), Bilingual Spanish with PEDIATRICS CASE MANAGEMENT experience for this role. Must have current licensure… more
- Mountains Community Hospital (Lake Arrowhead, CA)
- Full Time - Exempt position SUMMARY The Case Manager is responsible for utilization management and case management of patient admissions at MCH by ... collecting and recording all information and data needed for utilization review as requested and required by third party payers. Monitors and audits medical record… more
- Trinity Health (Darby, PA)
- …with the RN Care Coordination Manager , provides support to the utilization management , denials and appeals process for the THMA South hospitals. ... to provide support to the Emergency Department Case Manager , Utilization RNs, and Utilization Management support staff. Also adheres to the … 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 ... (MCG) + Experience and understanding of federal and state regulations governing utilization management + Accredited Case Manager (ACM) - American Case … more
- Ellis Medicine (Schenectady, NY)
- …Discharge Planner's primary function is to work with the Social Worker, Nurse Case Manager , or Utilization Management Nurse to facilitate patient discharge ... per CMS Conditions of Participation at the direction of the Case Manager . + Utilization Management Activities: + Collaborates with Case Managers and other… more
- LA Care Health Plan (Los Angeles, CA)
- …Certification in Certified Professional in Utilization Review (CPUR), Certified Case Manager (CCM), Utilization Management or Compliance Salary Range ... the coordination of member care with internal LA Care departments such as Care Management (CM), Utilization Management (UM), Managed Long Term Services and… more
- Molina Healthcare (Dallas, TX)
- …or State Clinical Social Worker/Counseling (or related field) License Certified Case Manager (CCM), Utilization Management Certification (CPHM), Certified ... for the development, implementation, and delivery of training curriculum for Utilization Management , Case Management , and LTSS staff. Leads and manages… more
