- Independent Health (Buffalo, NY)
- …perks, benefits and commitment to diversity and inclusion. **Overview** The Program Manager - Utilization Management (UM) will be accountable for the ... assess and make recommendations for improvements to maintain an effective and efficient utilization management process, as well as manage medical expenses based… more
- Dignity Health (Rancho Cordova, CA)
- …This Manager will support our operations in Southern California. The Utilization Management (UM) Manager is responsible for managing day-to-day ... medical necessity determinations; processes appeals and reconsiderations. Act as a working manager within Utilization Management , performing essential duties… more
- CVS Health (Lansing, MI)
- …**Position Summary:** The Associate Manager is responsible for oversight of Utilization Management /Case Management staff. This position is responsible ... Registered Nurse + 3+ years of Managed Care experience + 1+ years of Utilization Management experience + 1+ year Leadership experience (formal or informal roles)… 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
- VNS Health (Manhattan, NY)
- OverviewManages the utilization management team to ensure that standards for service delivery and team/staff performance levels are met or exceeded. This ... quality issues or complaints, and/or approvals requiring next level authorization (eg, utilization management , high cost services, out of network services,… more
- Virginia Mason Franciscan Health (Bremerton, WA)
- …bonus eligibility, and more! **Responsibilities** **JOB SUMMARY/PURPOSE** Provides leadership to Utilization Management RNs, Denials RNs and support staff to ... payer and regulatory requirements. This role would directly manage the Utilization Management staff as a centralized function to support Acute Facilities across… more
- Prime Healthcare (National City, CA)
- …and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/186068/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
- Evolent (Columbus, OH)
- …contractual agreements. **Collaboration Opportunities** : The Coordinator, Intake Utilization Management reports directly to the Manager , Utilization ... Stay for the culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management ** at Evolent will serve as a point of contact for processing… more
- Prime Healthcare (National City, CA)
- …and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/187724/case- manager -rn 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
- UCLA Health (Los Angeles, CA)
- Description Under the direction and supervision of the Utilization Management Manager , the Utilization Management Specialist is responsible for ... experience, and training + Minimum three years of experience in utilization management , care coordination, or a similar role within a healthcare setting… more
- Evolent (Columbus, OH)
- …agreements. **Collaboration Opportunities** : The Coordinator, Intake Utilization Management reports directly to the Manager , Intake Utilization ... Stay for the culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management ** at Evolent will serve as a point of contact for processing… more
- Amazon (Seattle, WA)
- …them to completion. We're seeking an experienced Technical Infrastructure Program Manager to oversee data center electrical infrastructure optimization projects. You ... will lead cross-functional and technical teams identify sub-optimal utilization , determine root causes, design solutions and drive project delivery. Along the way,… more
- Trinity Health (Boise, ID)
- …**Description:** Responsible for the day to day operations of Clinical Resource Management /Case Management , Social Work, Bundled Payment for Care Improvement and ... Transition Support at Nampa. Responsible for lead management for the development, communication and successful execution of established objectives (financial and… 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
- Guthrie (Cortland, NY)
- …safe discharge, based on assessed needs and available resources. The Acute Case Manager also performs Utilization Management throughout the continuum of ... Position Summary: This is an integrated Case Management and Utilization Review position. The Acute Care Case Manager utilizes industry accepted processes for… more
- Stanford Health Care (Palo Alto, CA)
- …practice. Here, your leadership, coaching, and mentoring would further develop our robust, Utilization Management team. Are you driven by health care innovation, ... and Abilities** + Knowledge of principles and best practices of case management , utilization review, social work, care coordination and discharge planning.… more
- UCLA Health (Los Angeles, CA)
- …You can do all this and more at UCLA Health. Under the direction of the Utilization Management , Assistant Manager , you will play a key role in processing ... role within a leading health organization. Help ensure smooth and efficient case management processes to support quality care. Take your expertise to the next level.… 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
- Sharp HealthCare (San Diego, CA)
- …of RN experience. **What You Will Do** As a member of the System Integrated Care Management (ICM) team the Utilization Manager (UM) II position supports ... (MCG) + Experience and understanding of federal and state regulations governing utilization management + Accredited Case Manager (ACM) - American Case … 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