- Merck & Co. (North Wales, PA)
- …identified growth opportunities supported by vaccine launches and through increased utilization of our inline vaccines. The Contracting and Distribution Strategies ... across the US Vaccine BU (marketing and sales teams), Integrated Account Management , and the many Operational Headquarters extended teams to ensure contractual… more
- Cambia Health Solutions, Inc (Portland, OR)
- Behavioral Health Utilization Management Clinician Work from home within Oregon, Washington, Idaho or Utah Build a career with purpose. Join our Cause to create ... better. As a member of the Behavioral Health team, our Clinicians provide utilization management (such as prospective concurrent and retrospective review) to… more
- Northeast Georgia Health System, Inc (Oakwood, GA)
- …in order for completion of the pre-certification process.Works in conjunction with Physician offices, Case Management , Utilization Review, and patients ... of our communities. About the Role:Job SummaryUnder the supervision of the Utilization Review Manager, this position is responsible for ensuring the delivery of… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …optimal outcomes.Maintains positive attitude, and communicates appropriately with patients/families, Physician , management and other staff; responds positively ... of individual patient needs; Works collaborate with the Physicians, patient/family, nursing, utilization review and other members of the healthcare team to assure… more
- Roseland Community Hospital (Chicago, IL)
- Under direct supervision of the Director of Health Information Management and Care Transitions and as a part of a multidisciplinary team, the Clinical Social Worker ... patient's admission to the unit. 4. Assist the Psychiatrist, Physician and other unit staff members to understand significant...care. 8. Assist the patient and family in the utilization of appropriate community resources such as family and… more
- Northeast Georgia Health System, Inc (Oakwood, GA)
- …of system-wide opportunities as they relate to Value Analysis standardization, utilization and implementation. Facilitate Value Analysis Teams (VAT) to most ... vendors and departments to evaluate new and existing products to ensure utilization is optimized. Responsible for promoting and maintaining quality patient care… more
- LHC Group (Reno, NV)
- …care to home health patients assigned to the team's area in accordance with physician prescribed plan of care, and all applicable state and federal laws and ... reasonable, meets home health eligibility criteria, and is in accordance to physician orders. Oversees and assures development, implementation, and updates to the… more
- Cambia Health Solutions, Inc (Lewiston, ID)
- …Associates or Bachelor's Degree in Nursing or related field3 years of case management , utilization management , disease management , or behavioral ... Care Management Nurse (Future Opportunities)Work from home within Oregon,...and practicing within the scope of their license.Collaborates with physician advisors, internal and external customers, and other departments… more
- Cambia Health Solutions, Inc (Lewiston, ID)
- …(for behavioral health care management ) or related field3 years of case management , utilization management , disease management , or behavioral health ... Care Management Social WorkerWork from home within Oregon, Washington,...and practicing within the scope of their license.Collaborates with physician advisors, internal and external customers, and other departments… more
- Atrium Health Navicent (Macon, GA)
- …and patient satisfaction while managing the cost of care. Provides utilization management , clinical documentation integrity, discharge planning and post-acute ... care needs assessment and acts as a liaison for utilization management and clinical documentation improvement. Responsible...rounds on the patient care unit with the attending physician and other members of the health care team;… more
- Blanchard Valley Hospital (Findlay, OH)
- …Manager is to develop, implement and evaluate an organized inpatient case management service for pediatric and adult hospitalized patients under the direction of ... committees and meetings to contribute information regarding transitions of care and utilization of care resources for the purpose of improving patient care and… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …and present periodic reports on the departments including quality, costs, profitability, physician utilization , market share, as well as potential opportunities ... and visibility across all campuses. Responsibility includes the vision, direction, management and coordination of clinical invasive cardiac services, and vascular… more
- Northeast Georgia Health System, Inc (Braselton, GA)
- …on issues impacting care deliveryComputer literacy-advanced computer and data management skillsAbility to communicate effectively. Good written and oral ... departmentsSkill/competency in use of computer software program/systems impact unit performance/ management . Computer Literacy- Kronos, Bidshift, Quadramed, Excel, MS Word,… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …designs proactive discharge plans utilizing a team approach as demonstrated by cost management of patient stay and utilization for outside resources. Contributes ... served. Establishes a plan of care consistent with the medical findings and Physician orders. Thoroughly evaluates, monitors, and reassesses all patients on a timely… more
- Careers Integrated Resources Inc (Albuquerque, NM)
- …reports on service and recruiting activities and other items as required by management . . Respond to fee requests from providers. . Provide ongoing development of ... problem and research the impact and origin for resolution. Report problem to management and coordinate with either internal staff or the provider to assure… more
- Rose International (Atlanta, GA)
- …lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization ... college or university preferred.Experience Four (4) years of claims management experience or equivalent combination of education and experience required.Skills… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …meet established metrics, improve handoffs, reduce daily crisis regarding bed management , improve overall flow and drive the throughput policies and procedures. ... overall movement of patients in a safe, efficient manner and ensuring optimal utilization of resources, including, but not limited to; staff equipment and supplies,… more
- Atrium Health Charlotte (Charlotte, NC)
- …Sun 10hrs and Thurs and Fri 10 hours Job Summary Serves a case management role, responsible for an assigned group of patients, typically geographically related and ... accountable for the oversight and overall management of the post-acute services in the home setting....care to address the patient needs, individual goals and physician ordered services. Responsible for care coordination with the… more
- Beth Israel Lahey Health (Burlington, MA)
- … physician practices to achieve the organization's desired resource management and quality goals. **Job Description:** Purpose: Provide leadership and expertise ... relative to the level of care management , concurrent and retro commercial payer validation of medical...services, and promote efficient resource allocation - Serves as physician expert and provide support to utilization … more
- Hackensack Meridian Health (Hackensack, NJ)
- …a. Provides direction and support regarding CMS & NJDOH regulations governing Utilization Management & Clinical documentation. b. Oversight for accurate patient ... determinations - OBS vs. Inpatient c. Liaison to the Medical Staff supporting Utilization Management Committee processes d. Hospital Based Appeals Management … more
