- Elliot Health System (Candia, NH)
- …support to patient/family to facilitate adaptation to illness/disability. Utilization Management /Managed CareIntervenes with appropriate individuals/department ... patient care and/or length of stay. Collaborates with case manager to assess for patient's clinical course to verify...and collects clinical data in support of quality, risk management , utilization , infection control and resource … more
- Beth Israel Lahey Health (Plymouth, MA)
- …a job, you're making a difference in people's lives.** Full Time **Job Description:** ** Utilization Review & Denials management manager - Full Time** **Who ... and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager...prioritize the well-being of our employees. Our Total Rewards program offers competitive compensation and comprehensive benefits to enhance… more
- UNC Health Care (Raleigh, NC)
- …through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management staff to ... Utilization Management Plan. In addition, the Utilization Manager is responsible for revenue protection...October 1, 2015, must be enrolled in an accredited program within four years of employment, and obtain a… more
- VNS Health (Manhattan, NY)
- …and updates through on-going training, coaching and educational materials. + For Utilization Management Only: + Issues Determinations, Notices of Action, and ... health care services. Manages providers, members, team, or care manager generated requests for medical services and renders clinical...by state or federal regulations are saved in the Utilization Management System. + Reviews, evaluates and… more
- Elevance Health (Washington, DC)
- Manager ll HCMS - Utilization and Case Management (JR142403) **Location:** This position requires travel to our Washington, DC office 4 days each week. The ... in the development, implementation, and coordination of a comprehensive integrated Medical Management program designed to manage health outcomes in a highly… more
- Dignity Health (Phoenix, AZ)
- …Arizona and Nevada markets. Must have current Arizona unrestricted RN license.** The Utilization Management (UM) Manager is responsible for managing ... medical necessity determinations; processes appeals and reconsiderations. Act as a working manager within Utilization Management , performing essential duties… 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 ... Utilization Management Plan. In addition, the Utilization Manager is responsible for revenue protection...October 1, 2015, must be enrolled in an accredited program within four years of employment, and obtain a… more
- Beth Israel Lahey Health (Burlington, MA)
- …of three years of medical/surgical nursing care experience. -Two years of Case Management or Utilization Management experience desirable. - Demonstrated ... a difference in people's lives.** Joint role of Case Manager and Utilization Review Nurse Onsite at...to ensure a timely process. Registered Nurses (RNs) with utilization review experience, case management experience, and… 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
- Huron Consulting Group (Chicago, IL)
- …will be fully internal. This role is a Manager or Sr. Manager . Responsibilities: 50% Utilization * Oversee activities supporting persona: * Utilization ... actual project utilization . 50 % Staffing * Coordinate with Resource Management team on identifying resource for open roles on projects and perspective projects… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Utilization Review Manager for the Selikoff Centers for Occupational Health is responsible for the management of program ... a particular department/unit. This includes, but is not limited to, the management of: + Program -specific applications, quality improvement, staff education,… more
- Helio Health Inc. (Syracuse, NY)
- …into account information provided by the hiring manager and program Job LocationsUS-NY-Syracuse Category Case/Care Management Position Type Full-Time Work ... To support the mission of Helio Health, theUtilization Case Manager will enhance the program 's efforts to...staff on current principles and standards of practice surrounding utilization and denials management . + Use effective… more
- Sharp HealthCare (San Diego, CA)
- …Functions** + Collaboration and teamwork Provides consultation and direction for Case Manager Utilization Management , and non-clinical support team members ... practices. **What You Will Do** Supervisory responsibility for the acute care utilization management team. This position supervises, provides oversight and… more
- Amazon (Nashville, TN)
- …Successful candidates will be natural self-starters who have prior experience in program management partnering with cross-functional teams. This individual will ... program managers to help Amazon achieve best-in-class fleet utilization and capacity in the United States and Canada....for the holidays. Basic Qualifications - 5+ years of program or project management experience - Experience… more
- Ochsner Health (Jefferson, LA)
- …This job manages expense management , vendor relationships, contract management , standardization and consolidation processes and utilization analysis. ... supply utilization improvements. + Good judgment, organizational and time management skills. + Consulting and group presentation skills. + Ability to travel… more
- Hackensack Meridian Health (North Bergen, NJ)
- …transform healthcare and serve as a leader of positive change. The **Care Coordinator, Utilization Management ** is a member of the healthcare team and is ... Accountable for a designated patient caseload; the Care Coordinator, Utilization Management plans effectively in order to...and refers quality issues for review to the Quality Management Program . + Participates in multidisciplinary rounds,… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position ... net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates,...implement a successful discharge plan. Works with the UM Manager and Physician Advisor on case reviews for pre-service,… more
- Amazon (New York, NY)
- …leader of advertising. Basic Qualifications - 5+ years of technical product or program management experience - 3+ years of software development experience - ... you to be an owner, problem solver, and risk manager , operating with a high degree of autonomy and...5+ years of technical program management working directly with software engineering… more
- US Tech Solutions (Columbia, SC)
- …Will Have Option to Work Remotely. + NICE TO HAVE skill sets/qualities: Utilization management experience and /or Appeals experience /strong clinical skills ... experience and /or UR experience/Process Appeals requests/can have experience in either Utilization management or Appeals. + Ability to process authorization… more
- Fallon Health (Worcester, MA)
- …a Registered Nurse in a clinical setting required. + 2 years' experience as a Utilization Management nurse in a managed care payer preferred. + One year ... by the Manager + Refers high-risk cases to the Case Management Department, Government Services Clinical Programs, Fallon Clinic Care Coordination + Department… more
