- Alameda Health System (Oakland, CA)
- …plans Role Overview: Alameda Health System is hiring! The Director of Utilization Management holds a critical role encompassing operational oversight, strategic ... hoc duties as needed. In essence, they orchestrate efficient utilization management to deliver high-quality patient care....in the classification. Lead and manage a team of utilization review professionals providing guidance, training, and… more
- Harbor Health Services, Inc. (Mattapan, MA)
- …for more than 580 participants. We are currently seeking a Director of Utilization Management & Quality Programs. Harbor Health offers an excellent, ... Reporting to the Senior Director of Health Plan Operations, the Director of Utilization Management and Quality Programs is responsible for the day-to-day… more
- Buckeye Community Health Plan (Thornville, OH)
- …functions for the business unit. Provides medical leadership of all for utilization management , cost containment, and medical quality improvement activities. ... Performs medical review activities pertaining to utilization review...expertise in the operation of approved quality improvement and utilization management programs in accordance with regulatory,… more
- USAA (San Antonio, TX)
- …rules and regulations and use of regulatory reporting platforms ie Axiom, etc Utilization of financial management tools ie Oracle Cloud General Ledger (GL), ... Reporting Senior , you will serve as a key contributor in the preparation, review , and analysis of reports compiled for regulatory agencies to include the FR Y-9C,… more
- Christus Health (Wake Village, TX)
- …chart peer review , case records review and utilization review as deemed necessary by management . Performs all other duties as assigned. Requirements: ... Education/Skills Masters level degree in speech language pathology is required. Basic Computer Knowledge Ability to communicate effectively, both verbally and in writing. Experience New graduate entry level or any amount of experience in speech therapy is… more
- Christus Health (Leary, TX)
- …chart peer review , case records review and utilization review as deemed necessary by management . Performs all other duties as assigned. Requirements: ... Education/Skills Masters level degree in Speech Language Pathology is required Basic computer knowledge Ability to communicate effectively, both verbally and written Experience New graduate entry level or any amount of experience in speech therapy is… more
- Christus Health (Red Lick, TX)
- …chart peer review , case records review and utilization review as deemed necessary by management . Performs all other duties as assigned. Requirements: ... Education/Skills Masters level degree in speech language pathology is required. Basic Computer Knowledge Ability to communicate effectively, both verbally and in writing. Experience New graduate entry level or any amount of experience in speech therapy is… more
- Interim HealthCare (Greenwood, IN)
- …Registered Nurse (RN) in home health or similar setting; previous case management / utilization review experience preferred. OASIS experience preferred. ... implementation and ongoing assessment of the patient's plan of care through the management of home health aides, LPNs, RNs, and other caregivers. Communicate patient… more
- Harford County Government Department of Public Works (Perryman, MD)
- …Duties: Supports the preparation of the annual budget and assists with the management of budgets, ensuring cost control and expenses are in alignment with the ... construction, etc. Compiles and prepares written and verbal reports for management and regulatory authorities Researches, prepares reports, and analyzes data on… more
- Fresenius Medical Care (Fayetteville, NC)
- …and acts as the liaison for patient care as per the disease management agreement, including initial and ongoing validation of member eligibility. Facilitate timely ... workup of patients for access management , dialysis services, patient education, hospitalizations, and kidney transplantation as appropriate, and ensures coordination… more
- Butterball (Warsaw, NC)
- …maintaining safety culture and ensuring continuous improvement through the utilization of Butterball Operating System Solutions (BOSS). Supports and empowers ... tasks. Participates in HR activities such as hiring, terminations, performance management , goal setting, team member development, scheduling, etc. Enforces systems,… more
- Fresenius Medical Care (Hayward, WI)
- …auditing activities. Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. Manages clinic financials ... including efficient utilization of supplies or equipment and regular profits and loss review . Responsible for all required network reporting and on-site state or… more
- Yale New Haven Health (Danbury, CT)
- …A Charge Nurse. Meets Performance Expectations For Customer Service, Teamwork, Resource Utilization , And Staff And Self Development As Outlined In Performance ... Review . Performs Other Duties As Assigned Or Directed To...Neuro Assessment Demonstrates Skill And Knowledge In The Airway Management Of The Neuro Patient Demonstrates Skill And Understanding… more
- Yale New Haven Health (West Haven, CT)
- …A Charge Nurse. Meets Performance Expectations For Customer Service, Teamwork, Resource Utilization , And Staff And Self Development As Outlined In Performance ... Review . Performs Other Duties As Assigned Or Directed To...Neuro Assessment Demonstrates Skill And Knowledge In The Airway Management Of The Neuro Patient Demonstrates Skill And Understanding… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …depending on customer and departmental needs. + Plans, implements, and documents utilization management activities which incorporate a thorough understanding of ... productivity and gain efficiencies for performance improvement opportunities in the Utilization Management Department. + Assists in updating departmental… more
- Centene Corporation (Sacramento, CA)
- … team to ensure appropriate care to members. Supervises day-to-day activities of utilization management team. + Monitors and tracks UM resources to ensure ... adherence to performance, compliance, quality, and efficiency standards + Collaborates with utilization management team to resolve complex care member issues +… more
- CommonSpirit Health (Phoenix, AZ)
- **Job Summary and Responsibilities** The System Vice President of Utilization Management is a key member of the healthcare organization's leadership team and is ... and accountability for creating, implementing, and leading an integrated system-wide utilization management program which includes comprehensive denials … more
- Fallon Health (Worcester, MA)
- …strategic leadership and oversight responsibility for the clinical and operational utilization management activities for all inpatient and outpatient care, ... and staff across all product lines. **Responsibilities** ** Utilization Management :** + Oversees all administrative, operational and clinical functions related to… more
- UNC Health Care (Morrisville, NC)
- …the unique communities we serve. **Summary** : The **Executive System Director of Utilization Management (UM)** is a strategic and operational leader responsible ... for designing, implementing, and standardizing utilization management functions across a large healthcare...Operational oversight of centralized and site-specific UM teams, including utilization review nurses and support staff. Cultivate… more
- CVS Health (Austin, TX)
- …+ Job Description Primary Job Duties & Responsibilities Drives effective utilization management practices by ensuring appropriate and cost-effective allocation ... efficient use of healthcare resources. Applies clinical expertise and knowledge of utilization management principles to influence stakeholders and networks of… more
