- Sanford Health (SD)
- …Conduct level of care medical necessity reviews within patient's medical records. Performs utilization management (UM) activities in accordance with UM plan to ... utilization and potentially, prior authorization. Assists the department in monitoring the utilization of resources, risk management and quality of care for… more
- Cleveland Clinic (Weston, FL)
- …the Miami-Fort Lauderdale metro area and remains a top hospital in Florida. As a Utilization Management (UM) Specialist , you will work under the general ... .** This position offers the flexibility of working from home and support in gaining your case management...*Achieves a minimum of 85% on IRR quarterly. *Completes Utilization Management for assigned patients with a… more
- FLACRA (Clifton Springs, NY)
- PER DIEM UTILIZATION MANAGEMENT SPECIALIST Finger Lakes Area Counseling & Recovery Agency Clifton Springs, NY (Onsite) Per Diem Apply Now ... one year of work experience in the behavioral health field with knowledge of utilization management practices. Valid NYS Drivers' License. Get job alerts by… more
- BayCare Health System (Cotton Plant, AR)
- …responsibility and clinical excellence. **BayCare Health System** is currently seeking a ** Utilization Review Specialist Senior** to join our outstanding and ... of 16 community-based hospitals, a long-term acute care facility, home health services, outpatient centers and thousands of physicians....compassionate team. **The Utilization Review Specialist Senior responsibilities include:** +… more
- BayCare Health System (Cotton Plant, AR)
- …of trust, dignity, respect, responsibility and clinical excellence. **The Denials Specialist - Utilization Review responsibilities include:** + Timely reviews of ... year Medicaid/Medicare experience. Equal Opportunity Employer Veterans/Disabled **Position** Denials Specialist - Utilization Review **Location** Clearwater:Morton Plant… more
- Spectrum Billing Solutions (Skokie, IL)
- …cycle management company for healthcare organizations. We are looking to add a Utilization Review (UR) Specialist to our growing team. The UR Specialist ... in a cohesive and rewarding environment. This is a remote or office/ home hybrid position. Responsibilities include: + Review patient admission and clinical… more
- Corewell Health (Caledonia, MI)
- …and continued stay. Educates medical staff/other health care professionals regarding utilization management and quality requirements. Makes recommendations and ... provides financial and utilization management (UM) information to other members...plans, spas, and more! + Optional identity theft protection, home and auto insurance, pet insurance + Traditional and… more
- Improveit Home Remodeling (Columbus, OH)
- …and play a crucial role in shaping the employee experience at Improveit Home Remodeling. Payroll Specialist Responsibilities: + Responsible for timely, accurate, ... leaders for over 35 years. As the market for home improvement services continues to increase, our Company is...provides training as needed to ensure compliance and full utilization of tools. + Process daily, weekly, monthly, and… more
- LA Care Health Plan (Los Angeles, CA)
- …the coordination of member care with internal LA Care departments such as Care Management (CM), Utilization Management (UM), Managed Long Term Services and ... Enhanced Care Management Clinical Specialist II Job Category:... Utilization Review (CPUR), Certified Case Manager (CCM), Utilization Management or Compliance Salary Range Disclaimer:… more
- AdventHealth (New Smyrna Beach, FL)
- …documents avoidable days, and facilitates progression of care. Collaborates with Utilization Management staff for collaboration on patient status changes ... to care management Current working knowledge of discharge planning, utilization management , care management , performance improvement and managed… more
- AdventHealth (Orlando, FL)
- …documents avoidable days, and facilitates progression of care. + Collaborates with Utilization Management staff for collaboration on patient status changes and ... care planning and are core competencies of this role. The Social Work Specialist facilitates the collaborative management of patient care across the continuum,… more
- Ventura County (Ventura, CA)
- …eligibility for public assistance in a public human services agency or comparable case management experience. HS Client Benefit Specialist II: One (1) year of ... HS Client Benefit Specialist Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/4440930) Apply HS Client Benefit...The County includes 42 miles of coastline which is home to the fol-lowing cities and points of interest:… more
- LA Care Health Plan (Los Angeles, CA)
- Care Management Specialist II Job Category: Clinical Department: Care Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ... support the safety net required to achieve that purpose. Job Summary The Care Management Specialist II utilizes clinical skills and training to perform essential… more
- University of Pennsylvania (Philadelphia, PA)
- …programs and resources, and much more. Posted Job Title Research Specialist /Database Administrator, Mack Institute for Innovation Management , Wharton School ... and development; establishes policies and procedures pertaining to database management , security, maintenance, optimization and utilization ; assures security… more
- Veterans Affairs, Veterans Health Administration (Hines, IL)
- …Works in collaboration with the Patient Safety, HRO, Innovation, Systems Redesign, Risk Management , Infection Control and Utilization Management teams for ... tracers, chart reviews and QI initiatives. The incumbent serves as a Specialist within the Accreditation & Quality Management Programs. Serves as the point of… more
- St. Luke's University Health Network (Lehighton, PA)
- …partners with participants to facilitate their recovery and community integration through utilization of the Specialist 's personal life experience and first-hand ... ability to pay for health care. The Certified Peer Specialist (CPS) has the lived experience of a mental...to model coping techniques and recovery tools needed for self- management of their health condition(s) and pursuit of their… more
- Louisiana Department of State Civil Service (New Orleans, LA)
- ADULT PROTECTION SPECIALIST 1 - 3 Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4565726) Apply ADULT PROTECTION SPECIALIST 1 - 3 Salary ... of quality services, the development and stimulation of services of others, and the utilization of available resources in the most effective manner. LDH serves as a… more
- MyFlorida (Marianna, FL)
- RESIDENTIAL UNIT SPECIALIST LEAD WORKER - 67040013 (SUNLAND - UNIT 1) Date: Jun 8, 2024 Location: MARIANNA, FL, US, 32446 MARIANNA, FL, US, 32448 MARIANNA, FL, US, ... Agency for Persons with Disabilities Working Title: RESIDENTIAL UNIT SPECIALIST LEAD WORKER - 67040013 (SUNLAND - UNIT 1)...This is a position assigned specific to a residential home to enhance the delivery of quality services. This… more
- Mohawk Valley Health System (Utica, NY)
- …Full Time - Days Department: MEDICAL EDUCATION ADMIN Job Summary The Scheduling Specialist is responsible for the development and management of department ... State Department of Health (NYSDOH) and other regulatory bodies. The Scheduling Specialist acts as the central scheduler between clinical practices, the residency… more
- BAE Systems (Broomfield, CO)
- …may be available based on position level and/or job specifics. **Configuration Management Specialist III** **99244BR** EEO Career Site Equal Opportunity ... data items to support technical meetings. + Support program management and engineering staff in utilization of...plan, and other perks including discounts on things like home , auto, and pet insurance. Our leave programs include… more