- Sharecare (Madison, WI)
- …change techniques, the nurse helps to drive cost effective and appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is ... according to the disease management program intervention guidelines. A Disease Management Nurse is supervised by an Operations Manager (OM). All Sharecare… more
- Highmark Health (Madison, WI)
- …Nursing **EXPERIENCE** **Required** + 7 years in any combination of clinical, case/ utilization management and/or disease/condition management experience, or ... and federal law standards and are within the care manager 's professional discipline. + For assigned case load, create...first 6 months of employment. **Preferred** + Certification in utilization management or a related field +… more
- Elevance Health (Sparta, WI)
- …associates, and may be involved in process improvement initiatives. + Submits utilization /authorization requests to utilization management with documentation ... **LTSS Service Coordinator (Case Manager )** **Hiring near Southwestern Wisconsin in counties:** Pepin,...plan, engaging the member's circle of support and overall management of the individuals physical health (PH)/ behavioral … more
- CenterWell (Madison, WI)
- …**Additional Information** Will report to the Director of Physician Strategy at Utilization Management . The Medical Director conducts Utilization review ... work, communication of decisions to internal associates, participation in care management and possible participation in care facilitation with hospitals. The… more
- Highmark Health (Madison, WI)
- …terms through regular on-site audits. Apply an active role in network management , training, monitoring and enforcement of company policies and procedures while ... confidentiality agreements. Monitor financial performance of contracts by tracking utilization and competitive environment, including group specific performance guarantees.… more
- CenterWell (Madison, WI)
- …a part of our caring community and help us put health first** The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and independent ... volume and fast paced environment + Previous experience in utilization management + Education: BSN or bachelor's...go beyond physical health - addressing the social, emotional, behavioral and financial needs that can impact our patients'… more
- Elevance Health (Waukesha, WI)
- …The **Medical Director-PSCCR** is responsible for the administration of physical and/or behavioral health medical services, to ensure the appropriate and most cost ... to Medical Director Associates. + Works independently with oversight from immediate manager . + May be responsible for an entire clinical program and/or independently… more