- Blue KC (MO)
- …discount program** **Job Description Summary:** Presents data-driven insights and clinical health information to large self-funded client groups and insurance ... articulates the value of Blue KC's approach to managing care delivery to the employer groups. + Serves as...attends client meetings (with benefits managers and executives) to review health outcomes and cost information. + Actively monitors… more
- The Cigna Group (Bloomfield, CT)
- …/ Wellness programs (eg, utilization management, case management, demand management, medical review , care plans, health care coaching, incentives, etc.) ... **Job Overview:** This role is responsible for driving the Clinical Quality data acquisition strategy and data product support within the Enterprise Quality &… more
- HCR Home Care (Rochester, NY)
- … and approve all new interim orders before they are sent to physician. Notify Clinical Manager /Regional Director if unable to approve the order. + Assure orders ... new lab order via fax and email clinician to review and n otify case manager and... functions (ie, TIFs, phone calls, etc.). + Alert Clinical Manager /Regional Director of changes in patient… more
- HCA Healthcare (Melbourne, FL)
- …at Home we support our colleagues in their positions. Join our Team as a(an) Clinical Manager Home Health and access programs to assist with every stage of ... gain certifications and job skills. Apply today for our Clinical Manager Home Health opening and continue...Manager Home Health opening. Our team will promptly review your application. Highly qualified candidates will be contacted… more
- Fresenius Medical Center (East Hartford, CT)
- …of their clinical and operational processes to impact patient centered care resulting in improved patient outcomes and satisfaction and decreased morbidity and ... Advisory Board Recommended Algorithms and Standing Orders, clinical pathways and clinical policies and procedures to improve care coordination and care… more
- CVS Health (Oak Brook, IL)
- …we do it all with heart, each and every day. **Position Summary** This Clinical Case Manager Behavioral Health position is with Aetna's Long-Term Services and ... resources. Evaluation of Members: - Through the use of care management tools and information/data review , conducts...and service needs that may impact member outcomes and care planning components with appropriate referral to clinical… more
- Commander, Navy Installations (San Diego, CA)
- …and risk management activities, including Ongoing Professional Practice Evaluation, peer review and clinical case consultation on FAP treatment. Coordinate ... Summary Serve as a Non-medical Clinical Counselor within Commander, Navy Installations Command (CNIC),...clients with issues falling outside the authorized scope of care (eg, schizophrenia, bipolar disorder, eating disorders, substance use… more
- CVS Health (Salt Lake City, UT)
- …participation in case management programs. + Completes a Comprehensive Assessment and Plan of care . + Will document in clinical systems to support legacy Aetna ... English **Preferred Qualifications** + Crisis intervention skills preferred + Managed care /utilization review experience preferred + Case management and… more
- Huron Consulting Group (Chicago, IL)
- …to improve clinical outcomes and reduce the cost of providing patient care . Investing in new partnerships, clinical services and technology is not enough ... closely with employed physician advisors to support decision-making and adherence to care standards. + On-site Review Preparation: Assists in preparation for… more
- Trinity Health (Livonia, MI)
- …Ensures all compliance and regulatory standards are met. Ensures that direct reports perform clinical validation as part of the review process and remain current ... and co-morbidities are a complete reflection of the patient's clinical status and care . Resolves all discrepancies in a courteous manner. Demonstrates expertise… more