- Carle Health (Urbana, IL)
- … utilization issues in appropriate locations, including but not limited to: case management/ utilization review software and the multidisciplinary plan of ... (IDFPR)Illinois Department of Financial and Professional Regulation (IDFPR); Accredited Case Manager (ACM) within 3 years -...and physician to determine next level of care Conducts case review presentations to educate peers on… more
- Highmark Health (Harrisburg, PA)
- …Inc. **Job Description :** **JOB SUMMARY** This job implements effective complimentary utilization and case management strategies for an assigned member panel. ... industry, corporate, state, and federal law standards and are within the care manager 's professional discipline. + For assigned case load, create care plans… more
- Fallon Health (Worcester, MA)
- …Authorization nurse in a managed care payer preferred. * One year experience as a case manager in a payer or facility setting highly preferred. * Relevant ... Keeps records and submits reports as assigned by the Manager * Refers high-risk cases to the appropriate FH...to a physician reviewer for consideration, ensuring the timely review of the referred case * Incrementally… more
- Dignity Health (Los Angeles, CA)
- …90 days of hire. + Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. + Able to apply clinical guidelines to ensure ... multiple stakeholders + Professional communication skills. + Understand how utilization management and case management programs integrate....least five (5) years of nursing experience. + Certified Case Manager (CCM), Accredited Case … more
- Dignity Health (Oxnard, CA)
- …AHA BLS card **Skills** + Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. + Able to apply clinical guidelines to ... multiple stakeholders + Professional communication skills. + Understand how utilization management and case management programs integrate....least five (5) years of nursing experience. + Certified Case Manager (CCM), Accredited Case … more
- Dignity Health (Long Beach, CA)
- …+ AHA BLS card + Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. + Able to apply clinical guidelines to ensure ... multiple stakeholders + Professional communication skills. + Understand how utilization management and case management programs integrate....least five (5) years of nursing experience. + Certified Case Manager (CCM) Accredited Case … more
- Dignity Health (Bakersfield, CA)
- …+ AHA BLS card + Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. + Able to apply clinical guidelines to ensure ... multiple stakeholders + Professional communication skills. + Understand how utilization management and case management programs integrate....least five (5) years of nursing experience. + Certified Case Manager (CCM) Accredited Case … more
- Dignity Health (Long Beach, CA)
- …+ AHA BLS card + Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. + Able to apply clinical guidelines to ensure ... multiple stakeholders + Professional communication skills. + Understand how utilization management and case management programs integrate....least five (5) years of nursing experience. + Certified Case Manager (CCM), Accredited Case … more
- Dignity Health (Glendale, CA)
- …+ AHA BLS card + Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. + Able to apply clinical guidelines to ensure ... multiple stakeholders + Professional communication skills. + Understand how utilization management and case management programs integrate....least five (5) years of nursing experience. + Certified Case Manager (CCM), Accredited Case … more
- PPL Corporation (Harrodsburg, KY)
- …generating assets, promoting safety while ensuring adequate generating capacity and efficient utilization of the assets and resources necessary to deliver power to ... and scheduling of unit outages, load restrictions, personnel scheduling, and utilization of resources supplied by other departments and vendors. + Ensures… more