- Omaha Children's Hospital (Omaha, NE)
- …Brief Overview** Utilization Management (UM) is a specialty area of Nursing Case Management (NCM) and is responsible for reviewing and assessing all ... and Abilities** + The basic principles of healthcare resource management . + Clinical pathways and trajectories of...Hire Required and + Certification in a nationally recognized case management /utilization management organization Upon… more
- Trinity Health (Albany, NY)
- …compassionate and transforming healing presence within our communities. **POSITION SUMMARY** The Clinical Risk Management Analyst is responsible for the overall ... patient safety and clinical risk management functions related to review...to influence change without direct authority, and negotiation skills. ** WORK ENVIRONMENT AND HAZARDS:** Office and/or Clinical … more
- Providence (Olympia, WA)
- …Chance Act." **Requsition ID:** 351392 **Company:** Providence Jobs **Job Category:** Care Management **Job Function:** Clinical Care **Job Schedule:** Full time ... **The Role:** Under the supervision of the North Division Executive Director of Care Management , the Director of Care Management is a pivotal role responsible… more
- Molina Healthcare (MS)
- …* Facilitates initial review of assigned case levels and assists in case management assignment to care managers. * Reviews data to identify principle ... JOB DESCRIPTION Job SummaryProvides non- clinical administrative support to the care management function, and contributes to interdisciplinary team efforts… more
- Omaha Children's Hospital (Omaha, NE)
- …Brief Overview** Utilization Management (UM) is a specialty area of Nursing Case Management (NCM) and is responsible for reviewing and assessing all ... + Knowledge of the basic principles of healthcare resource management . + Knowledge of clinical pathways and...and/or Compact State Licensure Required and + RN-BC - Case Management Nurse Preferred Children's is the… more
- HCA Healthcare (Nashville, TN)
- … Management (HCM) will serve as a Subject Matter Advisor (SMA), applying their clinical and case management expertise to support HCA attorneys, insurance ... partners, and other representatives in evaluating the medical and case management components of disputes requiring Hospital...Management required + 3+ years of experience in Clinical Nursing required + 3+ years of experience in… more
- Elevance Health (Overland Park, KS)
- … clinical expertise in all aspects of utilization review and case management . Provides input on the clinical relevance to account reporting regarding use ... of all medical policies used for operational reviews. + Leading multidisciplinary rounds for case management /complex clinical management . + Peer-to-peer… more
- Select Medical (Cleveland, OH)
- …**Cleveland Clinic Rehabilitation Hospital - Fairhill** **Director of Quality Management ** **(DQM)** **Opening in October, the Cleveland Clinic Rehabilitation ... Tuition reimbursement and continuing education opportunities + **Elevate Your Skills:** Clinical ladder program. + **Ease the Burden:** Student debt benefit program… more
- Ventura County (Ventura, CA)
- …Acts as a liaison between in-patient facility and referral facilities/agencies and provides case management to patients referred; + Refers patients to community ... as needed for outside services for patients/families; + Conducts daily clinical reviews for utilization/quality management activities based on… more
- Beth Israel Lahey Health (Plymouth, MA)
- …nursing, health care administration or related field preferred or commensurate experience and Case Management Certification required + Minimum of 3 years of ... lives.** Full Time **Job Description:** **Utilization Review & Denials management manager - Full Time** **Who We Are:** At...denials. + Responsible for appeals and follow up on clinical denials escalated through a work queue,… more