- Henry Ford Health System (MI)
- …Review and Denials + Facilitating communication between insurance representatives, clinicians, case management , clinical staff, central business office, ... functions related to timely procurement of referrals and authorizations and denial management related to scheduled outpatient services.. This includes but is not… more
- J&J Family of Companies (Orlando, FL)
- … techniques, such as segmentation, research, relationship building, and superior resource management skills throughout assigned territory, to increase market ... RBD to discuss business plan implementation, issues and trends. Interacts with internal resource providers to gain resources and support for sales efforts.… more
- Texas Health Resources (Fort Worth, TX)
- …Ft. Worth, 1301 Pennsylvania Avenue, Ft. Worth, TX 76104 * Care Transition Management department + **Work hours:** PRN, mainly weekdays between 8:00AM-5:00PM, on an ... 5-weeks of training Monday to Friday ) **Care Transition Management department highlights:** * Supporting the 815-bed, Magnet-designated, full-service hospital… more
- Stanford Health Care (Palo Alto, CA)
- …position acts as a resource , providing feedback on appropriate complex case management referrals and working collaboratively with all disciplines to manage ... acute and skilled nursing facility concurrent review and complex and episodic case management , including the care plan development and ongoing intervention… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …I + Reviews and makes recommendations and/or decisions on Utilization or Case Management activities. Utilization review activities include: reviews of requests ... review determinations with providers and external physicians. + Conduct clinical appeal case reviews and may require...Qualifications) + Minimum 2-3 years of experience in medical management , utilization review and case management… more
- Providence (Olympia, WA)
- …dedicated team, ensuring a seamless continuum of care, patient advocacy, and efficient resource management from admission through to discharge. This role is ... Develop and maintain a comprehensive departmental customer satisfaction program. + **Human Resource Management :** Attract and retain top talent, coach, and… more
- Virginia Mason Franciscan Health (Burien, WA)
- …Advisor will conduct clinical reviews on cases referred by case /utilization management and/or other healthcare professionals in accordance with Hospital ... resources to achieve optimal outcomes * Notify the case manager of any conflict of interest in reviewing...of long-stay patients, in conjunction with the Director/Manager of Case Management and to facilitate determination of… more
- Volunteers of America Los Angeles (Santa Ana, CA)
- …are not eligible for VA care. SSVF health care navigators provide case management and care coordination, health education, interdisciplinary collaboration, ... assigned multidisciplinary team, including medical, nursing, and administrative specialists, and case management personnel. The SSVF health care navigator works… more
- Mount Sinai Health System (New York, NY)
- …outcomes while controlling costs. The Director collaborates closely with medical staff, vendors, case management , and payers to secure payment and benefits for ... in the state of employment required + Certification in Case Management (CCM, ACM) or Utilization ...Management preferred. + 7+ years of experience in clinical acute clinical , utilization management ,… more
- Nuvance Health (Danbury, CT)
- …and appeals specialists, non- clinical support staff while partnering with local case management leadership. This individual will support the pursuit of ... acute care setting * Minimum of 5 years of progressive leadership experience in case management or utilization review * Proven leadership experience with a track… more