- University of Southern California (Alhambra, CA)
- … of specific patient populations. The role integrates the functions of complex case management , utilization management , quality management , discharge ... assessment, planning, implementation, and evaluation to the process of case management . Some of the major duties...from multiple sources, as supported by the ambulatory care coordinator . 4. Analyze and interpret data in collaboration with… more
- Uniti (Alachua, FL)
- …executive level of staff and political representatives for municipal governments management personnel, to include executive levels. Includes document research of ... Jacksonville, Live Oak, and Orlando. _** **What You'll Do:** Right-of-Way Management + Develop and maintain relationships with agencies and individuals responsible… more
- Corewell Health (Royal Oak, MI)
- …a case load of patients that includes facilitating utilization management , and/or care coordination during the patient's stay, planning and expediting plans ... the care for groups of patients as it relates to disease management , resource utilization, access, discharge planning, quality, service and efficiently across the… more
- University of Southern California (Arcadia, CA)
- …Lead RN.* Prioritizes cases to provide service to most urgent case .* Organizes patient transportation, surgical team coordination, age specific admission evaluation ... andmedical groups.* Communicates with insurance company utilization review and authorization personnel.* Gathers and maintains data and reports as required… more
- General Motors (Warren, MI)
- …worldwide to optimize plant floor operations, strengthen GM's leadership in order management , and empower teams to deliver for our customers with precision, ... cross-functional alignment. + Provide comprehensive user support, training, and access management for GEPICS and related systems. Offer hands-on assistance during… more
- US Tech Solutions (Columbia, SC)
- …established clinical criteria to service requests or provides health management program interventions. + Utilizes clinical proficiency and claims knowledge/analysis ... cost effective outcomes. **Responsibilities:** + Performs medical or behavioral review/ authorization process. Ensures coverage for appropriate services within benefit… more
- Highmark Health (Buffalo, NY)
- …and then creates the case (data entry) in Highmark's Utilization Management system for Prior Authorization clinical review. Ensures all accurate information ... :** **JOB SUMMARY** This job captures all inbound inquires for utilization management review from providers and pharmacies. The incumbent assesses the request,… more
- BJC HealthCare (St. Louis, MO)
- …notification point until the period right before the procedure. + Coordinates with case management and physician offices insurance requirements for the surgical ... Ideal candidates will have some exposure to pre certification or prior authorization . Schedule: M-F 8 AM-4:30 PM **Overview** **Missouri Baptist Medical Center** ,… more
- Carle Health (Peoria, IL)
- …Coordination, will provide behavioral/physical health assessment and treatment planning, case management , support, education, and consultation. Will communicate ... related contracts, and UnityPlace. + Provides members/clients with disease management information as needed. Key Accountability + Participates in in-service… more
- UCLA Health (Los Angeles, CA)
- …of accurate demographic information, soliciting for insurance information and prior authorization requirements and follow up. Provide general information to incoming ... with patients, referring physicians, transplant team members, insurance companies case managers, governmental agencies, hospital staff, and other groups in… more