- Molina Healthcare (Sparks, NV)
- …services professionals in some or all of the following functions: care management , utilization management , behavioral health, care transitions, long-term ... * Assists in implementing health management , care management , utilization management , behavioral health...and unrestricted in state of practice. * Certified Case Manager (CCM), Certified Professional in Health Care Management… more
- SSM Health (St. Charles, MO)
- …regarding opportunities for improvement in standard work. May also be responsible for: utilization management process, ED case management process, admission ... process, and act as a case manager liaison with post acute providers (skilled nursing facilities,...Applies the existing body of evidence-based practice and scientific knowledge in health care to nursing practice, ensuring that… more
- UTMB Health (Galveston, TX)
- …BAS software, drafting software, and/or electronic document management and utilization . High containment laboratory knowledge and experience Working ... 6 months. Assignment in healthcare facilities requires a Certified Healthcare Facility Manager (CHFM). Acceptance of other facility management certifications in… more
- Campbell County Health (Gillette, WY)
- …County Memorial Hospital. Actively engages in departmental quality assurance and utilization management activities and processes to include monthly chart ... assessment/problem identification, individual, family and group therapy and case management . Develops and monitors treatment plans, monitors treatment progress,… more
- UNC Health Care (Raleigh, NC)
- …through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management staff to ... & the Hospitals? Utilization Management Plan. In addition, the Utilization Manager is responsible for revenue protection by reconciling physician orders,… more
- Beth Israel Lahey Health (Plymouth, MA)
- …a job, you're making a difference in people's lives.** Full Time **Job Description:** ** Utilization Review & Denials management manager - Full Time** **Who ... and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager...in utilization management and appeal/denial management . + Holds a strong working knowledge … more
- CVS Health (Baton Rouge, LA)
- …And we do it all with heart, each and every day. **Position Summary** The Utilization Management Manager of Prior Authorization oversees a team of clinical ... setting, management of direct reports preferred + Strong knowledge of utilization management principles, regulatory requirements, and payer requirements.… more
- Highmark Health (Harrisburg, PA)
- …Inc. **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health ... setting **Preferred** + Experience in UM/CM/QA/Managed Care + Medical/Surgical experience + Utilization Management (UM) or (UR) Utilization Review experience… more
- Elevance Health (Washington, DC)
- …office 4 days each week. The office is located at 609 H. Street NE.** The ** Manager of Utilization Management ** **ll** is responsible for managing a team of ... and acuity. + Provides direct oversight and is responsible for Utilization Management execution/decision making for managed member populations. Primary… more
- UCLA Health (Los Angeles, CA)
- …the next level. You can do all this and more at UCLA Health. As a Manager for Medicare Advantage Utilization Management , you'll provide direct management ... + Thorough knowledge of health care industry, utilization review, utilization management , and...off-site meetings and conferences + ACM - Accredited Case Manager preferred + CCM - Certified Case Manager… more
