- Magellan Health Services (Boise, ID)
- …community agencies as appropriate. Proposes alternative plans of treatment when requests for services do not meet medical necessity criteria. + Participates in ... solutions that directly influence quality of care. General Job Information Title Care Manager ( UM /UR) - Remote, Idaho Licensed Grade 24 Work Experience -… more
- Magellan Health Services (Boise, ID)
- …of healthcare services in physical health, behavioral health or other medical specialty area based on pod management. Considerable skill in interpreting clinical ... for RN, Masters or Doctoral level provider. General Job Information Title Clinical Manager , Behavioral Health ( UM ) -Licensed, Remote in Idaho Grade 27 Work… more
- Queen's Health System (Honolulu, HI)
- …the business plan and alignment with the strategic plan and vision of the Medical Center. * Ensures functions, activities, services , and programs meet all ... and clinical operations of Emergency Department and Inpatient Case Management services . * Develops, implements, monitors and evaluates for effectiveness, a… more
- Elevance Health (Chicago, IL)
- …physician calls to gather medical appropriate information in order to make medical necessity determinations for services requested. + Makes medical ... **Clinical Operations Associate Medical Director** **Carelon Medical Benefit Management**...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- Ventura County (Ventura, CA)
- Manager - Patient Services - Ventura County Health...per year, increasing to 288 hours after 5 years of service , to 328 hours after 10 years of service ... Care Plan Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5064489) Apply Manager - Patient Services - Ventura County..., and to 368 hours after 15 years of service or other public service . *Credit for… more
- Cedars-Sinai (Beverly Hills, CA)
- …eligibility before processing authorizations. + Contacts facilities identified by the UM Nurses/ Manager /Director/ Medical Director to research any issues ... when requested. + Requests support documentation from IPAs / Medical Groups as requested by the UM ...patient population, including referrals to community resources, facilitation of medical services , referral to ancillary providers, etc.… more
- WellSpan Health (York, PA)
- … function is supported and completed by program staff. Routinely monitors completion of UM function. + Provides limited clinical services on a regular basis and ... day program. Works in close collaboration with the Nurse Manager to obtain desired outcomes. **Duties and Responsibilities** **Essential...range of services , from wellness and employer services solutions to advanced care for complex medical… more
- Veterans Affairs, Veterans Health Administration (Seattle, WA)
- Summary The VA Puget Sound Healthcare System is recruiting for a Nurse Manager to perform supervisory duties with the Patient Access Center and Patient Flow ... services at the VA hospital in Seattle, Washington. The Nurse Manager directly supervises the RN Utilization Management/Discharge Planners, AMSA Discharge… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …you to apply! Job Description: Summary: This position supports the workflow of the Medical Services division. Depending on the specific tasks assigned, the ... Medical Services Coordination Specialist provides administrative support...and triages functions for each call to appropriate + UM /BH/MCM/Quality service area. Provides preliminary support to… more
- Sharp HealthCare (San Diego, CA)
- … medical management activities to include tracking, trending and analyzing UM data. Works in collaboration with regional medical directors, ambulatory ... management departments. Participates in the development of the annual UM plan and implementation of corrective action plans related...and implements new programs under the direction of the manager of in-patient care management and the Director of… more