- Excellus BlueCross BlueShield (Rochester, NY)
- …of consistent and quality health care services. Examples may include: Utilization Management , Quality, Behavioral Health, Pharmacy, Registered Dietitian and ... within the group. + Responsible for all aspects of the Case Management department functions including quality, productivity, utilization performance, and… more
- CDPHP (Latham, NY)
- …of consistent and quality health care services. Examples may include: Utilization Management , Quality, Behavioral Health, Pharmacy, Registered Dietitian and ... within the group. + Responsible for all aspects of the Case Management department functions including quality, productivity, utilization performance, and… more
- University of Utah Health (Salt Lake City, UT)
- …+ Negotiates with third party payers relative to benefit levels, eligibility, utilization review , and reimbursement. + Identifies actual and potential delays ... integral to our mission. EO/AA_ + This position provides clinical case management services aimed at enhancing patient-centered care and maximizing outcomes across… more
- Magellan Health Services (Albuquerque, NM)
- …the management , direct supervision and coordination of clinical and/or nonclinical management staff, including utilization management and intensive care ... and on-going management of designated staff. + Performs care management review activities consistent with Magellan policies, procedures, and standards.… more
- Catholic Health (Buffalo, NY)
- …(2) years acute care and/or community health nursing + Preferred prior insurance /managed care/ utilization review experience in the role of a Case Manager ... case management and discharge planning principles, the RN Care Manager engages the patient/patient representative in developing and implementing a post hospital… more
- HCA Healthcare (Gainesville, FL)
- …Case Management is preferred + BSN is preferred + Certification in Case Management , Nursing or Utilization Review is preferred HCA Florida North Florida ... hours volunteering in our communities. As an RN Case Manager with HCA Florida North Florida Hospital you can...patients, families, hospital staff, and outside agencies + Performs utilization management reviews and communicates information to… more
- Cedars-Sinai (Los Angeles, CA)
- …the Foundation, including patient assignment, risk and specialty network structures, and utilization management . Functions as key resource for staff and ... **Job Description** The Senior Manager , MN Clinical Ops is responsible for the...of assigned areas. Works closely with leadership and physician management in the centralized infrastructure development and operations for… more
- Elevance Health (OH)
- …to get an OH License or a NC License_** + Previous experience in case management / utilization management with a broad range of experience with complex ... **Behavioral Health Care Manager I - (Day Shift)** **Location** **- Virtual:**...preferred. + Bilingual in Spanish is highly preferred + Utilization Management experience is preferred + Previous… more
- Elevance Health (NC)
- …supervision. **Preferred Skills, Capabilities and Experiences:** + Previous experience in case management / utilization management with a broad range of ... **Behavioral Health Care Manager I - North Carolina** **Sign on Bonus:...preferred. + Bilingual in Spanish is highly preferred + Utilization Management experience is preferred + Previous… more
- Crouse Hospital (Syracuse, NY)
- …of hospital resources while maintaining the quality of care. + Participates in the utilization management process using standards of care to determine the most ... Crouse's Care Coordination Services team is hiring a Care Manager to review the services delivered to...- Five (5) years acute hospital experience. + Case Management or Utilization Management experience… more