- Northwell Health (New Hyde Park, NY)
- …the development, implementation, and maintenance of drug formularies, clinical utilization management (UM) criteria, and evidence-based drug therapy guidelines, and ... Responsibility** + Develops and monitors the hospital's policies/procedures regarding utilization of medications in collaboration with the medical staff, Pharmacy,… more
- University of Southern California (Arcadia, CA)
- …and accurate information to payers. The role integrates and coordinates utilization management, care facilitation, and discharge planning functions. The Case ... meet patient needs, manage the length of stay, and promote efficient utilization of resources. Specific functions within this role include: facilitation of… more
- State of Massachusetts (Boston, MA)
- …delivery of health care services through networks of providers, or that employ utilization review systems to evaluate the medical necessity and appropriateness ... applications for licensure. Review is of carriers' operations, including utilization review , quality assurance, contracts with pharmacies and prescription… more
- CenterWell (Marietta, GA)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... community and help us put health first** The Clinical Manager , Home Health Nursing enables patients to stay in...requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking… more
- SAM LLC (Atlanta, GA)
- …Manager . A Phase Manager also serves as the backup to their Project Manager , assisting with billing review , and proposal writing and review . + Execute ... responsible for oversight and reporting on spending and budget, utilization of resources, tracking deliverables, handling of field and... also serves as the backup to their Project Manager , assisting with billing review , and proposal… more
- Commonwealth Care Alliance (Boston, MA)
- …Position Summary: The Behavioral Health (BH) Provider Engagement Program Manager is responsible for cultivating strong, collaborative relationships with behavioral ... mission and supporting high-quality, coordinated care for members. In this role, the Program Manager acts as an account manager , relationship manager , and… more
- Highmark Health (Jefferson Hills, PA)
- …including but not limited to: appropriateness of care, documentation requirements, utilization review principles and criteria, insurance benefits and ... outcomes, engages patients/caregivers in their healthcare, and supports effective resource utilization . Serves as key team members in the management of readmissions,… more
- Parsons Corporation (San Antonio, TX)
- …on workflow efficiency, and maintaining research documents. Additionally, the Program Manager II will assist with space utilization , financial tracking, ... talent and redefine what's possible. **Job Description:** Parsons is seeking a **Program Manager II** to support Naval Medical Research Unit - San Antonio (NAMRU-SA)… more
- HCA Healthcare (Tallahassee, FL)
- …position if current and compliant** + **Certification in Case Management, Nursing, or Utilization Review , preferred** + **Three years of nursing experience in ... to make a real impact. As a(an) RN Case Manager you can be a part of change. **Benefits**...supporting a balance of optimal care and appropriate resource utilization . The RN CM Care Coordinator will identify potential… more
- HCA Healthcare (Tallahassee, FL)
- …position if current and compliant** + **Certification in Case Management, Nursing, or Utilization Review , preferred** + **Three years of nursing experience in ... organization that invests in you as a(an) RN Case Manager PRN? At HCA Florida Capital Hospital, you come...supporting a balance of optimal care and appropriate resource utilization . The RN CM Care Coordinator will identify potential… more
Recent Jobs
-
Business Development Supervisor (Sales)
- Canon USA & Affiliates (Itasca, IL)