- Cedars-Sinai (Beverly Hills, CA)
- …member eligibility before processing authorizations. + Contacts facilities identified by the UM Nurses/Manager/ Director / Medical Director to research any ... Doing** The Case Management Coordinator provides support to the utilization review process. The coordinator works collaboratively with all...when requested. + Requests support documentation from IPAs / Medical Groups as requested by the UM … more
- HCA Healthcare (Englewood, CO)
- …and retirement of our colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no cost or for a low ... health coverage as well as free telemedicine services and free AirMed medical transportation. + Additional options for dental and vision benefits, life and… more
- Corewell Health (Farmington Hills, MI)
- …status and level of care. Uses defined resources to guide decisions, including Medical Director Care Management, Physician Advisors, and management staff. + ... hospital outpatient, observation or inpatient services. + May review cases for medical necessity, uses InterQual and/or other UR/ UM Committee-approved medical… more
- Corewell Health (Royal Oak, MI)
- …status and level of care. Uses defined resources to guide decisions, including Medical Director Care Management, Physician Advisors, and management staff. 5. ... hospital outpatient, observation or inpatient services. 4. May review cases for medical necessity, uses InterQual and/or other UR/ UM Committee-approved … more
- Dignity Health (Rancho Cordova, CA)
- …criteria. This position will work closely with the hospitalist team, Dignity Health Medical Foundation Medical Director 's, specialists, clinic staff and ... and policies. Approve services or forward requests to the appropriate Physician or Medical Director with recommendations for other. - Complete medical … more
- University of Miami (Miami, FL)
- …logistical knowledge of organ donation/recovery process in a timely manner. + Keeps UM LAORA Clinical Operations Director and Organ Allocation and Recovery ... responsible for all activities related to the allocation and utilization of organs from donors. Including, organ allocation for...of recovered organs when necessary. + Familiar with all medical aspects of organ donation and bring any questions… more
- AdventHealth (Orlando, FL)
- …relationships and share observations and provider improvement opportunities. Collaborates with Medical Director (s) to review and provide insight regarding ... teams. Provides education and serves as a resource to Medical Staff colleagues regarding best practices, Utilization ...concurrent review, and denials as a back up to UM Physician Advisory as and when needed. Assists with… more
- Rush University Medical Center (Chicago, IL)
- …care. Applies criteria, performs concurrent review process. Works with physicians and Medical Director regarding Case issues and concurrent denials as indicated. ... **Job Description** Location: Chicago, Illinois Business Unit: Rush Medical Center Hospital: Rush University Medical Center Department: Care Management **Work… more
- Ellis Medicine (Schenectady, NY)
- …patient through the continuum. + Maintains accurate, up-to-date documentation in the medical record. + Documents Utilization Management activities in MIDAS per ... function is to work with the Social Worker, Nurse Case Manager, or Utilization Management Nurse to facilitate patient discharge plans, support coordination of care… more
- Sharp HealthCare (San Diego, CA)
- …business practices. **What You Will Do** Under the direction of the Sharp Community Medical Group (SCMG) Director for Health Service and in collaboration with ... legislative compliance for the division. Under the direction of the SCMG Director for Health Services, develops financial (budget) and operational strategy of HCM… more