- Sharp HealthCare (San Diego, CA)
- …words per minute with 0-2 errors; proof work.Maintain knowledge of insurance, utilization review , scheduling requirements and support of front desk ... policies and procedures.Department specific requirements: all in collaboration with the Nurse Practitioner/referring provider:Wound and Skin Care:* Management of… more
- HCA Healthcare (Tallahassee, FL)
- …in your career path, we encourage you to apply for our Manager Case Management opening. We review all applications. Qualified candidates will be contacted by ... **Description** **Introduction** Do you have the career opportunities as a(an) Manager Case Management you want in your current role? We invest in what matters most… more
- Ellis Medicine (Schenectady, NY)
- …services provided by the Case Manager include, but are not limited to, utilization review , case management , care transition, collaboration with physicians ... experience in a hospital environment preferred. + Previous case management , utilization review , and discharge...transition of care with Social Worker + Serves as nurse consultant for Social Worker cases with Clinical or… more
- LA Care Health Plan (Los Angeles, CA)
- …by health risk assessment (HRA), risk stratification, predictive modeling, provider's utilization review vendors, members, Call Center, claims staff, Health ... Preferred Certified Case Manager (CCM) Accredited Case Manager (ACM) Certification Case Management Nurse - Board Certified (CMGT-BC) Required Training Physical… more
- Independent Health (Buffalo, NY)
- …day-to-day management of the RN staff of their assigned area (Case Management , Utilization Review and Population Health). This will include monitoring ... process; maintain a current and accurate database. + Provide high quality, professional utilization management services: (medical necessity review for Prior… more
- Sharp HealthCare (San Diego, CA)
- …of the manager of in-patient care management and the Director of Utilization Management . **Required Qualifications** + 3 Years Experience in the acute ... Facility/Regional - SCMG Operations meetings and task forces.Facilitate regional Utilization Management committees and other working regional… more
- HCA Healthcare (Englewood, CO)
- …identified patient and family needs with the efficacious and cost effective utilization of resources. Through concurrent clinical case management , patients will ... licensure in the State of Colorado as a Registered Nurse , or current active multistate nursing licensure, or LCSW...you, we encourage you to apply for our Case Management Manager opening. Our team will promptly review… more
- CareFirst (Baltimore, MD)
- …Licensure. **Experience:** 3 years Care Management , Discharge Coordination, Home Health, Utilization Review , Disease Management or other direct patient ... This role will assist leadership with the development and review of Care Management standards, program criteria, policies, and procedures to ensure quality… more
- Sutter Health (Burlingame, CA)
- …leading innovative case management programs. + 8 years experience in utilization management and discharge planning. + 8 years leadership experience in ... and guidelines. Has frequent contact with the Administrative Team, Nurse Executives and Directors, Risk Management &...8 years experience in coordinating UM Committees/and or Clinical Review teams. + 8 years experience coaching, counseling and… more
- CVS Health (Phoenix, AZ)
- …utilizes skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. They apply critical thinking and knowledge in ... limited to):** + Evaluation of Members + Through the use of care management tools and information/data review , conducts comprehensive evaluation of referred… more
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