- University of Rochester (Rochester, NY)
- …Identifies problems that include but are not limited to pre-certifications, Utilization Management, Medicaid Pending, third party payer issues, and denials/appeal ... and follow-up with assigned area, Financial Assistance, Social Work, Utilization Management, Medicaid Enrollment & Outreach, patients, families, third-party payers,… more
- Humana (Raleigh, NC)
- …scope. The Medical Director may speak with contracted external physicians, physician groups, facilities, or community groups to support regional market priorities, ... with prior experience participating in teams focusing on quality management, utilization management, case management, discharge planning and/or home health or… more
- Dartmouth Health (Keene, NH)
- …system which is sensitive to patient needs and expectations, promote effective utilization of resources, and support physician practice, while emphasizing care ... coordination across the continuum. Perform utilization management activities as necessary to ensure that medical necessity is appropriate to the patient's level of… more
- Cabinet Peaks Medical Center (Libby, MT)
- …nursing service activities to assure quality patient care and appropriate utilization of personnel. Reviews nursing staffing patterns, checks attendance, and revises ... charge nurse You will develop and maintain close working relationships with physician colleagues and other healthcare providers in assigned areas. Responsible for… more
- ChenMed (St. Petersburg, FL)
- …wellness tools and resources for the care team's awareness and utilization with patients in need. **Communication:** + Maintains communication with interdisciplinary ... with challenged caregivers/family systems of high-risk patients + Appropriate utilization of community-based resources + Teamwork skills in care coordination… more
- SUNY Upstate Medical University (Syracuse, NY)
- …reimbursement entities. This is achieved through a thorough chart review and utilization of first-level screening criteria to ensure patients are at the appropriate ... required for interface and collaboration with leadership, colleagues, providers, Physician Advisors, regulatory agencies, and other health care-related entities are… more
- Highmark Health (Trenton, NJ)
- …business relationships, the impact of Highmark's business decisions on Informatics, personnel utilization , and the use and planning of technology. The role involves ... nature for profiling providers, assessing patient outcomes, studying cost and utilization trends and quantitative projections of industry and competitor performance,… more
- HCA Healthcare (Nashville, TN)
- …of Care based on face to face or telemedicine assessment completed and physician consult. + Provides a thorough clinical review and risk assessment with appropriate ... is reimbursed by contacting managed care organizations and completing initial utilization review. Documents in Midas as required. Involves mobile crisis when… more
- University of Colorado (Aurora, CO)
- …The Associate Head for Clinical Affairs in Cardiology (Vice Chief) is the physician leader for clinical practice across the Division of Cardiology at CU Anschutz, ... a Division "operations playbook"o **Access/Scheduling:** Optimize template design, room utilization , referral standards, subspecialty triage, new/return ratios, cancellation/no-show reduction,… more
- University of Southern California (Glendale, CA)
- …chart with pertinent medical information, administers medication as directed by physician . + Provides direct patient care. + Administers medications. + Assess ... and monitor patients condition and notify physician /health care professional. + Demonstrates professional communication skills for the purpose of patient care,… more
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