- Providence (Burbank, CA)
- …Accountabilities include assessment and planning, coordination of care, resource utilization management and/ or review, discharge planning, documentation of ... + 1 year of experience in care management or utilization review in any setting, OR + Upon hire...care with leading-edge diagnostics and treatment, outpatient health centers, physician groups and clinics, numerous outreach programs, and hospice… more
- HCA Healthcare (Austin, TX)
- …Administers respiratory care to patients as ordered by the attending physician . Conducts diagnostic procedures to evaluate the need for, and response ... service coordination. + Actively participates in the Performance Improvement and Utilization Review programs. + Assumes a role in the maintenance of… more
- AdventHealth (Maitland, FL)
- …**Postal Code:** 32751 **Job Description:** + Communicates clinical cost, utilization , appropriate coding and documentation, quality, and member service opportunity ... develop and implement systems and processes to improve the clinical cost, utilization , appropriate coding and documentation, quality, and member service outcomes. +… more
- Providence (Orange, CA)
- …Upon hire: California Registered Nurse License. + 3 years Experience in Utilization Management. + Experience working with InterQual and MCG guidelines. **Preferred ... qualifications:** + Master's Degree in Nursing. + 5 years Experience as a utilization /case manager in an acute care setting. + Experience in a multi-hospital and/or… more
- Houston Methodist (The Woodlands, TX)
- …Demonstrates professional and technical competence in the selection, evaluation, utilization of treatment plans for increasingly complex patient populations ... services provided, as applicable. + Uses resources efficiently to maximize utilization of time and equipment. Self-motivated to independently manage time… more
- Houston Methodist (The Woodlands, TX)
- …in accordance with staffing grid. + Provides input into unit resource utilization including unit capital and operational budget needs. Oversees shift by shift ... resource utilization through the allocation of staff, supplies and contributions...wellness services; an outpatient laboratory; and several other multispecialty physician practices. In January 2022, Houston Methodist The Woodlands… more
- CVS Health (KY)
- …review, and appeal request. This position is primarily responsible for Utilization Management, including prior authorization and pre certification as well as ... UM experience working at Health Plan / Insurer or experience as a Physician Advisor or working for an Independent Review Organization a Plus **Preferred… more
- Veterans Affairs, Veterans Health Administration (Reno, NV)
- …Advanced MSA coordinates with the patient care team to review the clinic utilization by using various reports (eg, Clinic Utilization Statistical Summary). ... clinicians across multiple disciplines (eg medical doctors, nurse practitioners, physician assistants, psychologists, psychiatrists, social workers, clinical pharmacists, and… more
- State of Massachusetts (Boston, MA)
- …placement along the continuum of care. This vital role encompasses Utilization Review, Performance Improvement, Risk Assessment, Infection Surveillance, and the ... general summary and not all inclusive):_**__*/* * Oversee case coordination, utilization review, discharge planning, and resource allocation across assigned units. *… more
- GE HealthCare (CA)
- …sales forecasts and shared volume targets. With your Cardiac PET Physician Outreach teammate, conduct regular business analyses of the local market-customers, ... and appropriately impact the decision-making criteria to help increase awareness and utilization of Flyrcado. * Prioritize multiple projects and drive focus on… more