- AdventHealth (Winter Park, FL)
- …documents avoidable days, and facilitates progression of care. Collaborates with Utilization Management staff for collaboration on patient status changes ... Winter Park residents and community leaders to a 307-bed acute care facility that is a model of community...+ Health-related masters degree or MSN + Prior Care Management / Utilization Management experience +… more
- CVS Health (Springfield, IL)
- …role that primarily supports the Aetna Better Health Plan of Illinois. This UM ( Utilization Management ) Medical Director will be a "Work from Home" position ... and appeal request. This position is primarily responsible for Utilization Management , including prior authorization as well...review. Cases could focus on inpatient or outpatient services, acute and post acute services,… more
- Dignity Health (Woodland, CA)
- …barriers are identified assists the patient family caregiver care coordination with Utilization management as related to referrals. - Considers the population ... Dignity Health and area clinical integration programs and leads efforts to optimize utilization management and care coordination across the care continuum in the… more
- Select Medical (Pensacola, FL)
- … within the plan of care. + Demonstrates compliance with facility-wide Utilization Management policies and procedures. + Coordinates UR compliance with ... what is right. The Case Manager is responsible for utilization reviews and resource management , discharge planning,...step-down, med surg, vents)** + Adequate experience in an acute medical case management setting and confidence… more
- Johns Hopkins University (Baltimore, MD)
- …surgical patients + Support in-office procedures, including flexible laryngoscopy and post -operative drain management + Coordinate perioperative planning and ... post -surgical symptom management + Collaborate with attending surgeons on new patient...and implement plans of action for long- and short-term management of acute and chronic health care… more
- MaineGeneral Health (Augusta, ME)
- Job Summary:Provides clinical leadership and strategic support in utilization management (UM) and clinical documentation improvement (CDI), ensuring regulatory ... the individual will: + Provide clinical leadership and strategic support in utilization management (UM) and clinical documentation improvement (CDI), ensuring… more
- Trinity Health (Caldwell, ID)
- …across the health care continuum. Focuses on supporting patients upon discharge from an acute care and post acute care setting and providing chronic ... **CLINICAL PHARMACIST** **VALUE BASED CARE** Responsible for providing comprehensive medication management services for patients cared for by the Saint Alphonsus… more
- Sutter Health (Burlingame, CA)
- …22, CHA Consent Manual, CDPH and TJC. A broad knowledge base of post - acute levels of care and associated regulatory compliance requirements. General ... Responsible for Care Coordination and Care Transitions Planning throughout the acute care patient experience. This position works in collaboration with the… more
- CVS Health (Austin, TX)
- …review, and appeal request. This position is primarily responsible for Utilization Management , including prior authorization and precertification as well ... Independent Review Organization a Plus **Preferred Qualifications:** -Health plan/payor Utilization Management / Review experience -Electronic medical… more
- CVS Health (Charleston, WV)
- …concurrent review, and appeal request. This position is primarily responsible for Utilization Management , including prior authorization and pre certification as ... Independent Review Organization a Plus **Preferred Qualifications:** -Health plan/payor Utilization Management / Review experience. -Electronic medical… more