- Veterans Affairs, Veterans Health Administration (Cheyenne, WY)
- …hours with economic, legal, housing, and other SDoH factors, as well as crisis management related to Veteran and family coping with chronic health and mental health ... VA and community resources, programs, and benefits. Provides limited brief case management for the highest utilizers of Emergency Department services, to encourage … more
- Virginia Mason Franciscan Health (Silverdale, WA)
- …be on care coordination, communication and collaboration with utilization management , nursing, physicians, ancillary departments, insurers and post acute ... the patient experience. Performs other duties as assigned, including utilization review as necessary. **Job Requirements** **Required Education and Experience**… more
- UCLA Health (Los Angeles, CA)
- …Nursing staff) + CA RN License and BLS certification + Recent experience in case management , utilization management and discharge planning + Minimum of three ... quality, efficient, and cost-effective care. You will also perform utilization review while assuring the delivery of concurrent and... review while assuring the delivery of concurrent and post -hospital care. We're also looking to you to help… more
- Polaris Pharmacy Services, LLC (Fort Lauderdale, FL)
- …internal staff and external customers, supporting formulary initiatives, and executing utilization management tools like prior authorization programs and drug ... we're a dedicated partner in care, transforming how patients experience long-term, post - acute , correctional, PACE, and specialty pharmacy services. As industry… more
- Summit Medical Consultants LLC (Pueblo, CO)
- …and actively participates in medical staff duties. Participates in quality assurance, utilization management , and peer review programs to ensure high quality, ... Supports practice budgetary targets while maintaining standards of care. Participates in utilization and care management processes to ensure high quality,… more
- Prime Healthcare (Harlingen, TX)
- …manage care transitions. RN Case Managers also conduct discharge planning, utilization review, and helping patients navigate insurance and healthcare systems. ... plans, including referrals to rehab, home health, or long-term care facilities + Utilization Review: m onitor the use of hospital resources and services to ensure… more
- Apex Health Solutions (Houston, TX)
- …and cooperates with internal and external stakeholders. Collaborates effectively with Utilization Management , Quality Management , Pharmacy, Provider ... Summary Responsible for providing case management services and support to improve health outcomes...members, as well as pcp, specialists, clinic, hospital, and post - acute partners, along with community resources, to… more
- Ochsner Health (Lafayette, LA)
- …(CCM), Certified Professional Utilization Review (CPUR), Certified Professional in Utilization Management (CPUM) or Certified Professional in Healthcare ... liaison and communicator with the patient, caregivers, multi-disciplinary team members, and post - acute care and third party payers. Confirms a clear, specific… more
- Dartmouth Health (Keene, NH)
- …physician practice, while emphasizing care coordination across the continuum. Perform utilization management activities as necessary to ensure that medical ... research-based critical pathways and outcome measurement preferred. Experience in case management , utilization review and discharge planning preferred. Knowledge… more
- Trinity Health (Dublin, OH)
- …demeanor in difficult situations. . Knowledge of the functional operations of utilization management , discharge planning, care coordination and transitions of ... care . Understanding of pre- acute and post -aute venues of care and post - acute community resources. . Ability to work independently and exercise sound… more