- Kaleida Health (Buffalo, NY)
- …preferred. RN licensure required.** **Experience** **10 years of care management / utilization management experience required in hospital and/or ambulatory ... **VP Care Management Post-Acute Care Transition** **Location:** **Buffalo General Medical...daily oversight of operations, the VP will partner with Utilization Review , Revenue Cycle, and Clinical leadership… more
- CenterWell (Anderson, SC)
- …to the strategic intent Overseeing other clinicians which includes Physicians, Advanced Registered Nurse Practitioners (ARNP), and Physicians Assistants (PA) in: ... inquiries, requests, and complaints from patients + Ongoing chart review / audit of clinical staff to ensure quality...+ Identifying trends and areas of opportunity in pharmacy utilization (pharmacy management ) to impact Part D… more
- CenterWell (Savannah, GA)
- …to the strategic intent Overseeing other clinicians which includes Physicians, Advanced Registered Nurse Practitioners (ARNP), and Physicians Assistants (PA) in: ... inquiries, requests, and complaints from patients + Ongoing chart review / audit of clinical staff to ensure quality...+ Identifying trends and areas of opportunity in pharmacy utilization (pharmacy management ) to impact Part D… more
- Arnot Health (Elmira, NY)
- …related to the management of patient care . The Case Manager will review all patients for utilization management and appropriate discharge planning. The ... The Case Manager tracks and trends LOS , resource utilization , outliers, readmissions , denials , delay days...with a current license as a registered nurse . BSN or Case Management Certification… more
- WellSpan Health (York, PA)
- …therapy experience with an emphasis in home care. Preferred **Licenses:** + Licensed Registered Nurse Upon Hire Required + Heartsaver CPR/AED Upon Hire Required ... with team members to identify root cause and countermeasures.* Holds In Episode Management meetings on a regularly scheduled basis with individual staff to ensure… more
- Battelle Memorial Institute (Arlington, VA)
- …two years' nursing experience + Current, full, active, and unrestricted license as a Registered Nurse in any US State, the District of Columbia, Guam, Puerto ... within legal and professional parameters + Knowledge and skill in using pre-established utilization review criteria to recognize and report actual or potential… more
- Elevance Health (WA)
- …or equivalent. Requires a minimum of 2 years of clinical experience and/or utilization review experience. + Current active, valid and unrestricted LPN/LVN or ... RN license and/or certification to practice as a health...in multiple states. **Preferred Skills, Capabilities and Experiences:** + Utilization Management and/ore Case Management … more
- Calvary Hospital (Bronx, NY)
- …8. Knowledge of and experience in Quality Assessment and Improvement, Utilization Review . 9. Ability to develop management systems to track data over time. ... year Requirements QUALIFICATIONS: 1. Master of Nursing Degree required. 2. NYS unencumbered Registered Nurse License required. 3. Ten (10) to fifteen (15) years… more
- Parexel (Hartford, CT)
- …mitigations and drive resolution with cross-functional stakeholders as part of the Risk Management Plan. + Review and analyze metrics to derive meaningful ... practices like version control and literate programming. + BSN, RN , RPh, Pharm D, PA, MPH, or other applicable...project-level resourcing of staff and staff assignments. + Regularly review and update Data Management resources to… more
- KidsPeace Childrens Hospital (Schnecksville, PA)
- …as necessary collaboration/supervision agreements with Advance Practice Professionals (Certified Registered Nurse Practitioners or Physician Assistants) and ... telepsychiatry services based on the needs of the organization; d. Participating in utilization review activities including but not limited to development of… more