- Elara Caring (Conroe, TX)
- …Identifies and reports potential payment/coverage problems. + Supervises and coordinates utilization review activities. + Participates in strategic development ... Key Accounts, including participation in weekly, monthly, and quarterly review meetings, as needed. + Ensures accuracy of all...**What is Required?** + 5+ years Hospice experience + RN license in state of operations that is current… more
- HCA Healthcare (Tallahassee, FL)
- …and personal growth, we encourage you to apply for our Operating Room Nurse PRN-Surgery Center opening. We review all applications. Qualified candidates will ... have the PRN career opportunities as an Operating Room Nurse PRN-Surgery Center you want with your current employer?...the instrument and equipment set-up for your OR, including utilization of preference cards and ability to anticipate your… more
- Commonwealth Care Alliance (Boston, MA)
- …related to prior authorizations. **Process Improvement** + Partners with Clinical Operations management to develop and review workflows, to streamline processes ... and presents results. + Develops and analyzes quantitative reports to assess utilization , productivity and adherence to policies and procedures related to various… more
- CVS Health (Hartford, CT)
- …**Preferred Qualifications** * Appeals Experience * Managed Care Experience * Utilization review experience * Proficiency with computer skills including ... with heart, each and every day. **Position Summary** Responsible for the review and resolution of clinical appeals. Reviews documentation and interprets data… more
- LifePoint Health (Hickory, NC)
- …adaptation and outcome of care management as prescribed in the initial Utilization Review Plan with regard to resources, appropriateness of care and ... and family. * Must understand payer issues with regard to patient management and resulting implications of clinical decisions and anticipate to opportunities to… more
- HCA Healthcare (Englewood, CO)
- …shift. The House Supervisor participates as an active member of the nursing management team and assumes authority to manage all activities and personnel in ... the designated shift. Makes decisions regarding patient care and staff management using established policies/procedures. + Participates in the monitoring,… more
- Dignity Health (Carmichael, CA)
- …efficient manner to ensure timely and compliant care coordination, discharge planning, utilization review and social work interventions resulting in quality ... ** Nurse Manager of Care Coordination / Case Management ** **Sign On / Relocation Options** As our **...in Nursing or experience equivalent required. + Current CA RN licensure **Sign On / Relocation Options** **Where You'll… more
- US Tech Solutions (Tarrytown, NY)
- …initiatives. - Lead material resource selection, standardization, price optimization and utilization initiatives while promoting and utilizing Value Analysis in the ... processes as it pertains to new product initiatives, category management strategies etc. . Lead the development and focus...in the development and ongoing improvement of new product review and approval process, and assist in identifying and… more
- Nuvance Health (Danbury, CT)
- …VP/CNO for strategic growth targets. * Assumes responsibility for effective fiscal management of department to ensure proper utilization of financial resources. ... - One of America's 50 Best Hospitals * Surgical Review Corporation (SRC) - Robotic Center of Excellence *...related nursing practice standards in collaboration with the nursing management team. Responsible for the quality of patient care… more
- Garnet Health (Harris, NY)
- …Case Manager for the detox patient on the medical floor assuring discharge planning, utilization review , and insurance approval. Join the Garnet Health team and ... Medical Center - Catskills Emergency Department. Additionally will provide case management , and discharge planning for non-psychiatric patients. The Clinician is… more