- CVS Health (Frankfort, KY)
- …Length of Stay) to clinical staff. + Identifies triggers for referral into Aetna's Case Management , Disease Management , Mixed Services, and other Specialty ... resolution of claims payment issues. + Supports the administration of the hospital care, case management and quality management processes in compliance with… more
- Huntington Ingalls Industries (Virginia Beach, VA)
- Requisition Number: 23736 Required Travel : 0 - 10% Employment Type: Full Time/Salaried/Exempt Anticipated Salary Range: $74,347.00 - $105,000.00 Security Clearance: ... ISR operations and accelerated decision-making. With data fusion and mission management capabilities for the Department of Defense, the combatant commands and… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …state of employment. Knowledge, skills, and abilities- Strong knowledge of care management models, discharge planning, utilization review, and behavioral health ... 2. Actively promotes certification readiness for ACM or CCM. ** Travel ** : Less than 10% of the time may...minimum experience with at least 5 years in a management position. Certification- ACM (Accredited Case Manager)… more
- IQVIA (Chicago, IL)
- …sound, constructive judgment during demanding situations. + **Accountability.** Demonstrates excellent case management skills. Eager to take ownership, be ... Specialist Team who will be the certified sites primary day-to-day contact for case -level order management . While you will occasionally assist with advanced … more
- Excellus BlueCross BlueShield (Buffalo, NY)
- …divisions + Provides clinical leadership for the implementation of new utilization / case /quality management initiatives Minimum Qualifications: Level I ... Level I + Provides medical leadership of all for utilization management , cost containment, and medical quality...periods of time for business continuity. + Ability to travel across the Health Plan service region for meetings… more
- Community Based Care of Brevard, Inc. (Rockledge, FL)
- …This position uses Microsoft and a web based application for daily entry of case activity and the utilization management of service authorizations. 2+ ... complete family assessments and monthly home visits and develop case plans for families served in North and Central... plan outlining family needs, goals and services. Service Utilization UM/Wrap: This is strongly recommended in order to… more
- Elevance Health (Wilmington, NC)
- …or a degree in nursing. + Requires three (3) years of experience providing care management , case management , or care coordination to individuals served by ... term services and supports, Unmet health-related resource needs, and Integrated care management . We envision a North Carolina where all children and families thrive… more
- Houston Methodist (Houston, TX)
- …units through the facilitation and coordination of patient flow and bed utilization . The POE Nurse position collaborates with clinical staff and interprofessional ... health care team to ensure resource utilization is appropriate to the patient's clinical needs and within covered benefits. This position ensures a compassionate,… more
- CenterWell (Tallahassee, FL)
- …performance review and outcomes of care analysis to determine efficiency, the efficacy of case management system as well as any other systems and process. ... care to all patients served by the location. Receives case referrals. Reviews available patient information related to the...home health or hospice, with at least one-year of management experience preferred. + Willingness to travel … more
- ChenMed (Philadelphia, PA)
- …years' clinical work experience required + A minimum of one (1) year of utilization review and/or case management , home health, hospital discharge planning ... patients' progress and adjust and plan accordingly + Understanding utilization review and how to leverage with inpatient staff...individual patient care plans + Knowledge of nursing and case management theory and practice + Knowledge… more