- Bassett Healthcare (Cooperstown, NY)
- …timely and accurate information to payors. The role integrates and coordinates utilization management , care facilitation, and discharge planning functions. The ... barriers to efficient delivery of care in appropriate setting. + Completes utilization management and quality screening for assigned patients. + Applies… more
- CVS Health (Bloomfield, NJ)
- …to our members. Health service strategies, policies, and programs are comprised of utilization management , quality management , network management , ... Case Manager opportunity with 50 to 75% field travel in Essex County NJ. The working schedule is...Health service strategies, policies, and programs are comprised of utilization management , quality management , network… more
- Houston Methodist (Houston, TX)
- …ethics/healthcare law, clinical skill, etc. + Expert knowledge of discharge planning, utilization management , case management , performance improvement ... team for special project activities related but not limited to, throughput, readmissions, and utilization management to align with the visions and goals of the… more
- Houston Methodist (Nassau Bay, TX)
- …for state, local and federal programs + Comprehensive knowledge of discharge planning, utilization management , case management , performance improvement ... PRN (CM) position is a licensed registered nurse (RN) who comprehensively plans for case management of a target patient population on a designated unit(s). This… more
- Houston Methodist (Sugar Land, TX)
- …for state, local and federal programs + Comprehensive knowledge of discharge planning, utilization management , case management , performance improvement ... Certified position is a registered nurse (RN) responsible for comprehensively planning for case management of a targeted patient population on a designated… more
- CVS Health (Austin, TX)
- …skills preferred + Managed care/ utilization review experience preferred + Case management and discharge planning experience preferred **Education** + ... and/or interpretation of applicable criteria and clinical guidelines, standardized case management plans, policies, procedures, and regulatory standards… more
- Luke Staffing (Montgomery, AL)
- …software, and databases for community resources. . Integrate CM and utilization management (UM) and integrating nursing case management with social work ... o HCW must be certified -OR- certification eligible by the Commission for Case Management (CCM) or American Nurses Credentialing Center (ANCC). o Must… more
- Excellus BlueCross BlueShield (Dewitt, NY)
- …group. + Responsible for all aspects of the Case Management department functions including quality, productivity, utilization performance, and educational ... Job Description: Summary: Conducts case management program activities in accordance...consistent and quality health care services. Examples may include: Utilization Management , Quality, Behavioral Health, Pharmacy, Registered… more
- CVS Health (Orlando, FL)
- …Clinical Social Worker (LCSW) **Preferred Qualifications** + Bilingual Spanish + Managed care/ utilization review experience + Case management and discharge ... + Applies and interprets applicable criteria and clinical guidelines, standardized case management plans, policies, procedures, and regulatory standards while… more
- CVS Health (Dallas, TX)
- …to our members. Health service strategies, policies, and programs are comprised of utilization management , quality management , network management , ... is a **work from home** flexible position with expected travel up to 50% that will require home visits....is reimbursed as per company policy **Preferred Qualifications** + Case Management and/or home health care experience… more