- University of Southern California (Alhambra, CA)
- …Care Management Coordinators. 4. Makes appropriate referrals to supervisor or Medical Director , communicating accurate clinical information. 5. Participates in ... 1. Demonstrates sound clinical knowledge base regarding CM standards, UM standards, clinical standards of care, NCQA requirements, CMS...(MCG and/or InterQual) competency testing as requested by department director or Medical Director . +… more
- Saint Francis Health System (OK)
- …Triggers for individual patient situations, reporting them promptly to the UM Manager, appropriate clinicians and Process Improvement/Quality Director . Reviews ... levels of care and receipt of necessary services. The Utilization Management ( UM ) Registered Nurse will communicate with providers the details of reimbursement… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …other assigned duties to meet required turnaround times. * Prepares and presents cases to Medical Director (MD) for medical director oversight and ... Management services to its clients. The Utilization Management Nurse performs medical necessity and benefit review requests in accordance with national standards,… more
- University of Miami (Miami, FL)
- …the program's overall success. + Serves as a liaison between the Program Director (s), administrative leadership, UM /JMH Graduate Medical Education (GME) ... Ensures reports are submitted as required by the ACGME, the Graduate Medical Education Committee (GMEC), and other internal /external stakeholders. + Collaborates… more
- University of Miami (North Miami, FL)
- …here (https://www.myworkday.com/umiami/d/task/1422$7248.htmld) to log in to Workday to use the internal application process. To learn how to apply for a faculty ... work in North Miami, FL at UHealth SoLe Mia Medical Center. The Office Manager manages a variety of...+ Establishes and continuously assesses the effectiveness of the internal controls within the unit and compliance with University… more
- University of Miami (Miami, FL)
- …here (https://www.myworkday.com/umiami/d/task/1422$7248.htmld) to log in to Workday to use the internal application process. To learn how to apply for a faculty ... Miami is among the top research universities and academic medical centers in the nation, and one of the...incumbent may lecture or conduct demonstrations and teach across UM schools. The Associate Professor, tenure earing, will partner… more
- Rush University Medical Center (Chicago, IL)
- …care. Applies criteria, performs concurrent review process. Works with physicians and Medical Director regarding Case issues and concurrent denials as indicated. ... **Job Description** Location: Chicago, Illinois Business Unit: Rush Medical Center Hospital: Rush University Medical ...to, education, job-related experience and skills, as well as internal equity and industry specific market data. The pay… more
- University of Michigan (Ann Arbor, MI)
- …care complexes in the world and has been the site of many groundbreaking medical and technological advancements since the opening of the U-M Medical School ... $1.00 / hour The benefit package includes: + Excellent medical , dental and vision coverage + 2:1 Match on...resources available within the Ambulatory Care and Department of Internal Medicine/hepatology transplant settings to determine and meet the… more
- University of Miami (Miami, FL)
- …here (https://www.myworkday.com/umiami/d/task/1422$7248.htmld) to log in to Workday to use the internal application process. To learn how to apply for a faculty ... each clinic is well prepared consi sting of all medical records (print and electronic) are up to date...professional independence in the practice of nursing. 6. Consults internal experts when appropriate. 7. Maintains documentation of the… more
- University of Miami (Miami, FL)
- …here (https://www.myworkday.com/umiami/d/task/1422$7248.htmld) to log in to Workday to use the internal application process. To learn how to apply for a faculty ... routes non-routine, priority or confidential inquiries from external or internal sources with correspondence or other messaging on behalf...infrastructure. + Liaise with executive assistant from JHS and UM admin as well as CV surgery, Adult ICU… more