- YesCare Corp (Brentwood, TN)
- …and maintain pre-established review parameters under the direction of the YesCare Medical Director . + Identify and document comparisons with community standards, ... of care issues with the implementation of education to internal and external customers and process improvement initiatives. +...to ensure resources are maximized. + Work with other UM inpatient and outpatient nurse reviewers to assure proper… 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 ... position will serve as the SCCC Manager of research administration for the Director of the Sylvester Comprehensive Cancer Center, Dr. Stephen Nimer. This position… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …external standards set by regulatory and accreditation entities. Refers appropriate cases to the Medical Director for review. Refer to and work closely with Case ... refers potential quality of care and utilization issues to Medical Director . + Utilizes appropriate communication techniques...5 years. + Broad understanding of multiple areas (ie UM and CM). Incumbent is required to know multiple… more
- UTMB Health (Webster, TX)
- …or hospital transfers. If unsuccessful, elevates to department leadership and Senior Medical Director . Discharge Planning + Demonstrates skill in educating ... AS 400. + Demonstrates skill in accurately entering required UM data. + Monitors and facilitates appropriate utilization of...achieve target. + Presents LOS variances for review to Director and Inpatient Medical Director .… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …external standards set by regulatory and accreditation entities. Refers appropriate cases to the Medical Director for review. Refer to and work closely with Case ... refers potential quality of care and utilization issues to Medical Director . + Utilizes appropriate communication techniques...5 years. + Broad understanding of multiple areas (ie UM and CM). Incumbent is required to know multiple… 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 ... to IRBs, sponsors and master agreements, and coordinates with the Research Program Director on remediation. + Coordinates the efforts of relevant team members to… 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 ... to IRBs, sponsors and master agreements, and coordinates with the Research Program Director on remediation. + Coordinates the efforts of relevant team members to… more
- Huron Consulting Group (Chicago, IL)
- …by it. Together, we empower clients to create sustainable growth, optimize internal processes and deliver better consumer outcomes. Health systems, hospitals and ... medical clinics are under immense pressure to improve clinical...hospital contractual payor agreements. This position reports to the Director of Utilization Management and works with hospital leadership… 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 ... and research protocols. + Prepares reports of investigations and inquiries for internal or external use. + Assists in the preparation and presentation of… more
- Brighton Health Plan Solutions, LLC (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