- YesCare Corp (Philadelphia, PA)
- …justifications for non-formulary medication requests when necessary. + **Resource Utilization :** Resolve patient care issues using in-house resources before ... in all quality improvement initiatives, including sentinel event reviews. + ** Utilization Review:** Participate actively in utilization review processes,… more
- AdventHealth (Orlando, FL)
- …will drive excellence in quality, education, workforce engagement, and optimal utilization of APPs in delivering whole-person care while upholding the AdventHealth ... **Strategic Leadership:** + Develop and implement a strategic vision for APP utilization and integration across service lines, aligned with AHMG's mission and… more
- New York State Civil Service (Albany, NY)
- …with mental illness in a clinical capacity, as well as experience with utilization management and/or utilization review. ? The ideal candidate(s) will have ... direct care and utilization management experience, including familiarity with the review of medical evidence, psychiatric evidence, a knowledge base of child-serving… more
- Select Medical (Madison, WI)
- …by doing what is right. The Case Manager is responsible for utilization reviews and resource management, discharge planning, treatment plan management and financial ... patient specific, safe and timely discharge plan. + Performs verification of utilization criteria reviews. + Builds relationships and coordinate with payor sources… more
- Community Based Care of Brevard, Inc. (Brevard, FL)
- …Position Summary: This position is responsible for the clinical coordination, utilization management, and authorization of initial and ongoing services for children ... whenever possible. The position facilitates Team Review Meetings and the utilization review process, reviews and approves service requests, provides bypass service… more
- Select Medical (Alexandria, VA)
- …by doing what is right. The Case Manager is responsible for utilization reviews and resource management, discharge planning, treatment plan management and financial ... patient specific, safe and timely discharge plan. + Performs verification of utilization criteria reviews. + Builds relationships and coordinate with payor sources… more
- Select Medical (Madison, WI)
- …professional growth of the department, including, but not limited to: Utilization Review (UR) and resource management, discharge planning, treatment plan management ... patient-specific, safe and timely discharge plan. + Performing verification of utilization criteria reviews. + Building relationships and coordinating with payor… more
- Dartmouth Health (Keene, NH)
- …which is sensitive to patient needs and expectations, promote effective utilization of resources, and support physician practice, while emphasizing care coordination ... across the continuum. Perform utilization management activities as necessary to ensure that medical necessity is appropriate to the patient's level of care. Provide… more
- Trinity Health (Howell, MI)
- …with the Health System and with local contracts. Prepares reports of supply utilization ; reports unusual utilization trends. Works with dept management and ... ability and creativity required to identify potential cost savings and prepare utilization reports. Ability to lift 5-40lbs. **Our Commitment** Rooted in our Mission… more
- Humana (Baton Rouge, LA)
- …with prior experience participating in teams focusing on quality management, utilization management, case management, discharge planning and/or home health or post ... insurance, other healthcare providers, clinical group practice management. + Utilization management experience in a medical management review organization, such… more