- UnityPoint Health (Des Moines, IA)
- …continuity through elimination of fragmentation of care/service and facilitates the effective utilization of resources. Serves as educator and a central source of ... to include: clinical needs, barriers to quality care, effective utilization of resources and pursues denials of payment and...plan and execute a safe discharge + Collaborate with Utilization Management team on continued stay review. + Collaborates… more
- US Tech Solutions (RI)
- …+ Must have experience with Medcompass + Must have prior authorization utilization experience. + Managed Care/Medicare experience preferred. **Skills:** + MUST HAVE ... and Medicare/Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management review. + MUST HAVE 1 YEAR OF... management review. + MUST HAVE 1 YEAR OF UTILIZATION MANAGEMENT EXP, pref. knowledge of Milliman/MCG. + MUST… more
- US Tech Solutions (LA)
- …setting in a specialty area of the nursing field providing utilization management prior authorization reviews. Build strong direct relationships with providers ... 3 years nursing experience with a minimum of 1 year in utilization management/ prior authorization review experience. **Experience** : Utilization Management.… more
- ChenMed (Miami, FL)
- …team. The Physician Reviewer is the primary physician reviewer for Utilization Management/Clinical Appropriateness review cases in our organization. Other duties ... and Quality improvement in our developing area of Delegated Utilization Management. **ESSENTIAL JOB DUTIES/RESPONSIBILITIES:** + Provides Delegated Clinical… more
- Serco (MD)
- …deep understanding of shipyard manufacturing processes, including production flow, facility utilization , and the integration of trades, is essential for assessing ... a deep understanding of shipyard manufacturing processes, including production flow, facility utilization , and the integration of trades, is essential to assess how… more
- University of Maryland, Baltimore (Baltimore, MD)
- …to the delivery of medical care and clinical services such utilization review, quality assurance, policies, procedures and guidelines development. 3. Participates ... by University of Maryland Medical Center (UMMC). 8. Provides oversight of utilization and risk management activities including monitoring of service utilization ,… more
- Vanderbilt University Medical Center (Tullahoma, TN)
- …**:** + Workforce Development & Labor Management + Patient Satisfaction + Resource Utilization -- Designs approaches to improve the utilization of capacity (human ... efforts within VTHH to ensure timely management of patients, efficient utilization of resources, satisfaction, consistent and predictable work + systems, and… more
- Centene Corporation (Atlanta, GA)
- …issue resolution. Drive optimal performance in contract incentive performance, quality, and cost utilization . + Serve as primary contact for providers and act as a ... in the following areas: Risk/P4Q, Health Benefit Ratio (HBR), HEDIS/quality, cost and utilization , etc. + Completes special projects as assigned + Ability to travel… more
- Catholic Health Services (Roslyn, NY)
- …compliance with regulatory and external review agencies. + Participates in the Utilization Management Committee, reporting data on utilization trends, resource ... utilization and denials. + Serves as a resource to physicians, physician advisors, CM department, and hospital staff. + Collaborates with all disciplines and departments to optimize key clinical and financial outcomes. + Participates in committee work at… more
- Amgen (Washington, DC)
- …collect and analyze imaging data. + Proven leadership experience in the utilization of molecular imaging as a quantitative biomarker in clinical trials + ... Experience with the utilization of clinical MR imaging in evaluation of clinical...of suspected adverse events is preferred. + Experience is utilization of imaging in obesity and rare diseases is… more