- 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
- ChenMed (Cleveland, OH)
- …of social wellness tools for the care team's awareness and utilization .Communication. + Maintains communication with other healthcare team members by attending ... with challenged caregivers/family systems of high-risk patients + Appropriate utilization of community-based resources + Teamwork skills in care coordination… more
- Veterans Affairs, Veterans Health Administration (Johnson City, TN)
- …specialty care. Coordinates with the patient care team to review the clinic utilization by using various reports (eg, Clinic Utilization Statistical Summary). ... Collect, scans, and updates health insurance information, promote Veteran registration and utilization of My Healthy Vet (MHV). Train other MSAs on correct clinic… more