- Wellpath (Freehold, NJ)
- …education, and point of care support. **About this role** The Medical Director of Utilization Management leads and oversees utilization review, case ... appropriate utilization of medical services. The Medical Director of Utilization Management serves as a key liaison with external partners and stakeholders,… more
- Henry Ford Health System (Troy, MI)
- …other delegated pharmacist. Facilitates the operations of the Pharmacy Care Management Department by organizing, improving, and implementing pharmacy benefit ... management policies and procedures. Major areas of responsibility include...Additional Information + Organization: Community Care Services + Department: Pharmacy- Utilization Mgmt + Shift: Day Job + Union Code:… more
- George C. Grape Community Hospital (Hamburg, IA)
- …* Education & Collaboration: o Educate clinical staff on documentation requirements, utilization management processes, and infection control standards. o Serve ... of clinical nursing experience (acute care preferred). o Prior experience in utilization review, case management , quality improvement, and infection control… more
- Albany Medical Center (Albany, NY)
- …Day (United States of America) Salary Range: $71,612.39 - $110,999.20 Responsible for Utilization Management , Quality Screening and Delay Management for ... assigned patients. * Completes Utilization Management and Quality Screening for assigned patients.* Applies MCG...experience in an assigned service.* Recent experience in case management , utilization management and/or discharge… more
- University of Michigan (Ann Arbor, MI)
- …withRHIT certificationOR Associate degree RN + At least 2-5 years of experience in Utilization Management , Appeals Management or Case Management + ... self-directed and work independently **Desired Qualifications + Experience with a case management / utilization management software program and EPIC (MiChart)… more
- Henry Ford Health System (Troy, MI)
- …computers, and business software such as Microsoft Office. Organizational and time management skills, as evidenced by the capacity to prioritize multiple tasks and ... with customers. Additional Information + Organization: Community Care Services + Department: Pharmacy- Utilization Mgmt + Shift: Day Job + Union Code: Not Applicable… more
- Integra Partners (Troy, MI)
- …experienced in the managed care payor environment to perform pre-service and post-service utilization reviews and appeals for DMEPOS. This individual will play a key ... and adaptability, we help deliver better health outcomes and more efficient management of complex healthcare benefits. Integra Partners is a wholly owned subsidiary… more
- UNC Health Care (Hendersonville, NC)
- …management referrals. Initiates appropriate social work referrals. + Performs utilization management assessments and interventions, using collaboration with ... health and well-being of the unique communities we serve. Summary: The Utilization Manager (UM) assesses new admissions, continued stay and discharge review cases… more
- Providence (Mission Hills, CA)
- …strong clinical background combined with well-developed knowledge and skills in Utilization Management , medical necessity, and patient status determination. The ... **Description** **RN Utilization Review - Remote. This position will work... Utilization Management RN must effectively and efficiently manage a diverse… more
- BriteLife Recovery (Englewood, NJ)
- …compliance. + Maintain compliance with payer policies, HIPAA regulations, and internal utilization management protocols. + Monitor trends in denials, approvals, ... need from you? + Minimum of 2-3 years of experience in utilization review, case management , or insurance coordination in a behavioral health or substance use… more