- Hawaii Pacific Health (Lihue, HI)
- …long term care, or related field. **Preferred Qualifications:** Current Case Management or Utilization Management certification. EOE/AA/Disabled/Vets Hawai'i ... and programs, including cardiology, emergency, family practice, gastroenterology, health management , internal medicine, neurology, OB-GYN, oncology, orthopedics, pediatrics and… more
- Mohawk Valley Health System (Utica, NY)
- …+ 3 years of clinical experience. + Strong computer skills. PREFERRED: + Case Management , Utilization Management and Quality Management experience ... Transitional Care RN - Case Management - Full Time - Days Department: CASE MANAGEMENT Job Summary The RN - Transitional Care Coordinator is responsible for… more
- Molina Healthcare (Reno, NV)
- …in the development and execution of the Plan's disease management , case management , utilization management , and care management programs. Oversees ... of care management programs, including such programs as Quality Improvement, Utilization Management , Care Management , Predictive Modeling, and Disease … more
- UPMC (Pittsburgh, PA)
- …medical management best practices. + Actively participates in the utilization management and quality improvement review processes, including concurrent, ... policies of the Health Plan. Contributes to process improvement within the Utilization Management department. + Participates in activities to support policy… more
- Providence (Mission Hills, CA)
- …Oncology, Rehab, Pediatrics, Transplant, or Wound Care + 3 years - Experience in utilization management or case management . **Why Join Providence?** Our ... **Description** Care Management is a collaborative practice model including the...physicians, other practitioners, caregivers and the community. The care management process encompasses excellent communication, both verbal and written,… more
- The Cigna Group (Houston, TX)
- …data, systems, and applications for claims payment, enrollment, benefit design, and utilization management . + Familiarity with data mining and reporting tools, ... **Provider Data Management Analyst** Are you ready to make a...Analytics, Pricing & Solutions team as a Provider Data Management Analyst and help drive innovation, accuracy, and compliance… more
- Hawaii Pacific Health (Honolulu, HI)
- …long term care, or related field. **Preferred Qualifications:** Current Case Management or Utilization Management certification. EOE/AA/Disabled/Vets Hawai'i ... invasive cardiac surgery and total joint replacement. The Case Management team puts great emphasis on helping each patient...Our caring, professional staff provides timely medical and discharge management to meet clinical and service goals, and to… more
- Sutter Health (Modesto, CA)
- …Advisor will work closely with the medical staff, including house staff, and all utilization management (UM) personnel, Care Management (CM) personnel to ... meeting the organization's goals and objectives for ensuring the effective, efficient utilization of health care services. The PA will develop expertise on matters… more
- Cedars-Sinai (CA)
- …experience with community resources and social supports required. One (1) year of utilization management or managed care experience preferred. **Req ID** : 13036 ... to determine bed availability and communicates with the case management team. Assists patients with Durable Medical Equipment (DME)...-per diem, 10:00 pm - 6:30 am - Case Management **Department** : Case Management **Business Entity**… more
- Northwell Health (Bay Shore, NY)
- …Performs retrospective reviews as required. + * Participates in the maintenance of Utilization Management , Discharge Planning and Case Management statistics ... + * Keeps abreast of all changes in policies and procedures relating to Utilization Management , Discharge Planning and Case Management process. + * Attends … more