- PeaceHealth (Florence, OR)
- … management , home health or hospice may be considered.) + Utilization Management -Quality Managment experience preferred. + Third party reimbursement knowledge ... **Description** **PeaceHealth is seeking a RN for our Care Management Team in beautiful Florence Oregon! This position covers all inpatient units at our 21 bed… more
- Health Care Service Corporation (Mobile, AL)
- …Nursing + Three to Five (3-5) years recent experience in an acute-care environment, case- management , or utilization management position (experience can be a ... combination of LVN/RN licensure) + Previous HEDIS and/or CMS STARs experience a plus. **Preferred Job Qualifications:** + Bilingual (English/Spanish) + Previous HEDIS and/or CMS STARs experience + Strong proficiency level using Microsoft Excel + **Client-site… more
- Molina Healthcare (AZ)
- …**Job Summary** Molina's Behavioral Health function provides leadership and guidance for utilization management and case management programs for mental ... care management programs. **Knowledge/Skills/Abilities** Provides Psychiatric leadership for utilization management and case management programs for… more
- Molina Healthcare (Reno, NV)
- …services professionals in some or all of the following functions: care management , utilization management , behavioral health, care transitions, long-term ... of one or more of the following activities: care review, care management , utilization management (prior authorizations, inpatient/outpatient medical… more
- HCA Healthcare (Austin, TX)
- … review/ management . + Consults with facility-level staff regarding delegated utilization management and disease management operations under managed ... ongoing in-service programs to facility medical staff regarding clinical resource management , appropriate documents standards, utilization and quality issues,… more
- Sharp HealthCare (San Diego, CA)
- …of the manager of in-patient care management and the Director of Utilization Management . **Required Qualifications** + 3 Years Experience in the acute ... Facility/Regional - SCMG Operations meetings and task forces.Facilitate regional Utilization Management committees and other working regional… more
- CVS Health (Columbus, OH)
- …care pharmacy Active, unrestricted pharmacist licensure Demonstrated understanding of utilization management and formulary administration within the managed ... This includes benefit set-up, claims processing, contractual oversight, formulary management and updates, medication utilization review, prior authorization… more
- WMCHealth (Valhalla, NY)
- …+ Works with leadership team to support clinical documentation integrity and utilization management at the Medical Center. Qualifications / Requirements: + ... Officer Company: Westchester Medical Center City/State: Valhalla, NY Category: Executive/ Management Department: President & CEO'S Office Union: No Position: Full… more
- Albany Medical Center (Albany, NY)
- …works proactively with the Quality Improvement Teams, patient care standards, and utilization management to coordinate the appropriate use of resources to ... in an assigned service - required + Recent experience in case management , utilization management and/or discharge planning/home care in a high volume,… more
- The County of Los Angeles (Los Angeles, CA)
- …used to fill a vacancy in Department of Health Services, Harbor-UCLA Medical Center, Utilization Management Division. May also be used to fill other vacancies ... + Additional experience in clinical nursing. + Supervisory** experience in Utilization Review and/or Case Management . SPECIAL REQUIREMENT INFORMATION:… more