- Nuvance Health (Danbury, CT)
- …patient-centric vision and strategy for system-wide care coordination, encompassing utilization review (UR), denials management , discharge planning, social ... * Minimum of 5 years of progressive leadership experience in case management or utilization review * Proven leadership experience with a track record of success… more
- Rochester Regional Health (Rochester, NY)
- …efficient utilization of resources. Carries out activities related to utilization management , discharge planning, care coordination and referral to other ... York State as a Registered Nurse PREFERRED QUALIFICATIONS: + Case Management or Utilization Management experience + Bachelor's Degree EDUCATION: LICENSES /… more
- Ventura County (Ventura, CA)
- …Inpatient Psychiatric unit of the Ventura County Medical Center including utilization management , transfer coordination, discharge planning, and securing ... planning, evaluation, and review; + Performs daily clinical reviews to support utilization and quality management , ensuring compliance with guidelines and… more
- Magellan Health Services (Shreveport, LA)
- …Strong organization, time management and communication skills. Knowledge of utilization management procedures, mental health and substance abuse community ... collaboration with other members of the clinical team, authorizes and reviews utilization of mental health and substance abuse services provided in inpatient and/or… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …+ Design and implement provider journey optimization covering: onboarding, network management , utilization management interaction, claims processing, quality ... and technology domains. **What You'll Lead** **Strategic Initiative Portfolio Management ** + Own end-to-end execution of 5-8 enterprise transformation initiatives… more
- Molina Healthcare (Albuquerque, NM)
- …healthcare services professionals, in some or all of the following functions: utilization management , care management , care transitions, behavioral health, ... or more of the following key health care services (HCS) functions: care management , care transitions, utilization management , behavioral health and/or nurse… more
- HCA Healthcare (Nashville, TN)
- …+ Lead the development and implementation of enterprise-wide product standardization, utilization management , and supply chain clinical integration strategies. + ... standards and industry leading practices in product selection, procurement, and utilization . **Execution & Performance Management ** + Lead complex,… more
- Select Medical (Wilmington, DE)
- … within the plan of care. + Demonstrates compliance with facility-wide Utilization Management policies and procedures. + Coordinates UR compliance with ... what is right. The Case Manager is responsible for utilization reviews and resource management , discharge planning, treatment plan management and financial… more
- University of Rochester (Rochester, NY)
- …discharge. Identifies problems that include but are not limited to pre-certifications, Utilization Management , Medicaid Pending, third party payer issues, and ... communication and follow-up with assigned area, Financial Assistance, Social Work, Utilization Management , Medicaid Enrollment & Outreach, patients, families,… more
- UPMC (Delmont, PA)
- …of health insurance experience required. + 1 year of experience in clinical, utilization management , home care, discharge planning, and/or case management ... by the interdisciplinary team summarizing clinical and social history, healthcare resource utilization , case management interventions. Update the plan of care… more