- Select Medical (Lake Worth, FL)
- … 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
- Highmark Health (Harrisburg, PA)
- …Nursing **EXPERIENCE** **Required** + 7 years in any combination of clinical, case/ utilization management and/or disease/condition management experience, or ... within the first 6 months of employment. **Preferred** + Certification in utilization management or a related field + Certification in Case Management … more
- CommonSpirit Health (Phoenix, AZ)
- …strategy, ensuring bidirectional communication and shared accountability. **Test Stewardship & Utilization Management ** * Direct the design and implementation of ... stewardship, clinical standardization, integration of emerging diagnostics, and improved utilization of lab services to support safe, effective, and cost-conscious… more
- Trinity Health (Fresno, CA)
- …the acute care continuum for CVHP members. This includes discharge planning, utilization management , care coordination, and support for resource utilization ... an interdisciplinary team to improve patient care through the effective utilization of the facility's resources. The incumbent makes significant contributions toward… more
- Evolent (Lincoln, NE)
- …public plans such as Medicaid is preferred. + Experience with value-based care, utilization management , or regulatory reporting (eg, HEDIS, NCQA, Milliman) is ... visualization, this role will collaborate cross-functionally to influence the effective utilization of data to deliver actionable insights, drive recommendations and… more
- Trinity Health (Fresno, CA)
- …populations across the acute care continuum. This includes discharge planning, utilization management , care coordination collaboration, and support for resource ... with an interdisciplinary team to improve patient care through the effective utilization of the facility's resources. 1. Current licensure as a Registered Nurse… more
- Provider Solutions & Development (Mission Hills, CA)
- …medical group management experience required + Must have working knowledge of utilization management and review essential to operations management and to ... with, motivate, and assist medical staff leadership to adhere to utilization management , clinical documentation, and other legal/regulatory requirements +… more
- Community Based Care of Brevard, Inc. (Brevard, FL)
- …Position Summary: This position is responsible for the clinical coordination, utilization management , and authorization of initial and ongoing services ... ensuring the most efficient and effective use of agency resources. Utilization Management - Essential Function: Ensure that services authorized are clinically… more
- Houston Methodist (The Woodlands, TX)
- …state, local and federal programs + Comprehensive knowledge of discharge planning, utilization management , case management , performance improvement and ... position is a licensed registered nurse (RN) who comprehensively plans for case management of a target patient population on a designated unit(s). This position… more
- Bon Secours Mercy Health (Toledo, OH)
- …medical education, electronic health records, and clinical research. Support of quality management , utilization management , risk management , infection ... senior leadership team. Provides leadership and advisement in quality, case management , clinical research and clinical IT structures. Physician executive leadership… more