- Dignity Health (Gilbert, AZ)
- …emphasis will be on care coordination, communication and collaboration with utilization management , nursing, physicians, ancillary departments, insurers and post ... skills + Collaborate effectively with multiple stakeholders + Understand how utilization management and case management programs integrate + Ability to… more
- Dignity Health (Phoenix, AZ)
- …emphasis will be on care coordination, communication and collaboration with utilization management , nursing, physicians, ancillary departments, insurers and post ... skills. + Collaborate effectively with multiple stakeholders + Understand how utilization management and case management programs integrate. + Ability to… more
- CVS Health (Phoenix, AZ)
- …plan medical directors. + Attends and participates in clinical meetings with care management and utilization management . Provides subject matter expertise on ... direction of the Lead Director, Service Operations, this position will focus on utilization , quality and fraud waste and abuse review for individual cases for… more
- Ascension Health (Jacksonville, FL)
- …of recent work experience in a hospital setting, preferably with some Physician Advisory/ Utilization Management work experience. If you are ready to join a ... **Details** + **Specialty** : Case Management + **Subspecialty:** Physician Advisor + **Schedule** : Full Time | Hybrid (frequently on site) + **Call Schedule:** No… more
- Centene Corporation (Austin, TX)
- …strategic and clinical leadership for Behavioral Health across all clinical functions ( Utilization Management , Care Management , Quality, and Clinical ... for the product. + Take a macro-level view of behavioral health utilization management responsibilities to optimize clinical resource allocation and improve… more
- Geisinger (Lewistown, PA)
- …and efficiency results for assigned population. + Works to appropriately apply benefits and utilization management serving as a resource to the patient or member ... have prior RN experience in a hospital setting. Case Management experience is preferred and not required. The successful...of optimizing the patient or member's health status. Manages utilization and practice metrics to further refine the delivery… more
- Elevance Health (Viroqua, WI)
- …associates, and may be involved in process improvement initiatives. + Submits utilization /authorization requests to utilization management with documentation ... integrated care plan, engaging the member's circle of support and overall management of the individuals physical health (PH)/behavioral health (BH)/LTSS needs, as… more
- Danaher Corporation (Houston, TX)
- …includes some of the following: infection detection/control, sepsis care, decision support, utilization management , case management , ED patient workflow, ... leaders from nursing, emergency medicine, pharmacy, quality, patient safety, risk management , IT, infection control, laboratory, and administration is required. This… more
- UnityPoint Health (Des Moines, IA)
- …agencies and payers to plan and execute a safe discharge + Collaborate with Utilization Management team on continued stay review. + Collaborates with patients, ... continuity through elimination of fragmentation of care/service and facilitates the effective utilization of resources. Serves as educator and a central source of… more
- St. Luke's University Health Network (Bethlehem, PA)
- …, including but not limited to: RN care managers, assistants, coordinators, utilization management staff, and director. + Facilitates communication among all ... discharge interventions accordingly. + Actively addresses and monitors resource utilization and documents delays as appropriate. + Identifies patients with… more