- BayCare Health System (Riverview, FL)
- …The Site Manager II is responsible for: In a complex practice, oversees the utilization management and daily business operations of the physician practice at the ... + Responsible for patient access to services, insurance contract verification, utilization management , charge entry, collections, clinical support management… more
- Penn Medicine (Philadelphia, PA)
- …hospice, community resources, transportation, and quality data collection and risk management referral. Responsibilities: + Utilization management ... community resources + Participates and drives accountability in daily interdisciplinary meetings Utilization Management : + Adheres to guidelines to satisfy 3rd… more
- Humana (Carson City, NV)
- …interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , discharge ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a… more
- CareFirst (Washington, DC)
- …home or other levels of care. Utilizing experience and skills in both care management and utilization management , the Onsite Clinical Navigator will leverage ... experience. **Experience:** 5 years clinically related experience working in Care Management , Home Health, Discharge Coordination and/or Utilization Review.… more
- MTC (Raymondville, TX)
- …Monitor all potential catastrophic illnesses. 9. Implement basic cost containment and utilization management for patient care and facility operations. 10. Comply ... (EAP)** + **Paid Time Off (PTO)** + **Paid Holidays** **Impact lives with Management & Training Corporation (MTC) at the El Valle Detention Facility in Raymondville,… more
- Highmark Health (Frankfort, KY)
- …supporting, and optimizing the architectural strategy for **all clinical and utilization management applications** . Their expertise spans application, solution, ... and AI integration, extending this strategic oversight across **all clinical and utilization management applications** . This involves ensuring the completeness… more
- Beth Israel Lahey Health (Needham, MA)
- …practice model. **Job Description:** **Essential Responsibilities:** 1. Performs utilization management , care coordination, and discharge planning ... presenting symptoms, clinical status and treatment. 3. Utilizes the case management process of assessment, planning, implementation and evaluation to create case… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …bilingual Spanish speaker * 1+ years of managed care experience; eg case management /health coach, utilization management and/or auditing experience. * ... across the continuum of care by leveraging member partnership, pre-service clinical utilization review, case and disease management processes, skill sets and… more
- UCLA Health (Los Angeles, CA)
- …Licensure) Experience, Skills and Abilities: * Five years of hospital utilization management experience, with demonstrated success in quality improvement ... management , care variation management , patient flow/throughput management , ancillary services utilization and clinical documentation improvement. The… more
- ABM Industries (Washington, DC)
- …ABM's Quality Control software, ensuring the effective oversight of space utilization , asset management , maintenance, and data-driven decision-making. The CMMS ... allocation across the university's extensive infrastructure. **Key Responsibilities:** **Space Management :** + Plan and optimize space utilization , including… more