- Trinity Health (Syracuse, NY)
- …in terms of quality, safety, service, affordability, and technology. Oversees drug utilization management efforts; manages the pharmaceutical supply chain; and ... including new services/programs, revenue enhancement, expense reduction, managed care utilization systems, and strategies. Responsible for ensuring performance excellence… more
- HCA Healthcare (Gainesville, FL)
- …with physicians, patients, families, hospital staff, and outside agencies + Performs utilization management reviews and communicates information to third party ... is preferred + BSN is preferred + Certification in Case Management , Nursing or Utilization Review is preferred HCA Florida North Florida Hospital is a 523-bed,… more
- Cedars-Sinai (Los Angeles, CA)
- …the Foundation, including patient assignment, risk and specialty network structures, and utilization management . Functions as key resource for staff and ... and managing of assigned areas. Works closely with leadership and physician management in the centralized infrastructure development and operations for a specific… more
- Oshkosh Corporation (Roy, UT)
- …operations, and service provider networks. + Experience with dispatching, technician utilization management , service quality measures, VOC feedback, and KPI ... including on-site assistance, troubleshooting, and issue escalation. **Warranty Program Management ** + Administer and oversee warranty programs for all Jetway… more
- CVS Health (Hartford, CT)
- …including but not limited to, various IFP & Medicare Advantage claim policies and Utilization Management . **The Subject Matter Expert will make an impact by:** + ... HRP experience + Claims adjudication background + Knowledge of MedCompass and Utilization Management Configuration. + Knowledge of Medicare Advantage and/or IFP… more
- Summit Medical Consultants LLC (Pueblo, CO)
- …and actively participates in medical staff duties. Participates in quality assurance, utilization management , and peer review programs to ensure high quality, ... Supports practice budgetary targets while maintaining standards of care. Participates in utilization and care management processes to ensure high quality,… more
- Healthfirst (NY)
- **Duties/Responsibilities:** Provide strategic oversight and operational management for all utilization management functions, including prior authorization, ... for audits, performance improvement plans, and corrective actions related to utilization management Foster a culture of accountability, professional development,… more
- Catholic Health Services (Smithtown, NY)
- …patients across the acute care continuum. + Performs required activities for utilization management , PRI assessment and completion, transition planning, and ... clinical medical/surgical or specialty experience required. + 2-3 years' Utilization Management , Performance Improvement, Transition Planning and/or Care… more
- Henry Ford Health System (Troy, MI)
- …Administration Manual policies and the Master Tiering Database, requests by the Utilization Management Committee and HAP code-related committees, and other ... Team (BCT) and work with BCT on coding changes approved by the Utilization Management Committee or leadership. + Work with the Medical Policy Team on… more
- Molina Healthcare (TX)
- …reports submitted to the Eastern US Quality Improvement Collaborative (EQIC) and/or utilization management committees. + Participates as needed in joint ... proficient, self-directed, autonomous and experience working from home. Care Management & Waiver Service Auditing experience is highly preferred. Work… more
Recent Jobs
-
Factory Applications Engineer (Teradyne, North Reading)
- Teradyne (North Reading, MA)
-
Business Development Manager
- GardaWorld (Charlotte, NC)