- St. Luke's University Health Network (Easton, PA)
- …, including but not limited to: Social workers, assistants, coordinators, utilization management staff, and director. + Facilitates communication among ... BSN required or obtained within 3 years of hire, MSN and/or Case Management Certification preferred. TRAINING AND EXPERIENCE: Preference is for at least two years… more
- University of Rochester (Rochester, NY)
- …Medicare and other payer regulations for the coordination of benefits. + Notifies Utilization Management of clinical requests by third party payers. + Maintains ... considerations._ **Responsibilities:** GENERAL PURPOSE Manages and provides financial account management for all urgent, emergent, and pre-admission visits with a… more
- The Cigna Group (Bloomfield, CT)
- …Trend Consultation and Execution + Holistic clinical solution opportunities + Formulary, Utilization Management , and Rebate opportunities + Support of the above ... with a focus in clinical strategy within client account management and as a core member of our HPD...program prepares the resident for success in a client management role post-residency within our HPD team. **As a… more
- Penn Medicine (Princeton, NJ)
- …Effective and timely completion of documentation as well as coordination with utilization management reviewer. + Performance Improvement + Participate in ... treatment, treatment plan implementation and coordination, discharge planning, and case management with social service support systems, schools and other relevant… more
- Ochsner Health (New Orleans, LA)
- …Preferred - 3 years of hospital-based experience in discharge planning, case management or utilization review. **Certifications** Required - Current registered ... a patient's hospitalization, which includes a review of the appropriate utilization of resources, balanced with the patient's right to self-determination. Reviews… more
- Texas Health Resources (Dallas, TX)
- …available resources. Assesses patient information utilizing psychological and medical knowledge. Utilization Review and Management * Performs effective ... Preferred * Three years' clinical experience required. * One year of hospital case management experience is preferred. * RN - Registered Nurse Upon Hire Req or LMSW… more
- Cleveland-Cliffs Inc. (Butler, PA)
- …bring a data-driven mindset to support strategic decision-making around labor utilization , overtime management , and performance-based compensation. Summary of ... Responsibilities + Analyze workforce data to identify trends in labor utilization , overtime, absenteeism, and productivity. + Develop and maintain labor standards,… more
- Humana (Columbia, SC)
- …provisioning + EPIC analyst certification/accreditations as they related to business functions ( utilization management , care management , etc ) + Previous ... OR A Bachelor's degree - Areas of consideration are: Product Management , Health Informatics, Business, Computer Science, Engineering, or related + Strategic… more
- Humana (Miramar, FL)
- …referral source and provider interactions and communications. Work with Pre-Authorization, Utilization Management , Billing, Pharmacy, Home Care and DME regarding ... The Pre-Service Coordinator is responsible for all aspects of referral management and accurately process incoming requests for homecare, DME/supplies and… more
- Baylor Scott & White Health (Temple, TX)
- …FACTORS** Strong leadership, decision making and delegation skills. Knowledge of care management , resource and utilization management . Skilled in care ... management and patient assessments. Excellent verbal and written communication skills required. Must be able to interact comfortably with physicians, nurses, clinical staff, patients, families and community agency representatives. Ability to monitor,… more
Recent Jobs
-
Associate Director, Global Regulatory Affairs - GI & Inflammation
- Takeda Pharmaceuticals (Boston, MA)