- Diversicare Healthcare Services & Diversicare Ther (Hoover, AL)
- …current license in respective field. 2. Knowledge of healthcare reimbursement, utilization management , and discharge planning. 3. Experience providing strategic ... in and facilitate Engage/72 HR Admission meetings as part of the care management system. + Manage the restorative nursing program, integrating it with the activity… more
- State of Connecticut, Department of Administrative Services (Bridgeport, CT)
- …Connecticut. Admissions to the psychiatric units are coordinated through a statewide Utilization Management process coordinated by the Office of the ... for independently performing the full range of paraprofessional functions in case management and crisis intervention services. EXAMPLES OF DUTIES + Participates in… more
- Veterans Affairs, Veterans Health Administration (San Antonio, TX)
- …similar role or with population served -Clinical supervision certification -Quality or utilization management experience -Former VA Trainee -Licensed to practice ... care coordination, direct clinical services, and chronic disease case management . Responsibilities VA Careers - Social Work: https://youtube.com/embed/enRhz\_ua\_UU Total… more
- AmeriHealth Caritas (Philadelphia, PA)
- …the PCC supports daily functions of the Personal Service Program, Integrated Care Management , and Utilization Management initiatives. This role involves ... it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other… more
- Veterans Affairs, Veterans Health Administration (San Antonio, TX)
- …similar role or with population served. Clinical supervision certification. Quality or utilization management experience. Former VA Trainee Reference: For more ... Independently identifies high-risk patients and provides clinical or case management services as warranted. Follows STVHCS standard operating procedures for… more
- BAYADA Home Health Care (Morristown, NJ)
- …+ Management and mentoring of Clinical Associates and field staff + Utilization Management + Developing and mentoring staff to become strong case managers ... Associate include: + A current New Jersey RN license. + Strong management and leadership experience. + Medicare Certified Home Care experience preferred, but… more
- BJC HealthCare (St. Louis, MO)
- …of Patient Care Services. The CM Service is comprised of three departments: Case Management , Utilization Management , and Social Work. Through the Triad Model ... the Emergency Department, Outpatient Clinics, Registration sites, and Health Information Management . The Service employs registered nurses, social workers, a license… more
- Cherry Bekaert (Chicago, IL)
- …to include facilitation of training, periodic meetings and other oversight. + Utilization management of staff. Service Excellence: + Promote innovative solutions ... the growth of the practice. Key Responsibilities: Client Engagement Management : + Lead and manage client engagements, both monthly...and a strategic mindset. + Proficiency in using financial management software and tools. + Ability to adapt to… more
- Elevance Health (Columbus, OH)
- …**Preferred Skills, Capabilities and Experiences** : + AS or BS in Nursing. + Utilization Management , medical management , or appeals experience. + Leadership ... or management experience. + Medicare experience. For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $66,640 to $99,960 Locations: Columbus, OH, In addition to your salary, Elevance Health… more
- Actalent (Eagan, MN)
- …Your main role will be utilizing your clinical skills to complete utilization management reviews (Prior authorizations, Coverage Exceptions, Quantity Limit ... months for extension. Skills Pharmacist, Retail, Clinical, Pharmacy Benefits Management , Pharmacy, Prior authorization, Pharmd, Compounding Top Skills Details… more
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