- Highland Hospital (Rochester, NY)
- …benefits, identifies and resolves coordination of benefits discrepancies, and notifies Utilization Management of additional clinical requests **Salary Range:** ... for out-of-network payers, refers our self-pay patients to Financial Case Management (FCM) for Medicaid assessment or Financial Assistance, reviews and validates… more
- Louisiana Department of State Civil Service (Houma, LA)
- …issues impacting care in a succinct and timely manner. + Consistently meets Utilization Management and billable services expectations + Maintain knowledge of ... medical care issues to appropriate sources + Responsible for patient management with a multidisciplinary team consisting of other clinical and nursing… more
- UTMB Health (Galveston, TX)
- …and accurate information to payers. The role integrates and coordinates utilization management , care coordination and discharge planning functions. **Equal ... Manager TDCJ **Galveston, Texas, United States** **Hot** Nursing & Care Management UTMB Health Requisition # 2504032 **Minimum Qualifications:** RN with Bachelor's… more
- Beth Israel Lahey Health (Beverly, MA)
- …Responsible for the overall operation of care transitions discharge planning and/or utilization management departments through oversight of daily and long-term ... and external stakeholders in clinical care coordination and outcomes management processes. Participates, leads and coordinates multidisciplinary teams/committees supporting… more
- Pacific Medical Centers (Seattle, WA)
- …dictionary entries, and plan benefits and exclusions. Assists with health plan utilization management reporting for the organization. Responsible for ensuring ... Department of Defense and its contractors. Provides support for the quality management program. Providence caregivers are not simply valued - they're invaluable.… more
- Veterans Affairs, Veterans Health Administration (Glendale, CO)
- …knowledge of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation requirements, community care ... position responsibilities that demonstrate leadership, experience and creative approaches to management of complex client care beyond the immediate practice setting.… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …Active clinical practice in order to participate in panel appeals + Experience in Utilization Management in a managed-care environment (as a clinician or in ... in process to evaluate clinical service requests + Practice anticipatory case management for members whose cases come for review, in partnership with case… more
- CommonSpirit Health (Lakewood, CO)
- …emphasis will be on care coordination, communication and collaboration with utilization management , nursing, physicians, ancillary departments, insurers and post ... two (2) years of acute hospital clinical experience or a Master's degree in Case Management or Nursing field in lieu of acute experience. + At least five years of… more
- Molina Healthcare (Cincinnati, OH)
- …supports + Work closely with a team of Care Coordination, Population Health and Utilization management SMEs and leaders + Assist with SharePoint review, ... ethic, self-motivated and ability to develop relationships + Good time management , organizational and interpersonal skills required + Computer experience including… more
- Queen's Health System (Ewa Beach, HI)
- …to, initiation and development of the plan of care, patient/family education, utilization management and discharge planning. II. TYPICAL PHYSICAL DEMANDS ... and Family Treatment Center includes occasionally accompanying patients outdoors. Management of confused/disoriented and combative patients may involve tasks which… more
Recent Jobs
-
Aircraft Mechanic F-35 Avionics - Level 4
- Lockheed Martin (Fort Smith, AR)
-
Cyber Governance and Resilience Manager
- Regions Bank (Hoover, AL)