- University of Southern California (Los Angeles, CA)
- …patient populations. The RN case manager role integrates the functions of utilization management , quality management , discharge planning assessment, and ... * Completes disposition form for medicare patients timely. + Consultant * Demonstrates sound clinical knowledge base....+ Pref Bachelor's degree + Pref 1 year Case management or utilization review experience within the… more
- Virginia Mason Franciscan Health (Tacoma, WA)
- …Advisor will conduct clinical reviews on cases referred by case/ utilization management and/or other healthcare professionals in accordance with Hospital ... objectives related to quality care of patients, regulatory compliance, and utilization management (including LOS). 4. The Physician Advisor should discuss… more
- Northwell Health (New York, NY)
- …or throughout the entire continuum of health care delivery. Performs resource management , utilization management , discharge planning, care facilitation, ... of the interdisciplinary health care team. Acts as a clinical resource/ consultant /educator to all staff in the...patient, family and interdisciplinary health care team to achieve clinical pathway and case management goals and… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …benefits and State and Federal Mandates and maintains current and working knowledge of Utilization Management Standards. + Clinical skills are excellent and ... area including, but not limited to, Medical and Pharmacy Utilization Management , quality management , member...at first level, appeal and inquiries. + Conducts peer-to-peer clinical reviews with attending physicians or other providers to… more
- HCA Healthcare (Austin, TX)
- …in-service programs to facility medical staff regarding clinical resource management , appropriate documents standards, utilization and quality issues, and ... management . + Consults with facility-level staff regarding delegated utilization management and disease management ...requirements associated with these functions. + Serves as a clinical resource and consultant to hospital case… more
- CommonSpirit Health (Englewood, CO)
- …and Responsibilities** **This is a remote position** As the Utilization Management Physician Advisor (PA), the PA conducts clinical case reviews referred ... and options/alternatives for care. The PA acts as a consultant to, and resource for, attending physicians regarding their...Management Teams: Makes telephonic/electronic contacts with case and utilization management to discuss clinical … more
- Nuvance Health (Danbury, CT)
- …of hospitalization, LOC status, LOS management , continued stay decisions, clinical review of patients, utilization review activities, resource utilization ... , quality, and administrative facets of the healthcare industry. * Strong clinical acumen; Knowledge of Care Management / Utilization Review principles,… more
- NHS Management, LLC (Tuscaloosa, AL)
- …of Nursing, Regional Administrator, Director of Medicare and Rehabilitation and MDS/ Clinical Information Consultant . + Conducts audits to ensure accurate ... Director of Nursing, Regional Administrator, Director of Medicare and Rehabilitation, and MDS/ Clinical Information Consultant . + Conducts an observation of the… more
- Immigration and Customs Enforcement (Los Fresnos, TX)
- …Behavioral Health Unit (BHU). The incumbent will report directly to the Clinical Director (CD) and/or Regional Behavioral Health Consultant . The Supervisory ... under the general supervision of the Clinical Director and receives Clinical supervision from the Regional Behavioral Health Consultant . Assignments are… more
- University of Southern California (Alhambra, CA)
- …Nursing + Req 5 years Clinical experience + Req 2 years Ambulatory case management or utilization review experience within the last three years + Req Ability ... populations. The role integrates the functions of complex case management , utilization management , quality ...12. Completes disposition form for medicare patients timely. + Consultant 1. Demonstrates sound clinical knowledge base… more