- US Tech Solutions (MI)
- …and/or interpretation of applicable criteria and guidelines, standardized case management plans, policies, procedures, and regulatory standards while assessing ... members needs to ensure appropriate administration of benefits + Utilizes case management and quality management processes in compliance with regulatory and… more
- Diversicare Healthcare Services & Diversicare Ther (Bryson City, NC)
- …**Qualifications** 1. Degree in nursing. 2. Knowledge of healthcare reimbursement, utilization management , and discharge planning. 3. Experience providing ... 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
- Fresenius Medical Center (Raleigh, NC)
- …Quality, and Technical Services departments. + Collaborates with or functions as the Home Therapies Program Manager to oversee the facility's Home Therapies ... Classification of Disease (ICD) coding. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review. +… more
- WellSpan Health (Chambersburg, PA)
- …**Essential Functions:** + Reviews assigned patients for medical necessity, utilization management , and appropriateness of setting for continued ... quality and cost of care efforts. + Liaisons between utilization management team, third party payers, and...develops a discharge plan, and coordinates discharge needs (DME, Home Health, IV antibiotics, etc.) in collaboration with patients,… more
- CenterWell (Marietta, GA)
- …+ Two years as a Registered Nurse with at least one-year of management experience in a home care, hospice or equivalent environment. + Home ... At a minimum, home care experience is required. + Management and people leadership experience, preferred. + OASIS experience, preferred. OASIS certification… more
- CenterWell (Orlando, FL)
- …+ Two years as a Registered Nurse with at least one-year of management experience in a home care, preferred **Scheduled Weekly Hours** 40 **Pay Range** ... driver's license, auto insurance and reliable transportation. + OASIS experience required + Management experience required + Home Health experience required… more
- Tufts Medicine (Lowell, MA)
- …services. Ensures compliance and consistency with agency policy, State and federal home health regulations. Responsible for the management of cost effective, ... + Provide effective guidance to professional staff regarding: justification for appropriate home health service utilization in terms of frequency, duration, and… more
- Tenet Healthcare (Detroit, MI)
- …national standards for case management scope of services including: * Utilization Management supporting medical necessity and denial prevention * Transition ... insurance, long term care, elder & childcare, auto & home insurance. Note: Eligibility for benefits may vary by...b) leads the implementation and oversight of the hospital Utilization Management Plan using data to drive… more
- University of Rochester (Brighton, NY)
- … services to patients of the Strong Memorial Hospital, Health, and Health Home Care Management Program. Collaborates with health, behavioral health and social ... most complex, high utilizing patients that need comprehensive care management services. Health Home core services include,...upon as needed + Document plan of care, patient utilization , care management activities and other required… more
- CenterWell (Raleigh, NC)
- …minimum of 2 years of experience as a Registered Nurse (RN). + Home health experience is required. + Management and people leadership experience is ... community and help us put health first** Reports To: Director, Area Home Health Branch Administration FLSA: Exempt **Work Schedule** : Full-time/32-40 Hours/Weekend… more