- CVS Health (Oklahoma City, OK)
- …and timely discharge, appropriate follow-up care, and next steps. + Coordinate with the Utilization Management team to review medical and payer records to ensure ... stay and identify any barriers to discharge. + Assist Utilization Management team with access to external...+ Bilingual (English/Spanish) **Education** + Minimum Associates degree in Nursing or BH license + BSN preferred **Anticipated Weekly… more
- Blue KC (MO)
- …clinical initiatives by providing direction to physicians and other providers, Provides utilization management for medical, surgical and pharmacy activity. + ... the form of Peer-to-Peers, and close collaboration with the nursing team. + Able to review at overall data...updates. + Serves as expert/resource on appeals related to utilization management issues. + Provides medical leadership… more
- AdventHealth (Orlando, FL)
- …or Social Worker: BSW Masters in related field 3 years in direct Care Management / Utilization Management experience in an acute care setting **Preferred ... Debt-free Education (Certifications and Degrees without out-of-pocket tuition expense) + Nursing Clinical Ladder Program **Our promise to you:** Joining AdventHealth… more
- Actalent (Santa Barbara, CA)
- …Registered Nurse assigned to various Health Services operational units, including Utilization Management , Case Management , Enhanced Care Management , ... Child Model, and Population Health programs. The role involves performing utilization management activities, care coordination, or population health activities… more
- AdventHealth (Palm Coast, FL)
- …+ Social Worker: BSW Masters in related field + 3 years in direct Care Management / Utilization Management experience in an acute care setting. + State ... Palm Coast, 32164 **The role you'll contribute:** The Care Management Manager is under the general leadership of the...specific RN license if a nurse . **Preferred qualification:** + Registered Nurse : BSN… more
- AdventHealth (Orlando, FL)
- …(manager level or above) in addition to 5 years of direct Care Management / Utilization Management experience and increasing leadership responsibility + RN-BC ... Rollins St, Orlando, FL 32803 **The role you'll contribute:** The Care Management Facility Director has full accountability and oversight for the overall operations… more
- AdventHealth (Daytona Beach, FL)
- …(manager level or above) in addition to 5 years of direct Care Management / Utilization Management experience and increasing leadership responsibility + RN-BC ... MEDICAL PKWY, Daytona Beach, 32117 **The role you'll contribute:** The Care Management Facility Director has full accountability and oversight for the overall… more
- Ivyhill Technologies LLC (Bethesda, MD)
- …an Associate's Degree and a minimum of 2 years of experience in Utilization Management , Referral Management , Authorization/Denials, or Medical Claims ... Team Ivyhill is currently seeking to hire Referral Management (Non- Nurse ) Reviewers to support its contract with the Integrated Referral Management and… more
- Sharp HealthCare (San Diego, CA)
- …of the manager of in-patient care management and the Director of Utilization Management . **Required Qualifications** + 3 Years Experience in the acute ... Facility/Regional - SCMG Operations meetings and task forces.Facilitate regional Utilization Management committees and other working regional… more
- AdventHealth (Tampa, FL)
- …or Social Worker: BSW Masters in related field. 3 years in direct Care Management / Utilization Management experience in an acute care setting. State specific ... Primary Stroke Center. **The role you'll contribute:** The Care Management Manager is under the general leadership of the...RN license if a nurse . This facility is an equal opportunity employer and… more