- Marshfield Clinic (Eau Claire, WI)
- …**Minimum Required:** One year of healthcare experience. **Preferred/Optional:** Discharge Planning, Utilization Review or Case Management experience in ... as a resource to the care team with regards to discharge planning and provides review of medical utilization to third party payers to obtain certification for… more
- CenterWell (Atlanta, GA)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... the utilization of Performance Improvement principles. + Responsible for review of the appropriate number of Case Managers and clinical staff documentation… more
- University of Rochester (Rochester, NY)
- …Serves as the primary internal contact for national and state registry data management questions, issues or concerns, but not limited to clinical data collection, ... validation, delivery, reconciliation, and data management activity timeliness. Concurrently and retrospectively reviews medical records and data to identify patient… more
- CareFirst (Baltimore, MD)
- …related experience working in Care Management , Discharge Coordination, Home Health, Utilization Review , Disease Management or other direct patient care ... **PURPOSE:** This position will support the Maryland government programs care management team, specifically the Medicare Advantage line of business. The Care… more
- Covenant Health Inc. (Morristown, TN)
- Overview Mgr. Quality and Care Management , Quality Management Full Time, 80 Hours Per Pay Period, Day Shift Some local travel required. Flexibility for some late ... Excellence, women can have their annual mammograms, biopsies, and can meet with a nurse navigator if needed. The Women's Center offers six newly remodeled labor and… more
- YesCare Corp (Philadelphia, PA)
- …Engage in all quality improvement initiatives, including sentinel event reviews. + ** Utilization Review :** Participate actively in utilization review ... requested. + Participate in quality care reviews and sponsor physician assistants or nurse practitioners as needed. + **Schedule Management :** Notify the Site… more
- Molina Healthcare (Bronx, NY)
- …and cost-effective member care. Essential Job Duties * Performs audits in utilization management , care management , member assessment, behavioral health, ... care experience, with at least 1 year experience in utilization management , care management , and/or...equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in… more
- HCA Healthcare (Overland Park, KS)
- …to Patient in Bed by facility by floor to identify opportunities + Assesses utilization of Bed Management technology for optimal use + Analyzes all aspects ... key role in division and facility Emergency Department and Bed Management process improvement projects by performing operational assessments and analyses,… more
- HCA Healthcare (Salem, VA)
- …and physicians. Coaches and manages staff performance. Uses the Performance Management Plan (PMP) process to communicate, educate, and set performance expectations. ... annual strategic plans, Professional Practice Model, Shared Governance bylaws, Nurse Residency Program, educational programs, clinical ladder, and essential Nursing… more
- Alameda Health System (San Leandro, CA)
- …preferred. Minimum Experience: Two years related in acute care facility and/or utilization review training. Minimum Experience: Varied clinical experience or ... Management issues; other issues including concerns involving under/over utilization , avoidable days and quality issues. Coordinate daily with interdisciplinary… more