- Banner Health (AZ)
- …pre-service requests, provide case management , care coordination and perform utilization management duties within the appropriate time period as outlined ... health Plan consumer/beneficiaries' and providers with issues related to prior authorization, utilization management , and/or case management . Meets internal… more
- Select Medical (Lake Worth, FL)
- …functions and professional growth of the department, including, but not limited to: Utilization Review (UR) and resource management , discharge planning, ... focus on resource management . + Demonstrating compliance with facility-wide Utilization Management policies and procedures. + Coordinating UR compliance with… more
- Select Medical (San Diego, CA)
- …functions and professional growth of the department, including, but not limited to: Utilization Review (UR) and resource management , discharge planning, ... focus on resource management . + Demonstrating compliance with facility-wide Utilization Management policies and procedures. + Coordinating UR compliance with… more
- ERP International (Luke AFB, AZ)
- … Management Society of America (CMSA); American Accreditation Healthcare Commission/ Utilization Review Accreditation Commission (URAC); CAMH; (AAAHC); Health ... CM software, and databases for community resources. * Integrate CM and utilization management (UM) and integrating nursing case management with social work… more
- Providence (Olympia, WA)
- …admissions. + **Physician Relations:** Build strong cooperative relationships with physicians. + ** Utilization Management Oversight:** Lead the Utilization ... setting. + **Leadership Experience:** Minimum 3 years managing care coordination. Utilization review knowledge preferred. + **Independent Leadership:** Proven… more
- Virginia Mason Franciscan Health (Burien, WA)
- …of the medical staff and take on the role as leader of the Hospital's utilization review / management committee, which is charged with adhering to regulatory ... RAC entities, or other agents as required * Participate in the utilization review / management committee, in defining operational strategic objectives for the … more
- Corewell Health (Dearborn, MI)
- …discharge planning of all hospitalized patients. + Identifies patients that need care management services (ie utilization review ; care coordination; and/or ... years of relevant experience Three to five years' experience in care management , utilization review , home care and/or discharge planning. Preferred +… more
- Houston Methodist (Sugar Land, TX)
- …Senior Denials Management Specialist position is responsible for performing utilization review activities, and monitoring the clinical denial management ... years clinical nursing/patient care experience which includes three years in utilization review , case management or equivalent revenue cycle clinical role… more
- Corewell Health (Royal Oak, MI)
- …discharge planning of all hospitalized patients. 1. Identifies patients that need care management services (ie utilization review ; care coordination; and/or ... years of relevant experience Three to five years' experience in care management , utilization review , home care and/or discharge planning. Preferred +… more
- Carle Health (Champaign, IL)
- …also expected to onboard the new providers regarding utilization and case management objectives. + Conducts medical record review in appropriate cases for ... responsible for conducting clinical case reviews referred by the Utilization Management Team, the Case Management...clinical review on cases referred by Care Management staff /Social Work (remove) Utilization … more