- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …, and business case consultant for leadership as they relate to case/disease/ utilization management . * Coordinates the development, revision and implementation ... within insurance or health care setting in case/disease or utilization management * Bachelor's or Master's degree...discover more about what we have to offer, please review our benefits page. Role Designation Hybrid Anchored in… more
- Select Medical (Madison, WI)
- …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
- 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
- ERP International (Nellis AFB, NV)
- …* Knowledge of managed care principles, military and civilian population healthcare, case management , utilization management , and demand management ... the last 24 months o Experience in case management , condition management , discharge planning, utilization management , Telehealth, and performance… more
- Northern Light Health (Bangor, ME)
- …health care delivery to achieve optimal quality and financial outcomes. * Provides ongoing utilization review of primary care patients. Review for over ... in a fiscally responsible way. * Works to promote cost containment through utilization management * Collaborate effectively with physicians and managed care… more
- UNC Health Care (Rocky Mount, NC)
- … discharge planning priorities. 2. Assist in Facilitating Discharge Planning. 3. Assist in Utilization Management Process. 4. Complete FL2 for Long Term Care and ... of Status Notice, assisting in facilitating discharge planning, and assisting in utilization management processes. 7. Performs other duties as needed. Other… more
- PeaceHealth (Bellingham, WA)
- …home health or hospice experience may be considered and + Preferred: Utilization management /quality management experience **Credentials** + Required: ... information needed to justify continued hospitalization. Maintains any applicable care management databases. + Performs concurrent review to determine correct… more
- Pacific Medical Centers (Renton, WA)
- …The Supervisor Care Management RN is responsible for the supervision of case management (CM) and utilization management (UM) functions of US Family ... and processed in a timely manner. It includes timely review of medical necessity and authorization for all admitted...USFHP Medical Director(s) to develop and implement strategic case management and utilization management yearly… more
- Cleveland Clinic (Port Saint Lucie, FL)
- …A caregiver in this role utilizes clinical expertise and understanding of utilization review requirements, discharge planning process, and Medicare regulations ... in the development of department practices and procedures for utilization review and discharge planning, ensuring compliance...state of employment. + 3 years of experience in utilization management , case management , or… more
- HonorHealth (AZ)
- …coding accuracy and optimal reimbursement. + Attends JOC as requested by Utilization Management or Managed Care: Works with Director, Management ... a consultant or participant as needed: Care conferences Process improvement committees Utilization management LOS joint committees Resource Utilization … more
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