- University of Southern California (Arcadia, CA)
- …timely and accurate information to payers. The role integrates and coordinates utilization management , care facilitation, and discharge planning functions. The ... follows up to resolve problems with payers as needed. + Completes utilization management for assigned patients. + Coordinates/facilitates patient cares… more
- Logan Health (Kalispell, MT)
- …manner + Partnering with the Chief Medical Officer on utilization review initiatives, length of stay management , and patient throughput + Ensuring ... lead the way as our Manager of Clinical Documentation Integrity (CDI) & Utilization Review ! This role is ideal for a collaborative RN leader who understands the… more
- UNC Health Care (Smithfield, NC)
- …of care and cost effectiveness through the integrating and functions of case management , utilization review and discharge planning. The Care Manager ... discharge plan. Refer administrative tasks (eg, faxing, form processing) to Care Management Assistant. Consult Social Worker and/or Utilization Manager per… more
- Penn Medicine (North Brunswick, NJ)
- …of pre-certifications as well as coordination of utilization reviews with utilization management reviewer . Timely and accurate completion of UM ... treatment, treatment plan development and coordination, referent relations, discharge planning, utilization management with insurance companies, and case … more
- Penn Medicine (Hamilton, NJ)
- …of pre-certifications as well as coordination of utilization reviews with utilization management reviewer . Timely and accurate completion of UM ... treatment, treatment plan development and coordination, referent relations, discharge planning, utilization management with insurance companies, and case … more
- UCLA Health (Los Angeles, CA)
- Description At UCLA Health, the Utilization Management (UM) Review Nurse plays a vital role in ensuring the delivery of high-quality, evidence-based care. ... + A minimum of three years of experience in utilization management , preferred + Team leading or...+ Working knowledge of laws, rules, and regulations regarding utilization review and discharge planning functions of… more
- MaineGeneral Health (Augusta, ME)
- Job Summary:Provides clinical leadership and strategic support in utilization management (UM) and clinical documentation improvement (CDI), ensuring regulatory ... the individual will: + Provide clinical leadership and strategic support in utilization management (UM) and clinical documentation improvement (CDI), ensuring… more
- Evolent (Lansing, MI)
- …**What You'll Be Doing:** As a FMD, Radiology you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference ... utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality… more
- Evolent (Helena, MT)
- …Doing:** As a Field Medical Director, Oncology, you will be a key member of the utilization management team. We can offer you a meaningful way to make a ... utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality… more
- RxBenefits (Charlotte, NC)
- …channel management , B/G classifications, specialty designations, rebate eligibility, utilization trend, Utilization Management (UM) implications, ... prospect member size, marketing agreements, broker commissions, and drug utilization . + Be the SME on dozens of medical...closed won groups into a client record for Account Management (AM) and Implementation including the initial gathering of… more
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