- Commonwealth Care Alliance (Boston, MA)
- …member experience. * Address provider inquiries related to care coordination, utilization management , and program participation, collaborating with internal ... does not have direct reports. Essential Duties & Responsibilities: Provider Relationship Management * Serve as the primary relationship manager and point of contact… more
- McLaren Health Care (Bay City, MI)
- …to D/C). 4. Identifies unsigned level of care (LOC) orders; communicates with utilization management nurse and obtains orders from providers. 5. Reviews current ... **Three years of acute hospital care experience** _Preferred:_ + Experience in utilization management /case management , critical care, or patient… more
- Provider Solutions & Development (Mission Hills, CA)
- …of medical group management experience required + Must have working knowledge of utilization management and review essential to operations management ... with, motivate, and assist medical staff leadership to adhere to utilization management , clinical documentation, and other legal/regulatory requirements +… more
- Providence (Spokane, WA)
- …care environment. Accountabilities include assessment and planning, coordination of care, resource utilization management and/ or review , discharge planning, ... National Certification in area of specialty. + 1 year experience in care management or utilization review in any setting or successful completion of TIPS… more
- Providence (Olympia, WA)
- …care environment. Accountabilities include assessment and planning, coordination of care, resource utilization management and/ or review , discharge planning, ... in area of specialty upon hire. + 1 year experience in care management or utilization review in any setting or successful completion of TIPS program… more
- Lakeview NeuroRehabilitation Center (Waterford, WI)
- …3 years broad clinical experience, predominately in a medical-surgical setting. Case Management , discharge planning, and utilization review experience ... plan for the patient. + Has overall accountability for care coordination, utilization management , and discharge planning for patients within the assigned… more
- Katmai (Fort Carson, CO)
- …providers and ancillary healthcare workers. + Apply principles of utilization review (UR) and utilization management (UM) in processing specialty ... + Review collected data to identify areas requiring intensive management . Analyze data collected and prepare reports describing resource utilization … more
- Providence (Anchorage, AK)
- …care environment. Accountabilities include assessment and planning, coordination of care, resource utilization management and/ or review , discharge planning, ... Certification in area of specialty + 1 year of experience in care management or utilization review in any setting or successful completion of TIPS program… more
- New York State Civil Service (Albany, NY)
- …mental illness in a clinical capacity, as well as experience with utilization management and/or utilization review . ? The ideal candidate(s) will have ... direct care and utilization management experience, including familiarity with the review of medical evidence, psychiatric evidence, a knowledge base of… more
- Baystate Health (Springfield, MA)
- …management as outlined in the evidence based practice guidelines + Uses Utilization Analysis / Management principles, insures that patient's site of care ... preferred + Requires a working knowledge of community resources and Utilization /Quality Review standards. Understanding of the hospitals patient placement… more