- Ascension Health (Pensacola, FL)
- …two (2) years of proven leadership or management experience, preferably overseeing Case Management or Utilization Review teams in an Acute Care setting. ... **Details** + **Department:** Case Management + **Schedule:** Full time Day Shift +...an annual bonus incentive As the Director of Case Management for our Acute Care Services, you will lead… more
- Prime Healthcare (Evanston, IL)
- …+ Responsible for the coordination of the various activities of the Case Management Department including utilization management , social services and ... Plan. #LI-AG5 Qualifications EDUCATION, EXPERIENCE, TRAINING 1. Knowledge of Discharge Planning/ Utilization Management / Case Management terminology and… more
- Ochsner Health (Slidell, LA)
- …operative, and postoperative data components for the Program through the effective utilization of the hospital medical record systems. + Responsible for the accurate ... Medical Records, and Information Systems Departments whose support is necessary for the management and success of the Program. + Adapts behavior to the specific… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …Coordination Specialist provides administrative support for any of the programs of Utilization Management , Behavioral Health, Quality Management , or Member ... and review timeliness, workflow volumes, referrals generated to care management programs + Provides administrative support to the grievance and appeals process… more
- University of Southern California (Los Angeles, CA)
- …Degree Nursing + Req 5 years Clinical experience + Req 2 years Ambulatory case management or utilization review experience within the last three years + ... populations. The role integrates the functions of complex case management , utilization management , quality ...the Case Manager overlap into inpatient duties including: Concurrent review of all patients to validate that the appropriate… more
- Intermountain Health (Butte, MT)
- …. + Provide leadership and expertise to ensure that medical quality improvement and utilization management programs are carried out in clinical areas through the ... + Develop, implement and monitor medical policies and procedures (including case /disease management , utilization management and clinical programs) as they… more
- Cardinal Health (Tewksbury, MA)
- …DCOA as an objective tool to work with specific Medical Staff Departments or Utilization Management Teams to improve medication utilization + Ensures ... System Director of Pharmacy (HSD), Director of Pharmacy Operations and Account Management , and Cardinal Health Clinical Director, the Health System Clinical Director… more
- The Cigna Group (Bloomfield, CT)
- …management functions, including case management (CM), utilization management (UM), and escalated case review . Ensures policies, procedures, and ... operating within health plan environments, including fluency in medical management functions such as utilization management (UM), case management (CM),… more
- Magellan Health Services (Albuquerque, NM)
- …the management , direct supervision and coordination of clinical and/or nonclinical management staff, including utilization management and intensive care ... and on-going management of designated staff. + Performs care management review activities consistent with Magellan policies, procedures, and standards.… more
- HCA Healthcare (Nashville, TN)
- …treatment is reimbursed by contacting managed care organizations and completing initial utilization review . Documents in Midas as required. Involves mobile ... LCSW, LADAC) + Previous experience in Needs Assessment and Utilization Management strongly preferred. + Familiarity with...patients in regard to managed care organizations + Conducts utilization review for managed care cases in… more