- BD (Becton, Dickinson and Company) (Franklin Lakes, NJ)
- …planning, charter development, project timelines, budgets, resource allocation, risk management , and conducting Industrialization Gate Review System reviews. ... and Metrics:** Define and track benchmarks for program delivery, resource utilization , and risk management ; provide executive-level reporting and insights… more
- 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
- University of Rochester (Rochester, NY)
- …of Medicare and other payer regulations for the coordination of benefits. + Notify Utilization Management of clinical requests by third party payers. + Maintain ... Counseling, Medicaid Enrollment & Outreach, Financial Assistance, Registration and Insurance Management , Utilization Management , Social Work, Patient… more
- Actalent (Baton Rouge, LA)
- …service. + Knowledge of Medicare and Medicaid regulations. + Familiarity with utilization management processes. Additional Skills & Qualifications + Experience ... + Work with healthcare providers and the authorization team to ensure timely review of services and requests, ensuring members receive authorized care. + Coordinate… more
- Crouse Hospital (Syracuse, NY)
- …day management of the RN Care Managers in the department, including Utilization Management , Discharge Planning and Denials and Appeals functions. + Assessing ... Manager who is responsible for providing day to day management of the RN Care Managers in the department....acute care discharge planning + Preferred - Acute care utilization review experience Benefits Overview: + Medical,… more
- BronxCare Health System (Bronx, NY)
- …assist the department's leadership develop strategies for denial prevention, improved utilization management , documentation of medical necessity and identify ... of stay, avoidable day and barriers to discharge processes pertaining to utilization management . - Liaisons and coordinates with other hospital departments… more
- University of Rochester (Rochester, NY)
- …to discharge. Identifies problems, including but not limited to, pre-certifications, Utilization Management , Medicaid Pending, third party payer issues, and ... Communicates and follows-up with assigned area, Financial Assistance, Social Work, Utilization Management , Financial Case Management , patients, families,… more
- UPMC (Pittsburgh, PA)
- …the CMA's collaborations, practical comprehension and hands-on experience in clinical care/ utilization management will result by collecting and assisting with ... + Assist clinical team with scheduling transportation, scheduling appointments, and tracking utilization . + Refer members to appropriate case management , health … more
- Cedars-Sinai (Los Angeles, CA)
- …and financial management skills, including effective expense reduction, utilization management , budget control and revenue generation. Compensation Range ... and promote patient safety, continuous performance and quality improvement, risk management , and efficient resource utilization , all linked to evidence-based… more
- Humana (Carson City, NV)
- …. + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial ... their daily work. The Medical Director's work includes computer-based review of moderately complex to complex clinical scenarios, ...with prior experience participating in teams focusing on quality management , utilization management , case … more