- Providence (Everett, 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 or… more
- Henry Ford Health System (Detroit, MI)
- … skills. Knowledge of computers, Electronic Health Records, data base systems and utilization review /case management documentation systems. Desire to work ... bonus available for qualified experienced candidates with current 2 years MSW Case Management in a large acute care hospital setting. GENERAL SUMMARY: The Case… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …Skills and Experience * 2+ years of managed care experience; eg case management /health coach, utilization management and/or auditing experience (may be ... difference, join us. The Impact You Will Have Utilizing key principles of case management , the RN Specialist will research and analyze the member's health needs and… more
- Arnot Health (Elmira, NY)
- …related to the management of patient care . The Case Manager will review all patients for utilization management and appropriate discharge planning. The ... the guidelines. . Identifies the appropriate patients for Case Management services. . Maintains a working knowledge of the...The Case Manager tracks and trends LOS , resource utilization , outliers, readmissions , denials , delay days… more
- ChenMed (Chicago, IL)
- …explain primary care provider role. + Facilitates patient/family conferences to review treatment goals, optimize resource utilization , provide family education ... re: goals of care, palliative care and hospice. + Utilization /Financial Management -managing resource utilization and...quality of health care. + Applies skills in peer review to promote a culture of excellence. + Anticipates… more
- Humana (Lincoln, NE)
- …management + Utilization management experience in a medical management review organization such as Medicare Advantage, managed Medicaid, or Commercial ... The Medical Director relies on broad clinical expertise to review Medicare drug appeals (Part D & B). The...with prior experience participating in teams focusing on quality management , utilization management , or similar… more
- UPMC (Pittsburgh, PA)
- …evidence on medical interventions, as well as coverage policies and utilization management standards of national insurers, accountable care organizations, ... report results. + BSN required. Advanced degree is preferred. + Prior experience with utilization management and/or case management is strongly preferred. +… more
- Truman Medical Centers (Kansas City, MO)
- …in English, both spoken and written **Preferred Qualifications:** + RN experience in hospital utilization review , utilization management , or case ... you will identify patients who would benefit from case management services and coordinate care across the continuum by...+ Assess patient needs and determine eligibility for case management services + Collaborate with patients, families, and the… more
- Calvary Hospital (Bronx, NY)
- …and identify the expected length of stay (ELOS). The RNCM participates in the Utilization Review , Discharge Planning, Risk Management , and Quality Assessment ... Qualifications: + Five (5) or more years experience in either Utilization Management , Quality Assessment and Improvement, Risk Management , and/or Discharge… more
- St. Luke's University Health Network (Allentown, PA)
- …in order to facilitate a positive outcome for patients. + Assists in the utilization management of psychiatric patients. + Maintains clinical records of all ... + Provides case management duties as assigned by Supervisor. Case Management duties include individual assessments, utilization reviews, family or support… more