- Mohawk Valley Health System (Utica, NY)
- …of disease and patient management . Preferred: + Knowledge of Quality Management , Performance Improvement and Utilization Management requirements and ... Med/Surg, Critical Care and other acute care services that functions as a reviewer , data abstracts, supports Medical Staff committees and various departments of the… more
- Prime Healthcare (Chula Vista, CA)
- …EDUCATION, EXPERIENCE, TRAINING Required qualifications 1. Knowledge of Discharge Planning/ Utilization Management / Case Management terminology and ... development and implementations of discharge plans. Assists with case management referrals and authorizations. Maintains and coordinates Medicaid state submission… more
- Trinity Health (Columbus, OH)
- …5-7 years of clinical nursing experience with at least 2 years experience in utilization review , discharge planning, case management , or disease ... to common symptoms they might experience. + Coordinates with the utilization review , case management , discharge planning staff within network facilities.… more
- HCA Healthcare (Las Vegas, NV)
- …support the Supply Chain team to lead margin improvement activities, which includes inventory management and patient billing review . The VPDCO will review ... in operations, expense, clinical integration, quality, and service + Execute clinical utilization and expense management plans and ensure alignment with facility… more
- Sevita (Davenport, IA)
- …strategy to manage census, maintain occupancy, improve daily attendance, and/or maximize utilization + Financial Management + When applicable, approve purchase ... us all every day. Join us today, and experience a career well lived. **Program Management - Program Director IDD Services Host Home** **This role is based out of… more
- HCA Healthcare (Nashville, TN)
- …and evaluate changes in formulary strategy including exclusions, tier changes, and utilization management updates + Working knowledge of employee pharmacy ... member. + Meets member specific targets for contract performance, trend management , savings and strategic objectives. + Establishes productive, professional and… more
- CVS Health (Austin, TX)
- …is subject to change based on business needs. **Preferred Qualifications** 6+ months Case Management or Utilization Management experience Case Management ... responsible for telephonically assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the… more
- US Tech Solutions (Atchison, KS)
- …advantage for Aetna. Health Services strategies, policies, and programs are comprised of utilization management , quality management , network management ... Utilizes critical thinking and judgment to collaborate and inform the case management process, in order to facilitate appropriate healthcare outcomes for members by… more
- Travelers Insurance Company (Austin, TX)
- …skills **What is a Must Have?** + Licensed MD + 5 years clinical and utilization management experience + Certified by the American Board of Medical Specialties ... to keep Travelers at the leading edge of the P&C industry. Develop medical management strategies that help injured employees return to work as soon as medically… more
- Carnegie Mellon University (Pittsburgh, PA)
- …Provide analytical support and financial insight for audits, facilities projects, space utilization , grants management , and special projects. + Coordinate with ... + Coordinate with grant and contract accounting, including pre-award budget review , post-award expense tracking, effort reporting, and closeout. + Coordinate with… more