- LA Care Health Plan (Los Angeles, CA)
- …At least 8 years of clinical appeals and grievances experience in a managed care, utilization management and/or case management setting, At least 2 years in ... feedback on performance to department management . Work closely with management to review performance and quality standards on an ongoing basis. As well as… more
- Northwell Health (Sleepy Hollow, NY)
- …+ Facilitates patient management throughout hospitalization. + Performs concurrent utilization management using evidence based medical necessity criteria. + ... Submits data to management regarding case management and/or quality initiatives....collaboration with the health care team. + Conducts chart review for appropriateness of admission and continued length of… more
- McLaren Health Care (Bay City, MI)
- …Association or equivalent through the Military Training network (MTN) **_Preferred:_** + Utilization management ( review ) and discharge planning experience. + ... **Department** : Case Management - Inpatient Rehabilitation **Daily Work Times:** Variable **Shift:** Days **Scheduled Bi-Weekly Hours** : 0 **Position Summary:**… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …Skills and Experience * 1+ years of managed care experience; eg case management /health coach, utilization management and/or auditing experience. * ... Case Manager is a critical component of BCBSMN Care Management team as the primary clinician providing condition and...discover more about what we have to offer, please review our benefits page. PI277925377 Minimum Education Required -… more
- FlexStaff (Lake Success, NY)
- …+ Facilitates patient management throughout hospitalization + Performs concurrent utilization management using evidence based medical necessity criteria + ... Submits data to management regarding case management and/or quality initiatives...collaboration with the health care team + Conducts chart review for appropriateness of admission and continued length of… more
- MTC (Livingston, TX)
- …the use of appropriate sanitation methods. + Practice basic cost containment and utilization management for detainee care and facility operations. + Maintain ... plan **Make a Difference Where It Matters!** Operated by Management & Training Corporation, the **IAH Detention Facility in...of all medical records. Observe applicable HIPAA rules. + Review medical files to determine all provided services are… more
- CenterWell (Salt Lake City, UT)
- …Experience in MSO, Payor Org. + Experience in Medicare Risk Adjustment, Cost Management , Utilization Management . + Advanced organizational skills and/or ... areas as financial performance, incentive programs, quality and clinical management , population health, data sharing, connectivity, documentation and coding, HEDIS… more
- Cedars-Sinai (Beverly Hills, CA)
- …or serves as a liaison, for administrative support activities including facilities management , pharmacy, utilization management , quality management , ... staff certifications and licensing requirements. + Assists in the development, review , and revision of standard operating policies and procedures in collaboration… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …* 1+ years of medical call center or managed care experience; eg case management , utilization management * All relevant experience including work, education, ... Guide is a critical component of BCBSMs Integrated Health Management team. The position exists to provide member, provider...discover more about what we have to offer, please review our benefits page. PI277831885 Minimum Education Required -… more
- Cedars-Sinai (Los Angeles, CA)
- …and clinical (based on scope of practice) support activities including facilities management , patient billing, utilization management , quality management ... Job Duties and Responsibilities: + Greets patients, take appropriate vital signs, review current medications and record in medical record. + Coordinates, or serve… more