- Humana (Frankfort, KY)
- …and interpretation skills with prior experience leading teams focusing on quality management , utilization management , discharge planning and/or home health ... of services provided by other healthcare professionals in compliance with review policies, procedures, and performance standards. Advises executives to develop… more
- Luke Staffing (Fairfax, VA)
- …+ Comply with regulatory, MTF, and Joint Commission quality inspection/ peer review / utilization management requirements, and applicable system applications. ... and treatment, bio-electric implanted devices, advanced vestibular assessment and treatment/ management , and amplification and signal processing technology. In diagnosing… more
- Centene Corporation (Tallahassee, FL)
- …go/no-go decisions. + Ensure integration across claims, eligibility, provider, and utilization management systems. + Oversee data/reporting integration to ... for legal responses, including Payment Integrity and market communications. + Review and approve business solutions and implementation requirements for new business… more
- Diversicare Healthcare Services & Diversicare Ther (Bryson City, NC)
- …**Qualifications** 1. Degree in nursing. 2. Knowledge of healthcare reimbursement, utilization management , and discharge planning. 3. Experience providing ... in and facilitate Engage/72 HR Admission meetings as part of the care management system. + Manage the restorative nursing program, integrating it with the activity… more
- CGI Technologies and Solutions, Inc. (Canton, MA)
- …workflows across key functions such as claims, provider operations, member services, utilization management , care management , and finance. Ideal candidate ... accurate representation of roles, decisions, systems, compliance checkpoints, and exceptions. * Review and refine process maps, SIPOCs, and metadata for accuracy and… more
- Diversicare Healthcare Services & Diversicare Ther (Hartford, AL)
- …Degree in nursing 2. RN License 3. Knowledge of healthcare reimbursement, utilization management , and discharge planning. 4. Experience providing strategic ... in and facilitate Engage/72 HR Admission meetings as part of the care management system. + Manage the restorative nursing program, integrating it with the activity… more
- BAYADA Home Health Care (Morristown, NJ)
- …+ Management and mentoring of Clinical Associates and field staff + Utilization Management + Developing and mentoring staff to become strong case managers ... assurance teams + Orientation of field staff + Documentation review + Managing staff productivity + Leading team to...+ A current New Jersey RN license. + Strong management and leadership experience. + Medicare Certified Home Care… more
- Cherry Bekaert (Charlotte, NC)
- …to include facilitation of training, periodic meetings and other oversight. + Utilization management of staff. Service Excellence: + Promote innovative solutions ... and driving the growth of the practice. Key Responsibilities: Client Engagement Management : + Lead and manage client engagements, both monthly and consulting, from… more
- Katmai (Fort Carson, CO)
- …all levels of health care management to include outside agencies. Performs utilization management activities to optimize cost, quality, and access to care. ... and employ safe work habits. + Utilize available information management systems in daily practice for patient care and...facility staff members to facilitate patient care. + Accurately review and confirm completeness of patient chart and report… more
- Wiser (St. Louis, MO)
- …ArcGIS Pro software tools in the creation, attribution, schema development and utilization , management , and geo-referencing of data. + Experience in geo-enabling ... shall use an understanding of geography, research, GIS, and data conflation and management skills to produce the broad array of human geography products including… more
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