- Elevance Health (Indianapolis, IN)
- …and overseeing clinical/non-clinical activities. Will also be responsible for utilization review / management . May be responsible for ... be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US military… more
- Houston Methodist (Houston, TX)
- …in a hospital setting + Two years of experience in Hospital Quality Improvement, Case Management or Utilization Management role preferred + Two years of ... Conducts record review for performance improvement, peer review , patient safety, risk management and other projects. + Facilitates and leads process and… more
- Avera (Sioux Falls, SD)
- …the Clinical Appeals Specialist to ensure tracking and trending of all Utilization Review related denials/appeals are appropriately documented. + Assists with ... Surgery Scheduling, Clinical Departments, physicians, payers, Patient Access, Health Information Management , and Case Management . Demonstrates a willingness to… 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
- Northwell Health (Poughkeepsie, 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
- 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
- Cedars-Sinai (Beverly Hills, 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
- 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 (Beverly Hills, 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