- Elevance Health (Charleston, WV)
- …supervision. **Preferred Skills, Capabilities, and Experiences:** + Previous experience in case management / utilization management with a broad range of ... and outpatient professional treatment health benefits through telephonic or written review . **How you will make an impact:** + Uses appropriate screening… more
- HCA Healthcare (Cypress, TX)
- …timely and accurate information to payers. The role integrates and coordinates utilization management , care facilitation, and discharge planning functions. In ... experience in clinical practice area, 1-3 years of previous Case Management experience + Required Certification: CCMC preferred. + (LPN/LVN) Licensed Practical… more
- Penn Medicine (Monroe, NJ)
- …resolve EPIC work queues-escalate as needed.Coordinate with central admission, transportation, Utilization Management departments as needed.Maintains up to date ... front-end reports which may include the patient pre & post visit, charge review , and others as requested. Proactively prioritizes recovery of missing charges. Enters… more
- Penn Medicine (Mercerville, NJ)
- …EPIC work queues-escalate as needed. + Coordinate with central admission, transportation, Utilization Management departments as needed. + Maintains up to date ... may include the patient pre & post visit, charge review , and others as requested. Proactively prioritizes recovery of...in patient satisfaction surveys. Provides comments and feedback to management team to maintain and improve quality of services.… more
- Centene Corporation (Carson City, NV)
- …analysis, and/or ROI evaluation preferred. Familiarity with claims payment, utilization management , provider/vendor contracts, risk adjustment for government ... to leadership and/or customers + Manage multiple, variable tasks and data review processes with limited supervision within targeted timelines and thrive in a… more
- Hackensack Meridian Health (Neptune City, NJ)
- …screens ED inpatient admissions and observations as specified by the facility's Utilization Management / Review Committee for documentation completeness and ... with physicians, nursing staff, other patient caregivers, Health Information Management Department coding staff, and Emergency Trauma Department (ETD), to… more
- Trinity Health (Grove City, OH)
- …affordability. -Serve as a subject matter expert in your area, guiding drug utilization management and educational efforts. -Advocate for patients and pharmacy ... scheduling & assignment; + Participates in & contributes to the performance management / review process + Manages or contributes to the daily performance, daily… more
- Atlantic Health System (Morristown, NJ)
- …including preparing clinical updates and data metrics. + Plans and implements drug utilization management and quality improvement plans. + Liaison with site ... with site and enterprise pharmacy teams to support formulary management and pharmacoeconomic initiatives + Providing drug information to...100 Accountable Care Organizations to Know - Becker's Hospital Review + Best Employers for Workers over 50 -… more
- Bowery Residents Committee (Manhattan, NY)
- …and crisis intervention. Gather and review documentation as requested for utilization management reviews of clients on caseload including completion of ... MSW or CASAC-T License required. LMHC or LMSW preferred. Excellent time management skills. Bachelors strongly preferred. Knowledge of OASAS rules and regulations and… more
- Centene Corporation (Tallahassee, FL)
- …analysis, and/or ROI evaluation preferred. Familiarity with claims payment, utilization management , provider/vendor contracts, risk adjustment for government ... to leadership and/or customers + Manage multiple, variable tasks and data review processes with limited supervision within targeted timelines + Support the design,… more