- Baylor Scott & White Health (Temple, TX)
- …for assessing and coordinating patient care across the continuum to include case management , social work, utilization review and care coordination to ... and supports ongoing problem solving related to care coordination, discharge planning, case management and utilization review . Monitors processes and systems… more
- Highmark Health (Harrisburg, PA)
- …triaging members to appropriate resources for additional support. + Implement care management review processes that are consistent with established industry, ... Nursing **EXPERIENCE** **Required** + 7 years in any combination of clinical, case/ utilization management and/or disease/condition management experience, or… more
- Battelle Memorial Institute (Cannon AFB, NM)
- …program operations and high-quality patient care. **Responsibilities** + Assist with the management and treatment of outpatient behavioral health activities + ... in a dynamic, mission-driven environment. This position supports outpatient behavioral health activities by conducting intake interviews, assisting with patient… more
- Veterans Affairs, Veterans Health Administration (Omaha, NE)
- …Model for Pain Management . The incumbent will provide a variety of behavioral pain management strategies and frequently partner with other team members to ... with other team members to develop and implement an integrated pain management approach that maximizes the utilization of complementary and integrative… 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 ... for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services...expense, clinical integration, quality, and service + Execute clinical utilization and expense management plans and ensure… more
- Stantec (Irvine, CA)
- …in key roles such as Independent Technical Reviewers, as required. Oversee risk management related to projects and pursuits including review of contracts, fees, ... This role also collaborates with other BC Leaders to lead our behavioral safety culture, maintain quality and technical excellence for services delivered across… more
- Highmark Health (Jefferson Hills, PA)
- …including but not limited to: appropriateness of care, documentation requirements, utilization review principles and criteria, insurance benefits and ... utilization . Serves as key team members in the management of readmissions, length of stay, ED utilization...job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
- KBR (San Diego, CA)
- …compliance in meeting care goals. * Knowledge and skill in using pre-established utilization review criteria recognize and report actual or potential quality and ... Worker will function within an operational unit, as a Behavioral Health Care Provider and is responsible for the...the electronic medical records of all patients contacted for review by the managing physician; Routinely staffs difficult cases… more
- HCA Healthcare (Nashville, TN)
- …treatment is reimbursed by contacting managed care organizations and completing initial utilization review . Documents in Midas as required. Involves mobile ... LCSW, LADAC) + Previous experience in Needs Assessment and Utilization Management strongly preferred. + Familiarity with...patients in regard to managed care organizations + Conducts utilization review for managed care cases in… more
- Battelle Memorial Institute (Fort Bragg, NC)
- …environment. The Licensed Clinical Social Worker position serves as a behavioral health care provider within operational units, delivering evidence-based assessment, ... maintaining detailed medical records, possibly supervising trainees, performing case management , and engaging in military-specific training and activities as… more