- US Tech Solutions (Columbia, SC)
- …mental health/chemical dependency, orthopedic, general medicine/surgery. Or, 4 years utilization review /case management /clinical/or combination; 2 of ... change and increase member program engagement. + Performs medical or behavioral review /authorization process. Ensures coverage for appropriate services within… more
- CVS Health (Lansing, MI)
- …expert and provide oversight of the design, development, and deployment of Care Management , Utilization Management , Population Health, Health Equity and ... clinical excellence, achieving measurable health outcomes, and supporting quality and medical management in a highly matrixed environment. The CMO will also support… more
- ChenMed (East Point, GA)
- …explain primary care provider role. + Facilitates patient/family conferences to review treatment goals, optimize resource utilization , provide family education ... re: goals of care, palliative care and hospice. + Utilization /Financial Management -managing resource utilization and...quality of health care. + Applies skills in peer review to promote a culture of excellence. + Anticipates… more
- Veterans Affairs, Veterans Health Administration (Durham, NC)
- …(including but not limited to the Community Living Center, Inpatient Behavioral Health. Responsibilities Clinical: Evaluates, establishes goals based on evaluation ... understanding and practicing documentation and coding practices to maximize clinical utilization . Contributes to the maintenance of a safe, therapeutic environment… more
- New York State Civil Service (Newark, NY)
- …research psychology, industrial psychology, organizational psychology, health psychology, utilization review , guidance counseling, pastoral counseling, or ... IRAs and develop appropriate interventions: Behavior Support Plans, Higher Risk Behavioral Support Plans, Medication Monitoring Plans, Behavioral Guidelines,… more
- Catholic Health Initiatives (Bismarck, ND)
- …with family members, community resources, and other healthcare professionals. *Conducts utilization review : Act as a liaison with insurance companies ... and improved mental well-being.** **This role focuses on the behavioral health and case management aspects of...by completing utilization review to ensure coverage for the… more
- HCA Healthcare (Las Vegas, NV)
- …financial reporting, performance improvement, use of technology, regulatory compliance, drug utilization , clinical education and staff development, management of ... at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical… more
- CenterWell (Phoenix, AZ)
- …providing medical guidance and expertise. + Develop, implement and monitor the outcomes of utilization review and disease management programs to meet the ... care being provided meets appropriate standards and to ensure cost-effective utilization practices. + Oversee the development, revision, and implementation of… more
- US Tech Solutions (Columbia, SC)
- …A typical day would like in this role: Employee will be providing telephonic case management and utilization management for our members. The expectation is ... change and increase member program engagement. + Performs medical or behavioral review /authorization process. Ensures coverage for appropriate services within… more
- Veterans Affairs, Veterans Health Administration (Lincoln, NE)
- …with other team members to develop and implement an integrated pain management approach that maximizes the utilization of complementary and integrative ... VHA Education Loan Repayment Services program office after complete review of the EDRP application. Responsibilities The Pain Psychologists...Pain Care and VA Stepped Care Model for Pain Management . Major duties include but are not limited to… more