- CenterWell (Anderson, SC)
- …opportunities for education/coaching + Identifying trends and areas of opportunity in pharmacy utilization (pharmacy management ) to impact Part D per Member per ... is responsible for executing the clinical strategy through the management of their own patient panel as well as...clinicians with schedule templates, coverage, daily issues + Managing behavioral concerns of supervised staff + Assisting with PTO… more
- CenterWell (Savannah, GA)
- …opportunities for education/coaching + Identifying trends and areas of opportunity in pharmacy utilization (pharmacy management ) to impact Part D per Member per ... is responsible for executing the clinical strategy through the management of their own patient panel as well as...clinicians with schedule templates, coverage, daily issues + Managing behavioral concerns of supervised staff + Assisting with PTO… more
- HCA Healthcare (Richmond, VA)
- …of social work experience in an acute care setting preferred. + Previous case management or utilization review experience preferred. Chippenham Hospital has ... for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services...risk patients with discharge planning or psychosocial needs. + Review of patient notes identifying and addressing any conflict… more
- St. Luke's University Health Network (Allentown, PA)
- …in order to facilitate a positive outcome for patients. + Assists in the utilization management of psychiatric patients. + Maintains clinical records of all ... + Provides case management duties as assigned by Supervisor. Case Management duties include individual assessments, utilization reviews, family or support… more
- Highmark Health (Buffalo, NY)
- …Description :** **JOB SUMMARY** This job captures all inbound phone inquires for utilization management review from providers and pharmacies. The incumbent ... a prior authorization case in Highmark's Utilization Management system for Prior Authorization clinical review ,...job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
- Highmark Health (Buffalo, NY)
- …**Job Description :** **JOB SUMMARY** This job captures all inbound inquires for utilization management review from providers and pharmacies. The incumbent ... the case (data entry) in Highmark's Utilization Management system for Prior Authorization clinical review ....job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
- CareFirst (Baltimore, MD)
- …related experience working in Care Management , Discharge Coordination, Home Health, Utilization Review , Disease Management or other direct patient care ... supervision, the Care Manager researches and analyzes a member's medical and behavioral health needs and healthcare cost drivers. The Care Manager works closely… more
- State of Connecticut, Department of Administrative Services (Hartford, CT)
- …initiatives; + Prepares and/or reviews reports, medical records and correspondence; + Perform utilization review and management functions; + Attends court ... (approximately 0.4 FTE) and outpatient clients of the CRMHC Behavioral Health Home/Primary Care Clinic (approximately 0.6 FTE). This...training are most aligned with the role. To prepare, review this helpful Interview Preparation Guide to make the… more
- HCA Healthcare (San Antonio, TX)
- …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 ... reduction of variation in care delivery. - Promotes the utilization of alerts and best practices (eg Sentinel Event...that acknowledges both the value of event reporting and review of reported events. - Partner with Patient Safety… more
- HCA Healthcare (Sun City Center, FL)
- …Healthcare Quality) OR CHCQM (Diploma in American Board of Quality Assurance and Utilization Review Physicians). _Individuals without CPHQ or_ CHCQM _will be ... for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services...a healthcare environment + Previous experience in accreditation, quality, utilization management , or risk management … more