- HCA Healthcare (Wichita, KS)
- …or 2 years of critical care experience preferred + Certification in case management or utilization review preferred + InterQual experience preferred ... for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services...management regulatory guidelines per CMS. + Manages VPro utilization for case management vendors + Assists… more
- Adelante (Goodyear, AZ)
- …audits, continuing education, and the review of protocols and procedures + Review results of utilization and quality monitoring and participate in the ... comprehensive obstetrical and gynecological health care services through the identification, management and/or referral of the health problems and maintenance of… more
- Ventura County (Ventura, CA)
- …expand, and maintain the pool of eligible service providers. + Utilization review : + Uses professional skills in quality management activities such as ... other members of the mental health team. + Case Management : + provides case management /brokerage including linkage...work at an accredited college or university in the behavioral sciences and/or arts may be substituted for the… more
- University of Utah Health (Salt Lake City, UT)
- …+ Negotiates with third party payers relative to benefit levels, eligibility, utilization review , and reimbursement. + Identifies actual and potential delays ... are integral to our mission. EO/AA_ This position provides clinical case management services aimed at enhancing patient-centered care and maximizing outcomes across… more
- CVS Health (Frankfort, KY)
- …+ Discharge Planning Experience. + Motivational Interviewing skills + Managed Care/ Utilization Review Experience + Bilingual preferred. + BSN preferred ... person or telephonic contact to assess, plan, implement and coordinate all case management activities with members to evaluate the medical and psychosocial needs of… more
- Monte Nido (Waltham, MA)
- …regulatory agencies. + Conduct psychosocial assessments, participate in treatment planning, utilization review , and discharge planning. + Conduct individual, ... the opportunity for people to realize their healthy selves. **Family Therapist** **Walden Behavioral Care** **Waltham, MA** Walden Behavioral Care is one of the… more
- Beth Israel Lahey Health (Beverly, MA)
- …Coordination (ACNO) provides administrative direction and leadership for: Transitions of Care/Case Management , Utilization Review / Denials management , ... experience within an acute care hospital environment including Care Coordination and Utilization Management . - Demonstrated strength in management … more
- UPMC (Pittsburgh, PA)
- …the CMA's collaborations, practical comprehension and hands-on experience in clinical care/ utilization management will result by collecting and assisting with ... + Assist clinical team with scheduling transportation, scheduling appointments, and tracking utilization . + Refer members to appropriate case management , health … more
- HCA Healthcare (Salem, VA)
- …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 ... and physicians. Coaches and manages staff performance. Uses the Performance Management Plan (PMP) process to communicate, educate, and set performance expectations.… more
- HCA Healthcare (Fort Walton Beach, FL)
- …Case Management is preferred + BSN is preferred + Certification in Case Management , Nursing or Utilization Review is preferred HCA Florida Fort ... with physicians, patients, families, hospital staff, and outside agencies + Performs utilization management reviews and communicates information to third party… more