- HCA Healthcare (San Antonio, TX)
- …Preferred: Bachelor of Science in Nursing + At least one year experience in utilization review , resource management , discharge planning or case management ... no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as telemedicine services and free AirMed medical transportation.… more
- HCA Healthcare (Austin, TX)
- …interdepartmental service coordination. + Actively participates in the Performance Improvement and Utilization Review programs. + Assumes a role in the ... no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as telemedicine services and free AirMed medical transportation.… more
- Prime Healthcare (Harlingen, TX)
- …to manage care transitions. RN Case Managers also conduct discharge planning, utilization review , and helping patients navigate insurance and healthcare systems. ... to rehab, home health, or long-term care facilities + Utilization Review : m onitor the use of...experience preferred. At least one year experience in case management , discharge planning or nursing management , preferred.… more
- Henry Ford Health System (Troy, MI)
- …relevant contractual requirements and issues to internal customers such as Utilization Management , Finance, Patient Billing, Administration, Legal, etc. 7. ... Payors and facilitate resolution of contracting and operational issues, ie billing, utilization review , credentialing site visits, notification of site closures… more
- Beth Israel Lahey Health (Burlington, MA)
- …clerical and analytical tasks related to the accounts payable function. Activities include: utilization of ERP system and ancillary systems such as GHX and IDS to: ... review daily data loads, correct or release data into...electronic document repository. 10. Special projects as assigned by management as needed to meet the needs/goals of the… more
- HCA Healthcare (Richmond, VA)
- …concurrent review for all payers and maintains legible documentation as directed by the Utilization Management Plan + As a member of Case Management team ... for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services...experience as RN years demonstrated leadership experience + Commercial Utilization Management and/or Case Management … more
- State of Indiana (Indianapolis, IN)
- …essential functions of this role are as follows: + Planning & Project Management : Serve as a resource for proposal development and research process. Ensure ... accurately. Assist supervisor in the development of strategic planning and resource utilization . You will participate in providing project reviews in accordance with… more
- New York State Civil Service (Newark, NY)
- …experimental psychology, research psychology, industrial psychology, organizational psychology, utilization review , guidance counseling, etc. Additional Comments ... IRAs and develop appropriate interventions: Behavior Support Plans, Higher Risk Behavioral Support Plans, Medication Monitoring Plans, Behavioral Guidelines,… more
- US Tech Solutions (Atchison, KS)
- …advantage for Aetna. Health Services strategies, policies, and programs are comprised of utilization management , quality management , network management ... Utilizes critical thinking and judgment to collaborate and inform the case management process, in order to facilitate appropriate healthcare outcomes for members by… more
- State of Connecticut, Department of Administrative Services (Bridgeport, CT)
- …initiatives; + Prepares and/or reviews reports, medical records and correspondence; + Performs utilization review and management functions; + Attends court ... state + Contribute to the coordination of onsite medical, mental/ behavioral health and dental services + Get clinical exposure...training are most aligned with the role. To prepare, review this helpful Interview Preparation Guide to make the… more