- Logan Health (Kalispell, MT)
- …practice. + As applicable to assigned area(s): performs the duties of Utilization Review , precertification, concurrent reviews, and retro reviews; completes data ... Logan Health Wellness & Pain Management is proud to offer some of the...have or be at risk for depression and other behavioral health conditions. Experience treating patients with a trauma… more
- Highmark Health (Tallahassee, FL)
- …:** **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and ... and DOL regulations at all times. In addition to utilization review , the incumbent participates as the...member of the multidisciplinary team for case and disease management . They will advise the multidisciplinary team on cases,… more
- HCA Healthcare (Nashville, TN)
- … and supply chain operations. ii) Value Analysis iii) Clinical Resource Management Program iv) Product standardization and utilization + Interacts and ... invests in you as a PRN Director Clinical Resource Management ? At HealthTrust, a division of HCA, you come...for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services… more
- The County of Los Angeles (Los Angeles, CA)
- …the performance of subordinate supervisory staff and serves as first level reviewer of all performance evaluations. + Resolves or consults with subordinate ... supervisors to resolve problems of employee utilization , employee discipline, and grievances. + Develops in-service training activities to increase professional… more
- ChenMed (Tampa, FL)
- …will manage complex behavioral health patient issues by providing casework, utilization management and discharge planning services to promote the highest ... rapidly expanding and we need great people to join our team. The LCSW/ Behavioral Health Specialist assists, coordinates and manages the needs of the Behavioral… more
- CVS Health (Springfield, IL)
- …Prior Authorizations, Coordination with PCP and Specialty providers, Condition Management information and education, Medication management , Community Resources ... the Care Plan for any change in condition or behavioral health status Our TOC CMs are frontline advocates...who cannot advocate for themselves. The TOC team will review prior claims to address potential impact on current… more
- University of Utah Health (Salt Lake City, UT)
- …of time and attendance of direct reports. + Functions as Case Manager and/or Utilization Review Nurse as necessary. + Tracks and analyzes Case Manager quality ... This position is responsible for the day to day management of the Case Management Department. +...of service and utilization statistics. + Works collaboratively with information systems personnel… more
- Omaha Children's Hospital (Omaha, NE)
- …intensive outpatient, or inpatient care). Required + 1 year Prior experience in utilization review , case management , or managed care preferred. Preferred ... Authorization Therapist serves as a licensed clinician responsible for managing the utilization review and authorization process for patients receiving care… more
- Prime Healthcare (Boonton Township, NJ)
- …Plan. Qualifications Education and Work Experience + Knowledge of Discharge Planning/ Utilization Management / Case Management terminology and functions, ... of hospitals and healthcare facilities include Denville Hospital, Dover Hospital, Behavioral Health Centers in Boonton, Denville, and Parsippany, and an Imaging… more
- Prime Healthcare (Chula Vista, CA)
- …EDUCATION, EXPERIENCE, TRAINING Required qualifications 1. Knowledge of Discharge Planning/ Utilization Management / Case Management terminology and ... emergency services. In addition to our healthcare services, we offer comprehensive behavioral health services on the hospital campus and Bayview campus in Chula… more