- Providence (OR)
- …of Care Planning, Discharge Planning, Coordination of Outpatient Care) + Utilization Management Experience (EX. Concurrent Review, Prior Authorization, Medical ... Audits, Appeals or Delegation) + Experience working in a health plan, medical insurance plan or another similar work environment + Current nursing experience in the following areas: chronic pain management, cardiology, endocrinology, pediatrics, obstetrics,… more
- CVS Health (Pittsburgh, PA)
- …Market Checks** + Ensure template formularies design and application of utilization management (UM) criteria align with MHPAEA and other federal/state regulations. ... + Provide QA and sign-off on audit responses and corrective action plans. ** Utilization Management** + Understand UM development and management, including prior … more
- Florida Atlantic University (Boca Raton, FL)
- …Mapping and Documentation Coordinator reports directly to the Director of Space Utilization or designee and serves all University sites and campuses. This position ... of infrastructure drawings, specifications and as-built records. + Space Planning and Utilization : + Collect relevant data for space utilization studies to… more
- Air Education and Training Command (Altus AFB, OK)
- …Use Airspace (SUA) or Special Activity Airspace (SAA) recommendations, utilization review, documentation, administration, collaboration and impact implication for ... mission on matters pertaining to requirements, justification, acquisition, and utilization of tactical airspace associated with aircrew and training. Requirements… more
- Actalent (Porterville, CA)
- …expectations must be met + Partners with interdepartmental teams on projects within utilization management as part of the clinical review team + Partners and works ... taken on member medical records in health management systems according to utilization management policies and guidelines + Manages and collaborates with healthcare… more
- Centene Corporation (Sacramento, CA)
- …of care and facilities + Partners with interdepartmental teams on projects within utilization management as part of the clinical review team + Partners and works ... taken on member medical records in health management systems according to utilization management policies and guidelines + Manages and collaborates with healthcare… more
- Mayo Clinic (Rochester, MN)
- …multi-disciplinary teams. Major Functions of the RN Case Manager include: Utilization Review, including concurrent admission status and continued stay clinical ... of care throughout the continuum of care by ensuring appropriate utilization management, care coordination, resource utilization , and clinical documentation.… more
- Baystate Health (Springfield, MA)
- …for transfer requests seeking specialty services to ensure care can be provided prior to acceptance. Manages all internal flow/throughput for patients who may need ... on admission to identify level of care, potential need for practice guideline utilization , to determine the anticipated LOS and anticipated care needed for each… more
- ChenMed (Oakland Park, FL)
- …patient/family conferences to review treatment goals and optimize resource utilization ; provides family education and identifies post-hospital needs. + Serves ... reports adverse occurrences, and performs staff education related to resource utilization , discharge planning and psychosocial aspects of healthcare delivery. +… more
- The County of Los Angeles (Los Angeles, CA)
- …needs of the service are met and is subject to closure without prior notice. SPECIAL SALARY INFORMATION: Management Appraisal of Performance Plan (MAPP): This ... analysis, and making recommendations to line managers on matters such as: utilization of personnel; allocation of funds; workload and workload fluctuations; and… more