- Humana (Lansing, MI)
- …LTSS care management/coordination within Humana's population health strategy, education, utilization management, and quality improvement activities for the clinical ... + Collaborate with the Chief Medical Officer, Quality Improvement Director, Utilization Director, Population Health Management Director and National Medicaid LTSS… more
- Community Health Systems (Bullhead City, AZ)
- …assessments of new physician practices, urgent care centers, and walk-in clinics prior to AMR implementation. + Monitors system utilization , identifies training ... optimization of the Ambulatory Medical Record (AMR) system to ensure efficient utilization and adherence to best practices across clinical settings. This role… more
- The County of Los Angeles (Los Angeles, CA)
- …until the needs of the service are met and is subject to closure without prior notice. ABOUT LOS ANGELES COUNTY DEPARTMENT OF HEALTH SERVICES: The Los Angeles County ... + Additional experience in clinical nursing. + Supervisory** experience in Utilization Review and/or Case Management . SPECIAL REQUIREMENT INFORMATION: *In order… more
- Veterans Affairs, Veterans Health Administration (Lexington, KY)
- …specialty care. Coordinates with the patient care team to review the clinic utilization by using various reports (eg, Clinic Utilization Statistical Summary). ... Collect, scans, and updates health insurance information, promote Veteran registration and utilization of My HealthyVet (MHV). Train other MSAs on correct clinic… more
- Veterans Affairs, Veterans Health Administration (Fresno, CA)
- …in compliance with regulatory and accrediting bodies. Responsible for pharmacy utilization of resources and budget. Makes selections, assigns personnel, and serves ... of pharmacy, including adherence to clinical practice guidelines, evidence based medication utilization and cost effective care. Serves as a consultant and resource… more
- Veterans Affairs, Veterans Health Administration (Norton, VA)
- …specialty care. Coordinates with the patient care team to review the clinic utilization by using various reports (eg, Clinic Utilization Statistical Summary). ... Collect, scans, and updates health insurance information, promote Veteran registration and utilization of My Healthy Vet (MHV). Train other MSAs on correct clinic… more
- The Cigna Group (Morris Plains, NJ)
- …and relational database skills a plus. + MS Office Suite experience preferred. + Prior experience managing and working with large data sets a plus. + Some experience ... Users: A Group-based Trajectory Model + Non-behavioral health related health care utilization among 5-18 year olds diagnosed with reactive stress disorder +… more
- Veterans Affairs, Veterans Health Administration (Bay Pines, FL)
- …referral of patients, development and operation of quality assurance and utilization programs including peer reviews, open and closed medical record reviews ... and utilization review Provide inpatient Hospice and Palliative Care consultations...subject to urinalysis to screen for illegal drug use prior to appointment. Applicants who refuse to be tested… more
- Ellis Medicine (Schenectady, NY)
- …provided by the Case Manager include, but are not limited to, utilization review, case management, care transition, collaboration with physicians and social workers ... experience in a hospital environment preferred. + Previous case management, utilization review, and discharge planning experience highly preferred. Home care, payer,… more
- Guthrie (Sayre, PA)
- …aspects for Care Coordination including, but not limited to Case Management, Utilization Review (UR), Utilization Management (UM), and Medical Social Work. ... knowledge in and experience of payer contract language, as it relates to utilization management. Can navigate through the requirements imposed by all payers. … more