- Luke Staffing (Agana Heights, GU)
- …Government and professional clinical standards and clinical protocols. . Participate in Utilization Management/Case Management meetings to review and identify . ... into competency assessments of newly assigned unit personnel. . Collaborate in the review of unit standing operating procedures. . If directed, perform triage based… more
- Veterans Affairs, Veterans Health Administration (Birmingham, AL)
- …on current administrative guidelines. Coordinates with the patient care team to review clinic appointment availability ( utilization ) to ensure that clinic ... Those candidates that meet eligibility will be forwarded to the selecting official for a review . A selection may be made at any time during the opening of the… more
- Quanta Services (Aurora, CO)
- …and staffing assignments for Foremen and General Foreman, ensuring optimal resource utilization and accountability. + Prioritize Safety Compliance: Review and ... are aligned and prepared for project success. + Optimize Site Logistics: Review and develop comprehensive site logistics plans to streamline material flow, equipment… more
- Cleveland Clinic (Vero Beach, FL)
- …the world. As a Concurrent Denial Nurse, you will support the Utilization Management Department by reviewing concurrent and retrospective clinical inpatient denials ... Registered Nurse who is a subject matter expert in utilization management, has experience with MCG criteria, and is...to the department in general and the hospital. + Review and analyze concurrent and retrospective clinical denials and… more
- Atlantic Health System (Morristown, NJ)
- …A core focus of this role is optimization of post-acute care utilization , length of stay, and outcomes, supporting value-based care, readmission reduction, and ... AHS standards. + Monitor and optimize PAC network performance, including utilization patterns, readmissions from SNF, ED transfers, and avoidable acute escalations.… more
- 3M (Maplewood, MN)
- …innovative packaging and shipping solutions that improve trailer and container utilization , reduce transportation costs, and ensure full compliance with safety and ... Factor Improvement program. Responsibilities include optimizing trailer and container utilization , improving material handling practices, and documenting the best… more
- CareFirst (Baltimore, MD)
- …will play a pivotal role in the modernization and redesign of the utilization management department within the Health Services division. The Sr. Business Consultant ... initiatives in the changing healthcare industry. Using a deep understanding of utilization management, the Senor Business Consultant acts as a liaison between the… more
- ChenMed (Louisville, KY)
- …leaders, external clients and HMO to establish, maintain and support outpatient utilization management in PMR and delegated utilization management in ChenMed ... Medical Centers. **Primary Duties and Responsibilities** + Daily review of approved and pended outpatient requests for PMR clients and ChenMed Markets. + Provide… more
- CVS Health (FL)
- …consumer-focused, and acknowledges physicians for their clinical excellence and effective utilization of health care resources. Reporting to the Executive Behavioral ... Health Medical Director, Aetna Medicaid, this role is responsible for utilization , quality, and fraud, waste, and abuse reviews for individual cases involving… more
- Northwell Health (Forest Hills, NY)
- …Applies clinical expertise and medical appropriateness criteria to resource utilization and discharge planning. Job Responsibility 1. Coordinates and facilitates ... attending physician and/or physician advisor the appropriateness of resource utilization , consultation and treatment plan.Participates in interdisciplinary patient care… more