- US Tech Solutions (Columbia, SC)
- …promote quality, cost effective outcomes. Performs medical or behavioral review /authorization process. Ensures coverage for appropriate services within benefit and ... and contract benefits. + Utilizes allocated resources to back up review determinations. Identifies and makes referrals to appropriate staff (Medical Director,… more
- HCA Healthcare (Manchester, NH)
- …+ Focused or ongoing professional practice evaluations (FPPE/OPPE), performance improvement, utilization patterns, peer review , or other performance information. ... governance documents (ie bylaws, rules & regulations, policies) and implement annual review process. Serve as the primary liaison between the facility, Division… more
- Banner Health (Mesa, AZ)
- …of a facility perioperative services department(s). Tracks and manages budgets to review utilization and expenditures ensuring operational efficiency and revenue ... targets such as turnaround time, on time starts, preference card utilization , supply cost, block management, budget, and schedule optimization. Partners with… more
- Terracon (Dallas, TX)
- …Supervise daily department operations including staff training, development, and performance review , utilization of equipment and facilities, safety oversight, ... designated service line by providing training, inspections, and workforce/equipment utilization . + Partner with Director, Regional Operations and Operations Managers… more
- Walmart (Westminster, MA)
- …* Approve, track, and manage facility expenses against budget; monitor asset utilization ; and prepare, review , and analyze business reports * Forecast ... of integrity and belonging. This critical leader manages financials, oversees asset utilization , and leverages data to guide business decisions in a nonautomated… more
- CVS Health (Columbus, OH)
- …that promote high-quality healthcare for members. We are seeking a dedicated Utilization Management (UM) Nurse to join our remote team **Position Summary** The ... sedentary work, including extended periods of sitting, computer use, and document review . + Participate in occasional on-call rotations, including some weekends and… more
- Integra Partners (Troy, MI)
- …Director) with administrative and non-clinical tasks related to processing Utilization Management prior authorization sand appeals. JOB RESPONSIBILITIES + Monitor ... incoming faxes + Enter UM authorizations review requests in UM platform using ICD-10 and HCPCS codes + Verify eligibility and claim history in proprietary claims… more
- Akin Gump Strauss Hauer & Feld LLP (Washington, DC)
- …workloads, availability, and utilization and alert Director to areas of concern. Review monthly utilization reports and note any inconsistencies. + Work with ... on capabilities and availability. Maintain a working knowledge of team utilization , workload, developmental needs and professional development goals. Conduct ongoing… more
- McLaren Health Care (Bay City, MI)
- …or equivalent through the Military Training network (MTN) **_Preferred:_** + Utilization management ( review ) and discharge planning experience. + Certification ... in Case Management, either CCM or ACM (Commission for Case Management or American Case Management Association) more
- Banner Health (Phoenix, AZ)
- …management process. Reviews audit results and presents summary information for management utilization and review . 7. May coordinate the admission process ... including new resident evaluations. Provides verbal and written communication to residents, families and referrals sources regarding the process for admission to the center. Facilitates problem solving with residents, families, referral sources, insurance… more