- Florida Atlantic University (Boca Raton, FL)
- …Raton, FL. The Facilities Mapping and Documentation Coordinator reports directly to the Director of Space Utilization or designee and serves all University sites ... drawings, specifications and as-built records. + Space Planning and Utilization : + Collect relevant data for space utilization...and faculty, FAU offers: + Excellent benefit packages including Medical (PPO/HMO $50 per month single & $180 per… more
- Carle Health (Champaign, IL)
- …of research, new or existing regulatory requirements. Oversee and actively guide utilization review , medication monitoring, treatment plans and peer review ... state, and local government and payor requirements Provide guidance to the Executive Director , Behavioral Health, for focused review as it relates to mental… more
- AdventHealth (Orlando, FL)
- …conferences for complex transitions and/or placements, as needed. + Participates in hospital/ medical staff meetings to review patients meeting criteria related ... is under the general leadership of the Care Management Manager or Facility Director and assists in monitoring and performing the daily operations and supervision of… more
- Atlantic Health System (Morristown, NJ)
- …addressing gaps in internal and external resources, and sustainable connections to medical homes and sustainable social supports to improve the patient experience, ... achieve better health outcomes, decrease avoidable cost and utilization , and increase the utilization of preventative care and healthy behaviors to improve… more
- The County of Los Angeles (Los Angeles, CA)
- …for personnel, facilities and equipment for the Occupational Therapy Department to the Medical Director and Hospital Administrator. + Confers with the hospital ... goals, objectives, and standards for the effective and efficient utilization of fiscal, material and personnel resources within the...Medical Director , Chiefs of Surgical, … more
- Intermountain Health (Butte, MT)
- …and peer review . + Provide leadership and expertise to ensure that medical quality improvement and utilization management programs are carried out in ... monitor medical policies and procedures (including case /disease management, utilization management and clinical programs) as they relate to overall delivery of… more
- Pfizer (Bismarck, ND)
- …collaborative partnerships with decision-makers at large integrated delivery networks and medical groups to conduct needs assessments and deliver compliant solutions ... vaccines. + Negotiate and manage contracts with targeted Integrated Delivery Networks, Medical Groups and Buying Groups. Enable such through collaboration with PCA… more
- Actalent (Raleigh, NC)
- …policies and NCQA guidelines. + Overturn denied claims, uphold denials, and submit cases to the Medical Director for review . + Prepare case reviews for the ... Medical Director when criteria are not met based on additional...+ Proficient with Microsoft Office applications. + Experience with utilization or appeals review preferred. + Knowledge… more
- Children's Home Healthcare (Albuquerque, NM)
- …for Home Health services from insurance company. 7. Attend quarterly Utilization Review meetings as designated by the Director of Professional Services. 8. ... on a 60 days basis per company policy. 9. Review /approve plan of care and all related documents prior...10. Provide patient care as needed/requested by Administrator and/or Director of Nursing. 11. Schedule of in home Reassessments… more
- McLaren Health Care (Grand Blanc, MI)
- …care team. Educates health team colleagues about complex clinical appeals/denials, utilization review , including role, responsibilities tools, and methodologies. ... **Position Summary** : Responsible for assisting the Corporate Director of Denials Management in the coordination of...of recent denial management, case management, clinical documentation, or utilization review experience + Five years of… more