- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …+ Knowledge of NCQA UM accreditation requirements, Massachusetts, and Rhode Island utilization review regulations + Proficiency in Microsoft Office (Word, Excel, ... utilization management regulatory and accreditation standards, such as NCQA, Massachusetts utilization review regulations, Rhode Island utilization … more
- OLV Human Services (Lackawanna, NY)
- …health record (EHR) for documentation of services rendered. + Review utilization and service provision with supervisor + Coordinate and collaborate with ... claims, whistleblower policies and all others. + Any other duty as assigned by your Supervisor Skills: + Teamwork: Ability to work as part of a team, as well as… more
- Point32Health (MA)
- … management and care management principles. Health Plan experience performing utilization review activities. Experience with McKesson's InterQual Clinical ... Point32Health (https://www.point32health.org/) . **Job Summary** Under the supervision of the Utilization Management Supervisor , the Behavioral Health (BH) … more
- University of Michigan (Ann Arbor, MI)
- …position is unique in that it combines clinical/quality considerations with regulatory/financial/ utilization review demands. The position creates a balance ... software, such as Allscripts + Participate in venues to reduce barriers to discharge ** Utilization Review and Utilization Management** + Conduct clinical … more
- Bassett Healthcare (Oneonta, NY)
- …to staff regarding "new" therapeutic modalities and medications (measured by leadership review ) + Assists supervisor , manager and director in training of ... in absence of supervisor , manager and director + Assists in full utilization of staff working time, based on individual staff capabilities, assigns employees to… more
- The County of Los Angeles (Los Angeles, CA)
- …to this class work under the immediate supervision of a Data Scientist Supervisor , or supervisor or manager responsible for the data analytics, research, ... and prevention services including but not limited to forecasting utilization and cost, cost/finance analyses, cost-effectiveness analyses, and predictive/prescriptive… more
- The County of Los Angeles (Los Angeles, CA)
- …division to manage and track the number of departmental contracts requiring the Board of Supervisor 's review and approval. + Oversees the review and tracking ... databases, status reports, and projected timelines for submission to executive staff for review . + Develops new or modified policies and procedures for completion of… more
- Bassett Healthcare (Herkimer, NY)
- …no more than 3-5 exceptions, as measured by random supervisory chart review and/or direct supervisory observation and co-worker feedback. + Analyzes assessment data ... no more than 2-3 exceptions, as measured by random supervisory chart review and/or direct supervisory observation. + Identifies expected outcomes individualized to… more
- Bassett Healthcare (Cooperstown, NY)
- …no more than 3-5 exceptions, as measured by random supervisory chart review and/or direct supervisory observation and co-worker feedback. + Analyzes assessment data ... no more than 2-3 exceptions, as measured by random supervisory chart review and/or direct supervisory observation. + Identifies expected outcomes individualized to… more
- Bassett Healthcare (Cooperstown, NY)
- …no more than 3-5 exceptions, as measured by random supervisory chart review and/or direct supervisory observation and co-worker feedback. + Analyzes assessment data ... no more than 2-3 exceptions, as measured by random supervisory chart review and/or direct supervisory observation. + Identifies expected outcomes individualized to… more
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