- Katmai (Fort Carson, CO)
- …as needed to provide direction in care management. + Plan and prioritize utilization review (UR) activities to ensure identified patient needs are addressed ... analyze, update and record data. + Facilitate the development and integration of utilization management (UM) review policies and procedures into operations. +… more
- Katmai (Fort Carson, CO)
- …and providers, network/outside providers and ancillary healthcare workers. + Apply principles of utilization review (UR) and utilization management (UM) in ... processing referrals to specialty care. **ESSENTIAL DUTIES & RESPONSIBILITIES** + Review collected data to identify areas requiring intensive management. Analyze… more
- University of New Mexico - Hospitals (Albuquerque, NM)
- …patient responses to interventions in collaboration with quality assurance and utilization review , maintaining interdependent follow-up as necessary * VARIANCE ... to experience, education, and other business and organizational considerations. Department: Utilization Management - UH FTE: 1.00 Full Time Shift: Days Position… more
- NORC (Chicago, IL)
- …drug utilization practices and treatment recommendations, clinical practice guidelines review , FDA label review , clinical and oncology pharmacy. + Monitor ... changes to guidelines and assess their impact on drug utilization + Conduct FDA label reviews and synthesize clinical...and promotions, which is overseen by a formal Salary Review Committee (SRC)._ **WHAT WE DO:** NORC at the… more
- GCI Communication Corp (Anchorage, AK)
- …and utilization to meet business and operational needs. + Facilities Utilization & Performance: Regularly review network facilities utilization and ... the software and firmware upgrade/patch process, minimizing operational disruption. + Review and analyze the effectiveness of implemented network and service… more
- GCI Communication Corp (Anchorage, AK)
- …and utilization to meet business and operational needs. + Facilities Utilization & Performance: Regularly review network facilities utilization and ... the software and firmware upgrade/patch process, minimizing operational disruption. + Review and analyze the effectiveness of implemented network and service… more
- ERP International (Luke AFB, AZ)
- …Case Management Society of America (CMSA); American Accreditation Healthcare Commission/ Utilization Review Accreditation Commission (URAC); CAMH; (AAAHC); Health ... results of interventions, treatment delivery and timeliness of care; and utilization of resources. Monitors and evaluates the facility's case management program… more
- Commonwealth Care Alliance (Boston, MA)
- …understanding of CCA's mission, value-based approach, and expectations for quality, utilization , and member experience. - Address provider inquiries related to care ... coordination, utilization management, and program participation, collaborating with internal teams...BH and Health Home providers. - Participate in case review meetings and rounds as needed to enhance coordination… more
- Stony Brook University (Stony Brook, NY)
- …Department may include the following but are not limited to:** + Completes Utilization review screen for inpatient and observation cases. Activity includes UR ... cases for authorization for in patient stay. + Staff review short stay, long stay and complex cases to...patients who were readmitted within thirty days. Documents over utilization of resources and services. + All Medicare cases… more
- Christian Park Healthcare Center (Escanaba, MI)
- …team Assesses resident through physical assessment, interview and chart review . Discusses resident care needs with care givers, including physician, ... schedule and maintains PPS board for monitoring of Medicare days and RUGs utilization in the absence of the Care Management Coordinator Remains current with American… more
