- Highmark Health (Buffalo, NY)
- …:** **JOB SUMMARY** This job captures all inbound phone inquires for utilization management review from providers and pharmacies. The incumbent assesses ... verifying benefit coverage, creation of a prior authorization case in Highmark's Utilization Management system for Prior Authorization clinical review , status… more
- Highmark Health (Buffalo, NY)
- …Description :** **JOB SUMMARY** This job captures all inbound inquires for utilization management review from providers and pharmacies. The incumbent assesses ... for the member, and then creates the case (data entry) in Highmark's Utilization Management system for Prior Authorization clinical review . Ensures all accurate… more
- University of Southern California (Arcadia, CA)
- …outside referring physicians andmedical groups.* Communicates with insurance company utilization review and authorization personnel.* Gathers and maintains ... physician in complex cases with multiple practitioners.* Ensures appropriate resource utilization relevant to the financial, regulatory and clinical aspects of… more
- HCA Healthcare (Tallahassee, FL)
- …position if current and compliant** + **Certification in Case Management, Nursing, or Utilization Review , preferred** + **Three years of nursing experience in ... supporting a balance of optimal care and appropriate resource utilization . The RN CM Care Coordinator will...our RN Case Manager Part Time opening. We promptly review all applications. Highly qualified candidates will be contacted… more
- HCA Healthcare (Tallahassee, FL)
- …position if current and compliant** + **Certification in Case Management, Nursing, or Utilization Review , preferred** + **Three years of nursing experience in ... supporting a balance of optimal care and appropriate resource utilization . The RN CM Care Coordinator will...appropriate resource utilization . The RN CM Care Coordinator will identify potential barriers to patient throughput and… more
- HCA Healthcare (Tallahassee, FL)
- …for position if current and compliant + Certification in Case Management, Nursing, or Utilization Review , preferred + Three years of nursing experience in acute ... supporting a balance of optimal care and appropriate resource utilization . The RN CM Care Coordinator will...appropriate resource utilization . The RN CM Care Coordinator will identify potential barriers to patient throughput and… more
- Pomona Valley Hospital Medical Center (Pomona, CA)
- …education necessary to meet licensure requirements. One year experience in Utilization Review or Case Management discharge planning, current knowledge/use ... vital role within the Case Management Department. The LVN within the Utilization Management team collaborates closely with Case Managers, support staff, insurance… more
- Catholic Health Initiatives (Omaha, NE)
- …regulations pertaining to their practice. Performs other duties as assigned, including utilization review as necessary. **Job Requirements** Graduate of an ... multidisciplinary team to ensure progression of care and appropriate utilization of inpatient resources using established evidence based guidelines/criteria.… more
- US Courts (Detroit, MI)
- …management team. Design space and furniture plans to optimize space utilization . Use Computer-Aided Drafting (CAD) and Building Information Modeling (BIM) experience ... design standards of the GSA to determine the best course of action. Manage, review , and accept work performed by court and GSA consultants hired to address building… more
- Baystate Health (Springfield, MA)
- …efficient triaging and communication. Supports clinical management to ensure appropriate utilization of resources as well as patient safety and satisfaction ... and families related to hospice services and admission processes **4** ) Review reports and patient activity to prioritize admissions and routine visits. Work… more