- Sutter Health (Burlingame, CA)
- …the acute care patient experience. This position works in collaboration with the Physician , Utilization Manager , Medical Social Worker and bedside RN ... the achievement of optimal health, access to care, and appropriate utilization of resources balanced with the patients' self -determination while coordinating… more
- Sutter Health (Modesto, CA)
- …the acute care patient experience. This position works in collaboration with the Physician , Utilization Manager , Medical Social Worker and bedside RN ... the achievement of optimal health, access to care, and appropriate utilization of resources balanced with the patients' self -determination while coordinating… more
- Tufts Medicine (Burlington, MA)
- …assisting with the coordination of the Utilization Management Committee. The Utilization Management Operations Manager follows the system's Utilization ... In addition, this role focuses on performing the following Utilization duties: Ensures the delivery of clinical services is...- an expansive home care network, and large integrated physician network. We are an equal opportunity employer and… more
- Catholic Health Services (Melville, NY)
- …Health was named Long Island's Top Workplace! Job Details Position Summary: The Utilization and Appeals Manager (UAM) proactively conducts clinical reviews and ... queries from payors for additional clinical documentation. Acts as liaison between the Utilization and Appeals Management Department and the physician of record,… more
- Beth Israel Lahey Health (Plymouth, MA)
- …a job, you're making a difference in people's lives.** Full Time **Job Description:** ** Utilization Review & Denials management manager - Full Time** **Who We ... and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager , you...causes of denials for discussion with the internal team, physician advisor and the Utilization Review Committee… more
- UNC Health Care (Hendersonville, NC)
- …the health and well-being of the unique communities we serve. Summary: The Utilization Manager (UM) assesses new admissions, continued stay and discharge review ... met and care delivery is coordinated. The UM completes utilization reviews in accordance with federal regulations and the...patient data and treatments. Communicates daily with the Care Manager to manage level of care transitions & appropriate… more
- Houston Methodist (The Woodlands, TX)
- At Houston Methodist, the Case Manager PRN (CM) position is a licensed registered nurse (RN) who comprehensively plans for case management of a target patient ... improvements, patient satisfaction). **PEOPLE ESSENTIAL FUNCTIONS** + Collaborates with the physician and all members of the interprofessional health care team to… more
- UPMC (Hanover, PA)
- **UPMC is hiring a part time Professional Care Manager for our Utilization Review department in Hanover! This is a part time, day shift position with a rotating ... weekend and holiday schedule.** **Purpose:** The Care Manager (CM) coordinates the clinical and financial plan for patients. Performs overall utilization … more
- Tenet Healthcare (Detroit, MI)
- …outcomes Utilizes data to provide timely and meaningful information to the Utilization Management Committee and physician staff for performance improvement. ... Group Director Utilization Review - 2506000536 Description : The Detroit...with judicious resource management Oversees submission of cases to Physician Advisor to ensure timely referral, follow up and… more
- Catholic Health Services (Melville, NY)
- …for services and coordinates utilization /appeals management review. | Assist Utilization and Appeals Manager in setting up communications with payors ... as a liaison between patient account services, physicians, care coordinators, Utilization and Appeals Managers, physician advisors and facility departments.… more