- Genesis Healthcare (Franconia, NH)
- …oversight related to case management , quality improvement, care planning, clinical utilization , and patient identification is overseen. 22. Completes monthly ... services through appropriate utilization of resources, the promotion of clinical programs, and staff development in collaboration with licensed therapists,… more
- WellSense (NH)
- …that works for our members, no matter their circumstances. **Job Summary** The Clinical Care Manager provides holistic medical care management services for ... + Refers cases to Social Care Management , Behavioral Health Care Management , and Community Health Worker staff , as clinically indicated. + Consults… more
- Centene Corporation (Bedford, NH)
- …abuse across the continuum of care required + Experience with managed care, case management , utilization management , or quality improvement required + For ... be the one who changes everything for our 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified,… more
- HCA Healthcare (Manchester, NH)
- … services, and play a key role in the integration of HCA Clinical Strategies and HCA systems. **Medical Staff Administration** Develop facility credentialing ... deprovisioning of system access to align with practitioner's membership status and/or clinical privileges. Coordinate access by authorized facility staff to… more
- Beth Israel Lahey Health (Exeter, NH)
- …that values teamwork, innovation, and professional growth. Whether you're part of our clinical , administrative, or support staff , you'll play a key role in ... maintain smooth patient flow. 2. Responsible for human resource management of department staff including hiring, firing,...together with the Clinical Nurse educators to ensure clinical competencies for staff . Equal Opportunity… more
- Humana (Concord, NH)
- …corporate communications to be shared with senior leadership. + Supports trend management by conducting analysis of drug spend, utilization , and/or approval ... communicating with staff in different positions and all levels of management positions + Manages the Humana Michigan FIDE-SNP health plan relationship with our… more
- Evolent (Concord, NH)
- …for the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. Tasks ... independent nursing judgement and decision-making, physician-developed medical policies, and clinical decision-making criteria sets. The Clinical Review Nurse… more
- Evolent (Concord, NH)
- … Reviewer, Interventional Pain Management , you will be a key member of the utilization management team. We can offer you a meaningful way to make a ... better health outcomes. **Collaboration Opportunities:** + Routinely interacts with leadership and management staff , other Physicians, and staff whenever a… more
- Highmark Health (Concord, NH)
- …per week (Tuesday-Thursday).** This role supports the full application product lifecycle for ** clinical and utilization management software** , with a ... and technical teams. They function as a pivotal bridge, translating high-level ** clinical and utilization management software** business needs into… more
- Genesis Healthcare (Dover, NH)
- …oversight related to case management , quality improvement, care planning, clinical utilization , and patient identification is overseen by a licensed ... oversight related to case management , quality improvement, care planning, clinical utilization , and patient identification is overseen. Performs other… more