- Intermountain Health (Las Vegas, NV)
- **Job Description:** The Utilization Review Care Management Director is responsible for providing leadership and administrative direction for Utilization ... as part of UM team in delivering and collaborating on all aspects of utilization management and care coordination for membership in the Desert Region. The… more
- LA Care Health Plan (Los Angeles, CA)
- …skills. Preferred: Knowledge of National Committee for Quality Assurance (NCQA) requirements for Utilization Management or Care Management (CM). ... Utilization Management Nurse Specialist RN II...$115,509.00 (Mid.) - $142,166.00 (Max.) Established in 1997, LA Care Health Plan is an independent public agency created… more
- Ochsner Health (New Orleans, LA)
- …of EMRs + Demonstrated ability to deliver high quality, cost-effective, efficient patient care services + Utilization Management experience (preferred) + ... related to the Physician Advisor role and responsibilities including topics related to Utilization Management , Care Management and other related areas as… more
- Intermountain Health (Las Vegas, NV)
- …position interacts with MG clinicians, Affiliate Network PCPs and Specialists in the community, utilization management , care management , claims, network ... management , and finance. As the Medical Director for Utilization Management , you are responsible, in partnership...at Intermountain Nevada who set the course for Clinical Care and Care Management Initiatives… more
- Intermountain Health (Murray, UT)
- …the full continuum of their healthcare journey. + Oversees program components related to care management and utilization review for the specific line of ... add programs to impact trends. + Uses a data-driven approach to assess utilization management and care management operations and make program… more
- Sutter Health (Sacramento, CA)
- …Advisor will work closely with the medical staff, including house staff, and all utilization management (UM) personnel, Care Management (CM) personnel ... to optimize the use of hospital services. This includes care management processes that ensure patients are...delivery and case management within a managed care environment. + Comprehensive knowledge of Utilization … more
- Providence (Centralia, WA)
- …3 years Nursing **Preferred Qualifications:** + Bachelor's Degree Nursing Or + 3 years Utilization Review, Care Management , Quality Management , and/or ... a strong clinical background blended with well-developed knowledge and skills in Utilization Management (UM), medical necessity and patient status determination.… more
- CommonSpirit Health (Phoenix, AZ)
- …in facility committee meetings, such as Joint Operating Committee (JOC), as requested by Utilization Management or Care Management . + Contacts Attending ... quality patient care and effective and efficient utilization of health care services. This individual meets with case management and health care … more
- Fairview Health Services (Burnsville, MN)
- …consistent team performance through quality services, resource utilization and management of Care Management teams. Participates in patient-centered ... throughput and ensure compliance with all state and federal regulations related to care management and utilization services. Manages the daily operations of … more
- Martin's Point Health Care (Portland, ME)
- …Medical Directors and, as a Medical Director team, provide clinical support for the Health Management Utilization Management , Care Management and ... will drive the development, promotion and delivery of high quality, evidence-based utilization and care management programs and processes. The VP will lead… more