- Commonwealth Care Alliance (Boston, MA)
- …**Position Summary:** Reporting to the Manager Utilization Management , the Nurse Utilization Management (UM) Reviewer is responsible for day-to-day ... timely clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in… more
- Fresenius Medical Care (Brook Park, OH)
- …Quality, and Technical Services departments. Collaborates with or functions as the Home Therapies Program Manager to oversee the facility's Home Therapies ... Classification of Disease (ICD) coding. Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review.… more
- Commonwealth Care Alliance (Boston, MA)
- …Management is responsible for overseeing and managing the daily operation of the Utilization Management Review Nurse and Specialist staff responsible for ... & Utilization Mgmt Position Summary: Commonwealth Care Alliance's (CCA) Utilization Management (Authorization) Unit is primarily responsible for the… more
- Fresenius Medical Care (Albany, OR)
- Home Therapies Program Paid one on one training and education provided Empower, engage and train dialysis patients on peritoneal and home hemodialysis using ... programs and equipment Primarily works in the clinic setting and conducts initial home visits with another staff member present Position functions as an onsite… more
- Children's Hospital Los Angeles (Los Angeles, CA)
- …years nursing experience with advanced level pediatric clinical experience and utilization management and/or discharge planning experience. Thorough knowledge of ... **It's Work That Matters.** **Overview** **Purpose Statement/Position Summary:** The Nurse Care Manager performs complex discharge planning for patients...managed care, utilization management , discharges planning, and continuous quality… more
- Moses/Weitzman Health System (Meriden, CT)
- …licensure as appropriate. Fully established practice standards for productivity and appropriate utilization of care. Position is designed to support evening and or ... meeting client's health care needs. Participates with Community Health Center management in developing and achieving optimal clinical performance and organizational… more
- Endeavor Health (Skokie, IL)
- …(Population Health) is responsible for the case management , care coordination management , and utilization management of his/her population of patients ... for appropriate consultations and support services within established protocols Completes Utilization Management for assigned patients. Applies Milliman Care… more
- Stanford Health Care (Palo Alto, CA)
- …in clinical research, research, ICU, other intensive care setting, pediatrics, case management or nurse navigation preferredHuman subjects' protection and Good ... with minimal directions. + Understand and respond to multiple personalities and work/ management styles. + Resource management / utilization knowledge in… more
- BlueCross BlueShield of Tennessee (Memphis, TN)
- …we'd love to have you on our team\. **Job Responsibilities** + Supporting utilization management functions for more complex and non\-routine cases as needed\. ... from hospital care to the comfort of their own home ? Join us in empowering at\-risk individuals to navigate...for individuals with strong critical thinking skills, excellent time management , and the ability to prioritize task efficiently\. If… more
- Alameda Health System (San Leandro, CA)
- …in case management /community health preferred. Preferred Licenses/Certification: Public Health Nurse , Case Management , or Home Health. Required ... Management issues; other issues including concerns involving under/over utilization , avoidable days and quality issues. Coordinate daily with interdisciplinary… more
