- Gentiva (Mooresville, NC)
- …a lasting difference in people's lives every day. **Overview** We're looking for a ** Utilization Manager ** to join our team. This position will directly report ... to the Director of Utilization Management and is responsible for planning, coordinating, implementing,...PPD vendors: medical supplies, durable medical equipment, and pharmacy utilization . + Works closely with branch leadership to identify… more
- Samaritan Daytop Village (Rhinebeck, NY)
- …and goal of sustaining high quality care/service delivery to persons served, the Utilization Manager works to assist CASAC Counselors and supervisory staff as ... needed with assuring compliance with external and internal utilization review/quality and appropriateness requirements. What qualifications do you need: + Bachelor… more
- Helio Health Inc. (Syracuse, NY)
- …to track, review, and analyze data relating to continuous quality improvement. The Utilization Case Manager will work on a Full-Timebasis supporting our ... appropriate. + Assist in developing and administering policies and procedures for utilization . + Negotiating access to care for individuals seeking services at Helio… more
- Tufts Medicine (Burlington, MA)
- …assisting with the coordination of the Utilization Management Committee. The Utilization Management Operations Manager follows the system's Utilization ... payment processing. In addition, this role focuses on performing the following Utilization duties: Ensures the delivery of clinical services is appropriate and… more
- CoreCivic (Brentwood, TN)
- …will pay $82,000 - $97,400 with a 10% bonus eligible._ **SUMMARY:** The Manager , Utilization Management/Case Management provides Utilization Review and Case ... a responsibility to better the public good. CoreCivic is currently seeking a ** Manager , Health Services Audits** located at our corporate office in Brentwood, TN.… 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 ... from payors for additional clinical documentation. Acts as liaison between the Utilization and Appeals Management Department and the physician of record, as… more
- Trinity Health (Mason City, IA)
- …Type:** Full time **Shift:** Day Shift **Description:** **JOB SUMMARY:** The Utilization Review Case Manager responsibilities include case screening, insurance ... Works directly with members of care team to effectively ensure appropriate acute utilization management + Interacts with outside review agencies and payors to inform… more
- Dallas Behavioral Healthcare Hospital (Desoto, TX)
- The Utilization Review Case Manager is responsible for working with insurance companies and managed care systems for the authorization, concurrent and ... to help patients access the full range of their benefits through the utilization review process. + Conducts admission reviews. + Conducts concurrent and extended… more
- LifePoint Health (Gallatin, TN)
- …or related healthcare field. **Job:** **Nursing* **Organization:** ** **Title:** * Utilization Mgmt Case Manager FT* **Location:** *Tennessee-Gallatin* ... Monitors adherence to the hospital's utilization review plan to ensure appropriate use of hospital services, hospital admissions and extended hospitals stays.… more
- Beth Israel Lahey Health (Burlington, MA)
- …taking a job, you're making a difference in people's lives.** Joint role of Case Manager and Utilization Review Nurse Onsite at Lahey Hospital and Medical Center ... Case Manager for Hospital at Home Care Transitions coordinates utilization review, discharge planning and monitors quality assurance for Lahey Clinic inpatient… more