- Humana (Columbus, OH)
- …health first** Humana Healthy Horizons in Virginia is seeking a Manager, Utilization Management (Behavioral Health) who will utilize their clinical skills to support ... behavioral health services and/or benefit administration determinations. The Manager, Utilization Management (Behavioral Health) applies a Person-Centered approach, works… more
- Centene Corporation (Oklahoma City, OK)
- …on workplace flexibility. **Position Purpose:** Manages the behavioral health (BH) utilization review clinicians to ensure appropriate care to members. Manages BH ... utilization management issues related to member care, provider interactions,...to member care, provider interactions, and facilitates operations within utilization management. + Manages behavioral health (BH) utilization… more
- UNC Health Care (Chapel Hill, NC)
- …the health and well-being of the unique communities we serve. RN Utilization Manager position specifically for a Utilization Manager/Clinical Appeals Nurse. ... episode through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management staff to… more
- Regis HR Group (Miami, FL)
- Develops, manages and directs the Utilization Management programs for the primary care clinics. The key objective is to drive cost-effective, high-quality care with ... integrated functions such as Discharge Planning, Case Management program, Outside Utilization Review program and Extended Care Coordination to promote a centralized,… more
- Hackensack Meridian Health (Hackensack, NJ)
- **Overview** The Senior Utilization Review Physician Specialist collaborates with the healthcare team in the management and resolution of activities that assure the ... population and HackensackUMC. These include but are not limited to utilization review, hospital reimbursement, clinical compliance, case management, and transitions… more
- Immigration and Customs Enforcement (IN)
- …Director for Healthcare Compliance, Office of Health Plan Management. The Senior Utilization Review Consultant will report directly to the IHSC Regional ... Utilization Manager with the Utilization Management Program Administrator. This is a non-supervisory position. This position is only open to USPHS officers who… more
- Centene Corporation (Columbia, SC)
- …benefits including a fresh perspective on workplace flexibility. + Collaborates with utilization management team to resolve complex care member issues + Maintains ... knowledge of regulations, accreditation standards, and industry best practices related to utilization management + Works with utilization management team and… more
- Virginia Mason Franciscan Health (Bremerton, WA)
- …bonus eligibility, and more! **Responsibilities** **Job Summary / Purpose** The Utilization Management (UM) Director is responsible for the market(s) development, ... implementation, evaluation and direction of the Utilization Management Program and staff in support of the CommonSpirit Health Care Coordination model. The … more
- Beth Israel Lahey Health (Burlington, MA)
- …Center is now offering up to a $3,500 in signing bonuses for our Utilization Review positions. Important Details: * Signing Bonuses are paid out in three payments. ... **Job Description:** In conjunction with the admitting/attending physician, the Utilization Review RN assists in determining the appropriate admission status… more
- Trinity Health (Boise, ID)
- …years' experience in hospital based medicine with exposure to utilization management and documentation initiatives. 3. Demonstrated teamwork, performance analysis, ... with Trinity Health experts in managing and developing medical utilization programs and documentation initiatives. **Work Experience** **Job Description:** Saint… more
- Colorado State University (Fort Collins, CO)
- Posting Detail Information Working TitleWood Utilization and Marketing Program Specialist Position LocationFort Collins, CO Work LocationPosition is fully remote ... the benefit of present and future generations". The Wood Utilization and Marketing Program Specialist is a sub-staff of...supervision of the Manager of Program Delivery, the Wood Utilization and Marketing Program Specialist is responsible for the… more
- Beth Israel Lahey Health (Burlington, MA)
- …Advisor will play an active role in optimizing healthcare resource utilization , ensuring quality, patient care, and managing valuable organizational resources. The ... the director of care transitions to assess and guide the appropriate utilization of medical services while maintaining compliance with all regulatory requirements.… more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply UTILIZATION REVIEW NURSE SUPERVISOR ... direction, administrative and technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General Medical Center, one of the… more
- Sharp HealthCare (San Diego, CA)
- …the System Integrated Care Management (ICM) team the Transfer and Admissions Utilization Manager (UM) partners with the Centralized Patient Placement Center (CPPC) ... internal transfer requests and direct admission requests. This position supports utilization review functions to ensure appropriate patient status and assists with… more
- Children's Mercy Kansas City (Kansas City, MO)
- …of children beyond the walls of our hospital. Overview The Manager of Utilization Review will provide leadership to integrated inpatient teams and assist the ... as training/oversight of programs and services. Responsible for effective utilization review and proper resource management, including patient statusing processes,… more
- Providence (Seattle, WA)
- **Description** **THE ROLE** The Senior Director Utilization Management & Denials - Administration is 100% remote. The role requires a broad knowledge and focus on ... Utilization Management and Denials principles such as performance improvement, healthcare finance (including contractual arrangements, utilization /quality… more
- WellSpan Health (York, PA)
- Utilization Management Nurse (RN) - Case Management - Day (Temporary) Location: WellSpan Health, York, PA Schedule: Full Time Sign-On Bonus Eligible Remote/Hybrid ... geographic footprint. General Summary Performs a variety of reviews and applies utilization and case management techniques to determine the most efficient use of… more
- Beth Israel Lahey Health (Burlington, MA)
- …Shift:** Day (United States of America) Joint role of Case Manager and Utilization Review Nurse Hospital at Home Full Time Days 8:00am-4:30pm weekend and holiday ... Nurse (RN) Case Manager for Hospital at Home Care Transitions coordinates utilization review, discharge planning and monitors quality assurance for Lahey Clinic… more
- Universal Health Services (Riverside, CA)
- …Essential Job Duties Responsible for the collection of accurate data from utilization of services within the Utilization management Department. Prepare useful ... statistics from this data. Prepare monthly reports and analyze miscellaneous utilization data (ie percentage of C-sections, mental health utilization , home… more
- The Arora Group (Bethesda, MD)
- Licensed Practical Nurse (LPN) - Utilization Review Nurse Currently recruiting a Licensed Practical Nurse (LPN/LVN) - Utilization Review in Bethesda, Maryland to ... on Federal holidays. DUTIES OF THE LICENSED PRACTICAL NURSE (LPN/LVN) - UTILIZATION REVIEW: + Initiate, perform and complete assigned duties in providing care… more
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