- UNC Health (Chapel Hill, NC)
- …stay, and discharge reviews in accordance with federal regulations & the Hospitals? Utilization Management Plan. In addition, the Utilization Manager is ... appropriate case management referrals. Initiates appropriate social work referrals.3. Utilization Management Process - Performs utilization management… more
- UNC Health (Chapel Hill, NC)
- …of care and cost effectiveness through the integrating and functions of case management , utilization review and discharge planning. The Care Manager ... discharge plan. Refer administrative tasks (eg, faxing, form processing) to Care Management Assistant. Consult Social Worker and/or Utilization Manager per… more
- Saint Francis Health System (Tulsa, OK)
- Saint Francis Health System is seeking a Registered Nurse (RN) Virtual Care for a nursing job in Tulsa, Oklahoma.Job Description & RequirementsSpecialty: Virtual ... an on-site office location (not a remote position)Will perform admit, discharge chart review and other patient care duties from an office location via secure virtual… more
- Pathways Vermont (Burlington, VT)
- …with other community providers as requested Program ManagementOversee all Soteria staff training systems , including the Learning Management System in ADP, ... Practice Registered Nurse (APRN). Meet weekly for individual supervision, to review role expectations and provide feedbackProvide ongoing support for job completion… more
- Tower Water (Somerset, NJ)
- …Leverage technology and tools to streamline sales processes. Implement a customer relationship management (CRM) system for efficient tracking and management ... Tower Water Management is seeking an experienced Water Treatment Sales...Systems , prepare written proposals w/recommendations for improvement. -- Utilization of Value Selling approach -- Selling Service contracts… more
- Duke Health (Durham, NC)
- …on these topics to providers, patients and families as needed. Work with Utilization Management partners to provide information and feedback that will enhance ... care transitions across the continuum of care. Ensure optimum utilization of the patient's and the Health System...duties within the requirements of CMS and other external review agencies. -Work Performed Monitor daily census and assignment… more
- Duke Health (Durham, NC)
- …on these topics to providers, patients and families as needed. Work with Utilization Management partners to provide information and feedback that will enhance ... care transitions across the continuum of care. Ensure optimum utilization of the patient's and the Health System...duties within the requirements of CMS and other external review agencies. -Work Performed Monitor daily census and assignment… more
- Federal Home Loan Bank of Chicago (Chicago, IL)
- …knowledge implementing software designs. Extensive experience in developing strategic systems architecture plans. Experience modeling system diagrams, functional ... and your career.What You'll doIn this role, you will offer guidance, management , and leadership to the organization's solution architects. You'll be responsible for… more
- Yakima Valley Farm Workers Clinic (Cowiche, WA)
- …limited to: Drug Utilization Review Patient Counseling Drug Regimen Review Medication Therapy Management Collaborative Drug Therapy Management or ... a drug or device, as authorized by statute according to Drug Therapy Management Protocols Orders, interprets, and monitors laboratory tests Receipt or transfer of a… more
- Marion County (Salem, OR)
- …but also have numerous opportunities to engage with and address systems -level challenges. An ideal candidate would be compassionate, highly collaborative, have ... medical conditions. This position is an outward facing position, operates on a systems level and involves coordination with entities on the state and local levels,… more
- Marion County (Salem, OR)
- …and objectives of the programs, to ensure high-quality service delivery.Develop performance management systems and set metric benchmarks to ensure accountability ... opportunities to identify existing strengths and gaps in existing service delivery system .Budget, Contract and Grant Management Provide expertise, oversight and… more
- XPO (La Vergne, TN)
- …Facilitate the annual job selection/shift bid ( JSP ) process for shop employees Review and analyze trends in parts utilization , gains, shortages, usage, uptime, ... and recommending promotions and terminations. Observe, mentor, develop and review the performance and progress of mechanics and all...shop cost and supply on parts in tracking database system Communicate and coordinate with service center on units… more
- Guthrie (Sayre, PA)
- Position Summary: The Utilization Management (UM) Reviewer , in collaboration with other internal and external offices, payors, and providers and staff, is ... responsible for the coordinates Utilization Management (UM) processes and requirements for...prior authorization/certification for reimbursement of patient care services. The Utilization Reviewer : * Secures authorization as appropriate… more
- Baptist Memorial (Memphis, TN)
- Summary Responsible for the Utilization Review Program across the system . In collaboration with system care coordination leadership ensures the strategic ... of clinical experience at least 2 of which involve Utilization Review or Case Management ...+ Employee referral program Job Summary: Position: 18373 - System Manager- Utilization Review Facility: BMHCC… more
- Cleveland Clinic (Stuart, FL)
- …not only an excellent medical facility, but also a home away from home. As a Utilization Management (UM) RN Reviewer , you will work under the general ... review , concurrent review , retrospective chart review and clinical systems review ...a minimum of 85% on IRR quarterly. + Completes Utilization Management for assigned patients with a… more
- Atlantic Health System (Hackettstown, NJ)
- …process, CMS required patient notices and other regulatory requirements within the utilization management process. 10. Maintains proficiency in the application ... for CMS required patient notices. 8. Completes and documents utilization reviews, physician advisor referrals and other communications related...of organization selected clinical review criteria sets evidenced through IRR testing Graduate of… more
- Dignity Health (Northridge, CA)
- …400 care centers. Visit dignityhealth.org/northridgehospital for more information. The RN Utilization Management Coordinator (UMC) is responsible for assessing ... and in compliance of the Behavioral Health Dignity Health Utilization Review Policy. + The UMC will...+ Current CA Registered Nurse (RN) license + Prior Utilization Management experience in a clinical or… more
- Prime Therapeutics (Columbus, OH)
- …- Oncology - REMOTE **Job Description Summary** Key member of the utilization management team, and provides timely medical review of service requests that do ... VP, Medical Affairs in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + On a… more
- Evolent Health (Columbus, OH)
- …Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + On a ... you will be a key member of the utilization management team. We can offer you... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National… more
- Evolent Health (Columbus, OH)
- …Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + Participates ... you will be a key member of the utilization management team. We can offer you... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National… more
