- NYC Health Hospitals (New York, NY)
- …Purpose of Position: Under general supervision of the Director of Utilization Management , assists with the planning, organizing, directing, coordinating, ... supervise all administrative and managerial functions and processes of the Utilization Management Department in the absence of the director. 3. Formulate,… more
- Kaiser Permanente (Aurora, CO)
- …Salary Range: $57.16/hour - $73.93/hour Job Summary: Manages the day to day utilization management function of a team or teams of clinicians ensuring ... the unit staff, prepares department for internal and external audits, conducts utilization management audits and ensures compliance with policies and procedures… more
- UnitedHealth Group (Eden Prairie, MN)
- …on a global scale. Join us to start Caring. Connecting. Growing together. Utilization Management plays a critical role in driving value and appropriate ... resource utilization in today's healthcare environment. Optum Provider Utilization Management Services is a fast-paced product organization with a focus on… more
- UPMC Senior Communities (Pittsburgh, PA)
- The Medical Director, Utilization Management is responsible for assuring physician commitment and delivery of comprehensive high-quality health care to UPMC ... Life Changing Medicine happen. Responsibilities: Actively participates in the daily utilization management and quality improvement review processes, including… more
- Mercury Group Staffing (Hamden, CT)
- About the job RN Utilization Management - $60/hr - Hamden, CT Job Title: RN Utilization Management (UM) Pay Rate: $60.00/hr Contract Weeks: 12 Shift: ... Hours : 40 Location: Hamden, CT Requirements: Minimum 6 months of Utilization Management (UM) experience RN License in CT Description: We are looking for… more
- Central Health (Austin, TX)
- …Under the supervision of Director of Utilization or designee - the Utilization Management RN is responsible for assessing the medical appropriateness for ... healthcare services and monitoring patient progress for concurrent reviews. The Utilization Management RN will work in conjunction with Case Managers, Social… more
- Riverside County, CA (Moreno Valley, CA)
- …referrals, medical necessity, admission/discharge/ transfer process, and other utilization management activities; develop performance improvement plans; ... to reduce length of stay and to optimize quality outcomes that balance utilization management and fiscal reimbursement; develop and implement action plans to… more
- Kaiser Permanente (Panorama City, CA)
- …the interdisciplinary approach to providing continuity of care, including Utilization management , Transfer coordination, Discharge planning, and obtaining ... B21|AFSCME|SCNSC Job Level: Individual Contributor Department: Panorama City MOB #4 - Utilization Management - 0801 Pay Range: $60.79 - $74.4 / hour Travel: No more
- Ascension (Baltimore, MD)
- Details Department: Utilization Management Schedule: Part-time. Monday-Friday, 8:00AM-4:30PM. Facility: St. Agnes Hospital Location: Baltimore, MD Salary: ... and coordinate compliance to federally mandated and third party payer utilization management rules and regulations. Requirements Licensure / Certification… more
- Aequor (Tampa, FL)
- …payments annual estimations. Prepare and supervise tax cost center spending, PO utilization for LATAM Region. SharePoint Management and Coordination Supervise ... to provide examples of successful cross-functional collaborations and effective management of pressure situations. Elaboration of tax provisions for deferred… more
- Vivo HealthStaff (Burbank, CA)
- …Clinical Supervisor, UM Denial Compliance Location: Los Angeles Metropolitan Area Position Type: Hybrid (85% remote, 15% onsite in Burbank, CA) Company: Vivo ... HealthStaff Overview: Vivo HealthStaff is seeking a Clinical Supervisor for UM Denial Compliance. This role is essential in ensuring a high-quality, efficient, and compliant denial process, adhering to all regulatory, accreditation, and health plan standards… more
- American Traveler (Boston, MA)
- American Traveler is seeking an experienced RN Case Manager with acute case management experience and an active MA RN license. Job Details *Position is based in a ... hospital setting within the case management department, *Day shift schedule from 08:00 to 16:30,...licenses accepted), *Minimum of 2 years of acute case management experience required, *Current BLS certification from the American… more
- Fort Duncan Regional Medical Center (Eagle Pass, TX)
- …certification (CCM, ACM, CCM-RN) preferred. Proven leadership experience in acute care, utilization review, case management . Strong working knowledge of hospital ... Position Summary Lead and oversee the hospital's case management department, ensuring patients receive high-quality, efficient, and coordinated care from admission… more
- Twist BioScience (South San Francisco, CA)
- …adherence to GxP standards, and delivery of services. Optimize the utilization of internal development resources.Budget Management : Develop and manage ... and robust data integrity within a highly automated environment. The effective utilization and continuous enhancement of our proprietary MES technologies will ensure… more
- Talent Software Services (Santa Barbara, CA)
- Certifications Required: CA RN License Job Duties: The role involves coordinating utilization management , resource management , discharge planning, post-acute ... care referrals, and care facilitation. The individual will oversee the management of acute patient populations across the care continuum, focusing on providing… more
- Assurance Healthcare Staffing (Houston, TX)
- …inpatient case management program consist of the following: Care Facilitation, Utilization Management , Case Management and Discharge Planning. The ... is responsible for coordinating the use systems and processes for care/ utilization management at the hospital level. In addition, the Manager is responsible… more
- DeKalb Community Service Board (Decatur, GA)
- …for all authorization processes. Oversee timely reviews, denial prevention and appeal management . The Utilization Manager will provide developmental training to ... clinical teams to assist with peer-to-peer reviews and utilization expectations. Duties and Responsibilities: Supervise staff to coordinate/manage all authorization… more
- Offshore Staffing, Inc. (Houston, TX)
- …inpatient case management program consist of the following: Care Facilitation, Utilization Management , Case Management and Discharge Planning. The ... Director is responsible for developing systems and processes for care/ utilization management and discharge planning at the hospital level. In addition, the… more
- Cleveland Clinic Rehabilitation Hospital - Fairhill (Cleveland, OH)
- …allotted time frame; assuring payments of hospital-based services meeting patient-related utilization management criteria, and implementation of safe and ... Name: Cleveland Clinic Rehabilitation Hospital - Fairhill Position: Director of Case Management Location: Cleveland, OH Hours: 40 hours/week Opening in October, the… more
- Novo Nordisk Inc. (Hackensack, NJ)
- …appropriate patients that would benefit in order to ensure early trial and utilization Generate advocacy for Novo Nordisk products and services by sharing approved ... and customer groups Recognize opportunities to productively challenge HCPs clinical management of patients that respects their knowledge and experience and adds… more
