- New York State Civil Service (New York, NY)
- …require an accommodation.BASIC FUNCTION:Under the direct supervision of the Director of Contract Participation, the Project Manager , Utilization , will lead ... NY HELP No Agency Empire State Development, NYS Title Project Manager , Utilization - MWBE Occupational Category Other Professional Careers Salary Grade NS… more
- Beth Israel Lahey Health (Plymouth, MA)
- …a job, you're making a difference in people's lives.** Full Time **Job Description:** ** Utilization Review & Denials management manager - Full Time** **Who We ... and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager , you...of clinical denials. + Maintains current knowledge of payer contract changes as they pertain to level of care… more
- Ochsner Health (Jefferson, LA)
- …your future today!** This job manages expense management, vendor relationships, contract management, standardization and consolidation processes and utilization ... cost reduction initiatives throughout the organization by serving as a project manager and consultant to the clinical and non-clinical areas; tracks the system… more
- Catholic Health Services (Melville, NY)
- …why Catholic Health was named Long Island's Top Workplace! Job Details The Utilization and Appeals Manager (UAM) proactively conducts clinical reviews and ... payors for additional clinical documentation. + Acts as liaison between the Utilization and Appeals Management Department and the physician of record, as required.… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …This position is responsible for coordinating, integrating, and monitoring the utilization of physical health (PH) medical and healthcare services for members, ... on customer and departmental needs. + Plans, implements, and documents utilization management activities which incorporate a thorough understanding of clinical… more
- Molina Healthcare (GA)
- …in some or all of the following functions: care management, utilization management, behavioral health, care transitions, long-term services and supports (LTSS), ... more of the following activities: care review, care management, utilization management (prior authorizations, inpatient/outpatient medical necessity, etc.), transition… more
- Molina Healthcare (WA)
- …State RN or Clinical Social Worker/Counseling License. + Certified Case Manager (CCM), Utilization Management Certification (CPHM), Certified Professional in ... licensure and/or certification required ONLY if required by state contract , regulation or state board licensing mandate. + At...+ At least 2 years in case, disease or utilization management; managed care; or medical/behavioral health settings. +… more
- Guthrie (Troy, PA)
- …approaches and make recommendations for alternate levels of care. The Acute Case Manager also performs Utilization Management throughout the continuum of care in ... Acute Case Manager Position Summary: The Acute Case Manager...in an acute care setting with strong care management, utilization review, and payer knowledge. A Case Management certification… more
- National Youth Advocate Program (Columbus, OH)
- ** Utilization Manager /Continuous Quality Improvement Manager - Columbus** **Compensation:** $82,000 - $85,000 **Position Summary** The Utilization ... 401K Matching flexible hours, mileage reimbursement, phone allowance **Responsibilities** The Utilization Manager /Continuous Quality Improvement Manager will… more
- AdventHealth (Mansfield, TX)
- …of selected patient populations across the continuum of illness. The Nurse Manager promotes effective utilization of health care resources, monitors these ... ages, and a growing business community. **The role you'll contribute:** The Nurse Manager is a specialized health care professional who adheres to the goals,… more
- City of New York (New York, NY)
- …contracting and fiscal functions within the Office of Community Outreach. The Contract Manager is responsible for the utilization of fiscal and contract ... monitoring and oversight, and program-side responsibilities related to contract administration for NYC Benefits contracts . DSS...(1) Administrative Staff Analyst NM to function as a Contract Manager . Under the direction of the… more
- ERP International (Nellis AFB, NV)
- …additional education or clinical management of selected diseases. * Collaborates with case manager , utilization manager , and Managed Care Support Contractor ... International is seeking a full-time **Registered Nurse (RN) Disease Manager ** in support of theMike O'Callaghan Military Medical Center… more
- Promotion In Motion (Park Ridge, NJ)
- …trade spend ROI, recommendations for P&L enhancement, and efficient/optimized resource utilization . This manager will partner cross-functionally while assisting ... Manager , Sales Finance Job Details Job Location Park...operational efficiency. + Provide financial guidance and support for contract negotiations, pricing decisions, trade terms, and customer profitability… more
- The County of Los Angeles (Los Angeles, CA)
- … 10, ISD. The Opportunity The Equity in County Contracts Program Manager will serve as a centralized contract authority with specific responsibility for ... EQUITY IN COUNTY CONTRACTS PROGRAM MANAGER (ADMINISTRATIVE MANAGER...contract tiering opportunities in solicitations to divide large contract into multiple smaller contracts as a… more
- AdventHealth (Land O' Lakes, FL)
- …outcomes within effective time frames on a specific group of patients.The Case Manager is responsible for utilization reviews and resource management, discharge ... Service Awards, TWCE as Nice **The role you'll contribute:** The Case Manager is accountable for the organization, sequence of services and resources that… more
- Austin Industries (Irving, TX)
- …** for heavy civil projects in the **North** **Texas area.** The Equipment Service Manager is responsible for maximizing the utilization of Austin Bridge and ... equipment platform and refine and develop and implement new Infrastructure based utilization and management program + Participate in the development of capture plans… more
- Chiesi (Cary, NC)
- …Main Responsibilities + Conduct financial modeling and risk analyses for contracts . Develop strategic recommendations based on pricing proposals for presentation to ... governance committees. + Analyze product reimbursement and utilization management criteria against contracting objectives and Develop account business case and… more
- Actalent (Sunrise, FL)
- Job Title: Behavioral Health Utilization Review NurseJob Description The Utilization Management Nurse (UMN) plays a crucial role in reviewing requests for ... use of services. Under the general supervision of the Director and/or Manager /Supervisor of Medical Management, and in collaboration with the interdisciplinary team,… more
- Whidbey General Hospital (Coupeville, WA)
- …home health, Hospice, skilled nursing, anti-biotic regime, etc. The RN - Care Manager follows the hospital's Case Management/ Utilization Plan that integrates the ... time-we'd love to meet you! The RN - Care Manager is a health care professional with experience and...to assure compliance with CMS Conditions of Participation regarding Utilization Review and Discharge Planning. The RN - Care… more
- Amcor (Wytheville, VA)
- …function/department and works closely with the Plant Manager , and HR Manager to ensure the effective utilization of available resources. + Directly ... Recommend and implement programs to eliminate identified problems, to improve labor utilization , upgrade facilities, and reduce costs. + Seek bids on construction,… more