- RestoraCare Staffing (Houston, TX)
- …improvement, disease or population management and managed care reimbursement. Understanding of pre- acute and post - acute venues of care and post - ... Health Clinic (FQHC), skilled nursing facility, or wound clinic). Experience in utilization management , case management , discharge planning or other… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …appropriate intervention. Assess, coordinate and facilitate patient's discharge plan to assure post - acute needs are arranged and secured prior to discharge; ... of individual patient needs; Works collaborate with the Physicians, patient/family, nursing, utilization review and other members of the healthcare team to assure… 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 must be ... and care team. Educate and/or coordinate referrals to community resources and post - acute providers as necessary.5. Care Progression and Transition Planning -… more
- University Medical Center of El Paso (El Paso, TX)
- …services for a targeted patient population. Carries out activities related to utilization management , discharge planning, care coordination and referral to other ... computer skills. 4. Current working knowledge of discharge planning, utilization management , case management , performance...Flexible, open-minded and adaptable to change. 7. Understanding of pre- acute and post - acute venues of… more
- University Medical Center of El Paso (El Paso, TX)
- …services for a targeted patient population. Carries out activities related to utilization management , discharge planning, care coordination and referral to other ... management and computer skills. Current working knowledge of discharge planning, utilization management , case management , performance improvement and… more
- Menlo Park (Portland, OR)
- …Managing Acute Care Conditions (MACC), Nutrition at Risk (NAR), Utilization Review (UR), Quality Assurance Performance Improvement (QAPI) and other meetings as ... You need to have at least two years in supervisory/ management position, including experience with budgets, staff development, training...is a family of over 75 skilled nursing + post - acute care centers, as well as assisted… more
- Integrity Trade Services (Indianapolis, IN)
- …emotional, and demographic data to assess for appropriate admissions into Withdrawal Management based on written policies and the Utilization Review manual ... full-time* Integrity Trade Services is hiring a CMA/RMA for our withdrawal management client in Indianapolis to start at $18.36. Receive comprehensive benefits… more
- Atrium Health (Charlotte, NC)
- …group of patients, typically geographically related and accountable for the oversight and overall management of the post - acute services in the home setting. ... operational, and quality goals. Essential Functions Responsible for the daily management of an assigned patient caseload, ensuring timely care and documentation… more
- Sutter Health (Berkeley, CA)
- …change. This position coordinates the utilization management , resource management , discharge planning, post - acute care referrals and care ... interview patient/family and determine preferences for post - acute care services. Utilization Management . * Completes initial InterQual review screening… more
- Sutter Health (San Francisco, CA)
- …oversees the Case Management Assistants to determine preferences for post - acute care services. Utilization Management . * Reviews medical record to ... communicates to patient/family prior to transition. * Assures necessary paperwork for post - acute transfers to comply with state and federal regulatory… more
- ChenMed (Chicago, IL)
- …Coordinates as needed with the transitional care team, hospital, skilled nursing facility, post - acute , utilization management , and home-based services ... PCP requests for external cardiology referrals and participates in delegated utilization authorizations; determines level of urgency of follow-up, referral /… more
- ChenMed (Houston, TX)
- …Assists and coordinates, in conjunction with the transitional care team; hospital, SNF, post - acute , delegated utilization management and home-based ... Director/Manager, Center Managers, external sub-specialists and providers in hospitals and post - acute care facilities. **KNOWLEDGE, SKILLS AND ABILITIES:** +… more
- CVS Health (New York, NY)
- …state of NY. 5 years of nursing experience. 1 year experience in Utilization Management . Reliable transportation required.Mileage is reimbursed per our company ... + Responsible for performing other duties as requested by Associate Director, Post - Acute Care and MSHP Leadership Population Health Transitional Care… more
- Kaleida Health (Buffalo, NY)
- …equity, and any applicable collective bargaining agreement.* **Grade:** 600 **Position:** VP Care Management Post - Acute Care Transition **Union Code:** 00 - ... executive leadership and guidance for critical areas of Care Management (CM), Discharge Planning and Post - Acute...related or Business field preferred. 10 years of care management / utilization management experience required in… more
- Elevance Health (Columbus, OH)
- …with Managed Care, Utilization Management , Prior Auth, and Benefits Management decision support in the Post - Acute Domain, DME, Home Health, ... looking to hire a **National Solution Medical Director for Post Acute Care Solutions** . This high-performing...enhances relevant clinical guidelines. + Provides clinical leadership for Utilization Management , Case Management , Disease… more
- Elevance Health (Louisville, KY)
- **Clinical Operations Associate Medical Director** **Carelon Insights** ** Post Acute Care Utilization Review** _Schedule: 11-8 Central Time_ A proud member ... of the Elevance Health family of companies, Carelon Post Acute Solutions, formerly myNEXUS, is the...Associate Medical Director** is responsible for supporting the medical management staff ensuring timely and consistent medical decisions to… more
- Providence (Seattle, WA)
- …Medicare 5-Star, NCQU and/or URAC (preferred) + Knowledge of principles and practice of acute utilization management + Knowledge of evidence-based practice + ... **Description** **THE ROLE** The Senior Director Utilization Management & Denials - Administration is 100% remote. The role requires a broad knowledge and focus… more
- LA Care Health Plan (Los Angeles, CA)
- …in the acute setting. Works with UM leadership, including the Utilization Management Medical Director, on requests where determination requires extended ... Utilization Management Admissions Liaison RN II...Provides the primary clinical point of contact for inpatient acute care hospitals requesting Inpatient care/ post -stabilization admission… more
- Corewell Health (Southfield, MI)
- …everyone. Together, we are Corewell Health. Scope of work The Clinical Utilization Management (UM) Supervisor is responsible for monitoring, supervising, and ... performing daily Utilization Management functions, which includes but is...services in 22 hospitals, 300+ outpatient locations and several post - acute facilities-and Priority Health, a provider-sponsored health… more
- Sharp HealthCare (San Diego, CA)
- …the episode of care and supports other members of the System Centralized Utilization Management team to ensure final status reconciliation. This position ensures ... ensure appropriate patient status and assists with repatriation and post -stabilization reviews for patients before the patient is bedded,...Degree in a health related field + 3 Years Utilization Management or case management … more
