- Humana (Phoenix, AZ)
- …Degree or BSN degree. + Minimum 3 years of experience in NCQA Health Plan Accreditation and/or Utilization Management + Exceptional attention to detail. + ... help us put health first** We are seeking a Senior Accreditation Professional who will work in...on NCQA accreditation standards, especially related to Utilization Management and/or Behavioral Health; MED-Deeming … more
- Veterans Affairs, Veterans Health Administration (Prescott, AZ)
- …the Northern Arizona VA Healthcare System (NAVAHCS), is recruiting to fill a Senior Social Worker within the Home-Based Primary Care (HBPC) Program. The HBPC program ... chronic, disabling disease. HBPC provides palliative care, rehabilitation, disease management , and care coordination services. Responsibilities Total-Rewards-of-an-Allied-Health-VA-Career-Brochure.pdf Social Work:… more
- Evolent (Phoenix, AZ)
- …selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with the Senior Medical Director. ... , 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
- Veterans Affairs, Veterans Health Administration (Phoenix, AZ)
- …Executive Leadership Team on a daily basis and participates in overall planning and management activities at the senior management level within the Phoenix ... with patient care and regulatory standards Actively participates in overall planning and management activities at the senior management level within the… more
- Humana (Phoenix, AZ)
- …a part of our caring community and help us put health first** The Senior Utilization Management Behavioral Health Professional utilizes behavioral health ... and communication of medical services and/or benefit administration determinations. The Senior Utilization Management Behavioral Health Professional work… more
- Evolent (Phoenix, AZ)
- …selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with the Senior Medical Director. ... the mission. Stay for the culture. **What You'll Be Doing:** **Cardiovascular Utilization Management Reviewer (Interventional Cardiologist)** Are you ready to… more
- Dignity Health (Prescott Valley, AZ)
- …and experience + Minimum of 3 years of clinical care coordination experience, ( Utilization Management , Denial Management , Care Coordination) or 3 years ... electronic health record (Epic, Cerner, Meditech, and/or Paragon) + Understand how utilization management and care coordination programs integrate + Work as… more
- Evolent (Phoenix, AZ)
- …selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with the Senior Medical Director. ... Director 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 (Phoenix, AZ)
- …Doing:** Job Description As a FMD, Radiology you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference ... Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. +… more
- Banner Health (Phoenix, AZ)
- …The position provides system-wide management for the function of perioperative management . Supports senior leadership of the system, region and operational ... In addition, this position may be eligible for our Management Incentive Program as part of your Total Rewards...across the care continuum. Develops strategies and plans for utilization of procedures in the most clinically appropriate locations..… more
- Banner Health (Phoenix, AZ)
- …the operations of the unit to ensure smooth and efficient patient care management and resource utilization . 2. Leads change by developing, implementing and ... NIHSS Stroke Gold Elite Plus, Chest Pain and Pediatric Preparedness accreditation 's. The high-functioning multidisciplinary ED team works together cohesively to… more
- Banner Health (Glendale, AZ)
- …New Graduate RN Residency Program at Banner Health has received the highest accreditation by the American Nurses Credentialing Center (ANCC) as a Practice Transition ... Accreditation Program(R) (PTAP). Banner Health's New Nurse Experience (NNE)...years. Clinical Care Operations is the hub of patient management for the campus, including: bed assignment, unit staffing… more
- Banner Health (Phoenix, AZ)
- …the operations of the unit to ensure smooth and efficient patient care management and resource utilization . 2. Leads change by developing, implementing and ... and clinical support to patients and staff. Uses depth and breadth of clinical management knowledge to ensure the provision of high quality, safe, and cost effective… more
- Evolent (Phoenix, AZ)
- …members and providers + Appropriately identifies and refers quality issues to the Senior Director of Medical Management or Medical Director. + Appropriately ... policies + Creates adverse determination notifications that meet all accreditation , State, and Federal criteria + Uses Plain Language...identifies potential cases for Care Management programs + Communicates appropriate information to other staff… more