- Cleveland Clinic (Cleveland, OH)
- …career with one of the most respected healthcare organizations in the world. As a Utilization Management Specialist , you will perform UM activities, such as ... discharge plan. + Achieve a minimum of 85% on IRR quarterly. + Complete Utilization Management for assigned patients with a minimum of 25-30 reviews per day. +… more
- Mallinckrodt Pharmaceuticals (Cleveland, OH)
- Job Title Immunology Sales Specialist - Ophthalmology (Cleveland/Pittsburgh) Requisition JR000015416 Immunology Sales Specialist - Ophthalmology ... ability to drive results across large and complex territories. This specialist will overlay existing field teams, collaborating closely with portfolio… more
- Mallinckrodt Pharmaceuticals (Cleveland, OH)
- Job Title Immunology Sales Specialist - Nephrology (Cleveland) Requisition JR000015411 Immunology Sales Specialist - Nephrology (Cleveland) (Open) Location ... ability to drive results across large and complex territories. This specialist will overlay existing field teams, collaborating closely with portfolio… more
- Cleveland Clinic (Cleveland, OH)
- …organizations in the world. As a Safety, Quality and Patient Experience (SQPE) Specialist II at Lutheran Hospital, you will help drive excellence across a diverse ... ensure compliance with standards and improve performance across safety, quality, utilization and experience metrics. This is an exciting opportunity to advance… more
- Robert Half Accountemps (Richfield, OH)
- Description We are seeking a detail-oriented and skilled Accounts Payable Specialist to join our team in Richfield, Ohio. This Contract-to-Permanent position ... the broader business functions. Key Responsibilities: + Accounts Payable Management : + Process full-cycle accounts payable, including three-way matching and… more
- Bon Secours Mercy Health (Oberlin, OH)
- …sites and clinicians are recognized for clinical and operational excellence. **_Patient Access Specialist - Mercy Allen Hospital (Oberlin, OH)_** **This is a PRN "As ... of service goals as assigned. Patient Access staff are responsible for the utilization of quality auditing and reporting systems to ensure accounts are corrected.… more
- Molina Healthcare (Cleveland, OH)
- …clinical systems applications/platforms. Responsible for implementation and training delivery for utilization management , care management , long-term services ... in clinical systems analysis, and 1 year experience in a care management , utilization management , behavioral health, medical, or managed care setting, or… more
- Molina Healthcare (Cleveland, OH)
- …system requirements of internal customers as it pertains to other provider network management areas, such as provider contracts. This role is a multi facet internal ... training to ensure smooth project delivery, successful adoption and effective utilization of implemented solutions + Generates and prepares provider-related data and… more
- Danaher Corporation (Cleveland, OH)
- …includes some of the following: infection detection/control, sepsis care, decision support, utilization management , case management , ED patient workflow, ... leaders from nursing, emergency medicine, pharmacy, quality, patient safety, risk management , IT, infection control, laboratory, and administration is required. This… more
- Molina Healthcare (Cleveland, OH)
- …ensure appropriate reimbursement to providers. + Resolves escalated complaints regarding utilization management and long-term services and supports (LTSS) ... modification of payment decisions. + Serves as a clinical resource for utilization management , CMOs, physicians and member/provider inquiries/appeals. + Provides… more
- Molina Healthcare (Cleveland, OH)
- …ensure payment integrity. * Performs clinical reviews of medical records and other utilization management documentation to evaluate issues of coding and DRG ... tools to build workflow processes and training, auditing and production management resources. * Identifies potential claims outside of current concepts where… more
- Molina Healthcare (Cleveland, OH)
- …reports submitted to the Eastern US Quality Improvement Collaborative (EQIC) and/or utilization management committees. + Participates as needed in joint ... proficient, self-directed, autonomous and experience working from home. Care Management & Waiver Service Auditing experience is highly preferred. Work… more
- Molina Healthcare (Cleveland, OH)
- …at least 3 or more years in one or more of the following areas: utilization management , care management , care transitions, behavioral health, or equivalent ... work of external vendors. + Focuses on process improvement, organizational change management , program management and other processes relative to business needs.… more
- Parker Hannifin Corporation (Elyria, OH)
- …Supply Chain Manager. Will interact with all levels of Division management ; including operational, engineering, quality control, marketing and finance. May supervise ... the Sourcing/Commodity Manager, Sourcing Specialist , and Buyer. Key supplier and key customer contact...the company's position. Ensures purchasing strategy reflects the consistent utilization of local suppliers vs. Group strategic suppliers. +… more
- Cleveland Clinic (Garfield Heights, OH)
- …safety, quality and experience. As a Safety, Quality and Patient Experience (SQPE) Specialist - Sepsis Coordinator, you will play a critical role in advancing our ... compliance with all standards and favorable performance on safety, quality, utilization , and experience metrics. + Participate in engraining the safety, quality,… more