- NorthBay Health (Fairfield, CA)
- …of Care Management and Population Health which includes: Utilization Management , Utilization Review, Inpatient , Outpatient and Complex Case ... clinical experience in area of responsibility. A minimum of 3 years of director level experience in Case Management and Population Health strongly preferred.… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …organizational standardization. Participates in identifying expanded use of and improvement management utilization of NGHS continuum. Participates in identifying ... day to day operations of the department by supporting the case management and interdisciplinary healthcare team in facilitating patient care through the continuum.… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …administration identify areas of further savings.Assist Clinical Coordinator with FTE utilization and management .Serves as primary liaison between referral ... with the Clinical Coordinator and Nurse Manager to develop patient schedules for inpatient , DPH and IOP levels of care.Evaluates the ongoing needs of the patient… more
- Roseland Community Hospital (Chicago, IL)
- Under direct supervision of the Director of Health Information Management and Care Transitions and as a part of a multidisciplinary team, the Clinical Social ... care. 8. Assist the patient and family in the utilization of appropriate community resources such as family and...least 2 years of social work experience in an inpatient or milieu setting Must have experience working with… more
- Hartford HealthCare (Torrington, CT)
- …the Inpatient Nurse Director & Social Work Supervisor, the Inpatient Psychiatric Utilization Review Social Worker will work collaboratively with the IP ... Utilization Review Social Work Care Manager (LCSW) - Inpatient Psychiatry* **Location:** *Connecticut-Torrington-Charlotte Hungerford Hospital (10115)* **Requisition ID:**… more
- Point32Health (Canton, MA)
- …we are at Point32Health, click here (https://youtu.be/S5I\_HgoecJQ) . **Job Summary** The Director , Utilization Management is responsible for directing, ... and operations for all levels of utilization management review (ie, Precertification and Intake Services, Inpatient...leadership. The Director oversees and leads medical management activities related to precertification utilization … more
- Alameda Health System (Oakland, CA)
- Director , Inpatient System Care Management + Oakland, CA + Highland General Hospital + SYS Care Coordination + Full Time - Varies + Management + Req ... Alameda Health System is hiring!Under the direction of the Vice President of Care Management , the Director of Inpatient System Care Management … more
- Catholic Health Initiatives (Lexington, KY)
- …can happen both inside our hospitals and out in the community. **Responsibilities** The Utilization Management (UM) Director is responsible for the market(s) ... staff in support of the CommonSpirit Health Care Coordination model. The Utilization Management department processes authorizations, inpatient admission and… more
- CareFirst (Baltimore, MD)
- …location based on business needs and work activities/deliverables that week. The Director , Utilization Management provides strategic leadership of the ... utilization management team and is responsible for the design, assessment,...and call center, Commercial outpatient medical pre-authorization review, Commercial inpatient and outpatient behavioral health review, Medicare intake and… more
- Humana (Columbus, OH)
- …prior experience participating in teams focusing on quality management , utilization management , and acute inpatient rehabilitation **Preferred ... Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in… more
- Trinity Health (Boise, ID)
- …of two years' experience in hospital based medicine with exposure to utilization management and documentation initiatives. 3. Demonstrated teamwork, performance ... is seeking a physician leader to become our Medical Director of Documentation and Utilization Excellence. This...MDDUE will work in a dyad partnership with the Director of Clinical Resource Management . This position… more
- CommonSpirit Health Mountain Region (Centennial, CO)
- …resources to help you flourish and leaders who care about your success. The Utilization Management (UM) Director is responsible for the market(s) ... staff in support of the CommonSpirit Health Care Coordination model. The Utilization Management department processes authorizations, inpatient admission and… more
- Select Medical (Miami, FL)
- …_._ Apply for this job (https://jobs-selectmedicalcorp.icims.com/jobs/297891/ director -of-quality- management inpatient ... Hospital** *A joint venture with Select Medical* **Location: Miami, FL** ** Director of Quality Management ** **(DQM)** **Responsibilities** **Position Summary**… more
- Fallon Health (Worcester, MA)
- …MA (or licensable). Board certified in medical or surgical specialty. **Experience:** Utilization management ; network management ; medical policy and ... LinkedIn. **Summary of purpose:** This position works with both inpatient and outpatient Care Management nurses to...review + Pharmacy issues and referral requests + Medical director on-call coverage + Support the benefits and technology… more
- Guthrie (Sayre, PA)
- …but strong needs for clinical knowledge to leverage payors. Position Summary: The Utilization Management (UM) Reviewer, in collaboration with other internal and ... payors, and providers and staff, is responsible for the coordinates Utilization Management (UM) processes and requirements for prior authorization/certification… more
- Cambridge Health Alliance (Everett, MA)
- RN Case Manager - Inpatient Case Management Everett Apply Refer a Friend Back **Date Posted:** 09/17/2024 **Requisition Number:** 7716 **Location:** CHA Everett ... Days:** 8:00-4:30pm Rotating Wkends and Holidays **Category:** Registered Nurse **Department:** Inpatient Case Management Everett **Job Type:** Part Time **Work… more
- Trinity Health (Silver Spring, MD)
- …acute healthcare setting required. + Extensive knowledge of payer mechanisms and clinical utilization management is required **Preferred:** + At least 5-7 years ... + Full-Time 8am - 4:30pm + Reporting to the Director of Care Management + The RN...Manages the activities of RN Case Managers for in inpatient care coordination and utilization review. Oversees… more
- Penn Medicine (Princeton, NJ)
- …of human resource files with director . + Collaborate with Social Work/Case Management Director to develop and oversee all aspects of clinical services using ... your life's work? Summary: + Under supervision from the Director of Social Work/Case Management and other...of policies and procedures pertaining to Princeton House's overall inpatient social work case management services. +… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist LVN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position ... net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist LVN II will...of referral determination. Actively monitors for admissions in any inpatient setting. Performs telephonic and/or on site admission and… more
- Huron Consulting Group (Chicago, IL)
- …as the expert you are now and create your future. **Qualifications** The Utilization Management Specialist is responsible for ensuring the appropriate ... to facilitate optimal patient outcomes while managing healthcare costs. The Utilization Management Specialist ensures compliance with regulatory requirements and… more
