- UT Health Tyler (Tyler, TX)
- …, transition management and operational management of the Case Management Department to promote effective utilization of hospital resources, timely ... program and more Your team is bigger than your department : UT Health Tyler, the flagship hospital of the...with respect. Responsibilities The Manager of Case Management has overall responsibility for hospital utilization … more
- Elevance Health (Washington, DC)
- …degrees of medical complexity and acuity. Participates in case and/or utilization management execution/decision making for managed member populations. Primary ... in the development, implementation, and coordination of a comprehensive integrated Medical Management program designed to manage health outcomes in a highly complex… more
- UNC Health Care (Chapel Hill, NC)
- …through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management staff to ... Hospitals? Utilization Management Plan. In addition, the Utilization Manager is responsible for revenue protection by reconciling physician orders, bed… more
- Sharp HealthCare (San Diego, CA)
- …System Integrated Care Management (ICM) team the Transfer and Admissions Utilization Manager (UM) partners with the Centralized Patient Placement Center ... **Facility:** Corporate Offices **City** San Diego ** Department ** **Job Status** Regular **Shift** Day **FTE** 1...Experience and understanding of federal and state regulations governing utilization management + Accredited Case Manager… more
- Humana (Columbus, OH)
- …help us put health first** Humana Healthy Horizons in Virginia is seeking a Manager , Utilization Management (Behavioral Health) who will utilize their ... of behavioral health services and/or benefit administration determinations. The Manager , Utilization Management (Behavioral Health)...team or department SMART goals. + Supervises utilization management personnel and oversee all … more
- AmeriHealth Caritas (Newark, DE)
- ** Utilization Management Plan Oversight Manager (must reside in DE)** Location: Newark, DE Primary Job Function: Medical Management ID**: 34207 **Job ... and serves as SME for clinical components DE Medicaid Utilization Management Program. Works in close collaboration...practice required + 3+ years of utilization management experience + Demonstrated ability to assess department… more
- Cedars-Sinai (Los Angeles, CA)
- …Title** : CSMC 8750000 Utilization Management Utilization Review Case Manager FR 48010 Allen 429 1.00 ** Department ** : Utilization Management ... **Job Description** **Job Summary: Key Job Responsibilities** The Utilization Review Case Manager validates the...**Experience:** 3 years In acute nursing 2 years Case Management 1 year CPT coding **Physical Demands:** Lifting 50… more
- Sharp HealthCare (San Diego, CA)
- …of RN experience. **What You Will Do** As a member of the System Integrated Care Management (ICM) team the Utilization Manager (UM) II position supports ... **Facility:** Corporate Offices **City** San Diego ** Department ** **Job Status** Regular **Shift** Variable **FTE** 1...Experience and understanding of federal and state regulations governing utilization management + Accredited Case Manager… more
- Humana (Columbus, OH)
- …a part of our caring community and help us put health first** The Manager , Utilization Management Nursing uses clinical knowledge, communication skills, and ... appropriate allocation of member services, treatments, and resources. The Manager serves as a resource to Humana's management...the daily management and operations of the department . Oversees utilization management functions… more
- Beth Israel Lahey Health (Burlington, MA)
- …committees representing patient issues and department functions such as case management , utilization and CQI as requested. 16) Incorporates Lahey Clinic ... Day (United States of America) Joint role of Case Manager and Utilization Review Nurse Hospital at...of medical/surgical nursing care experience. -Two years of Case Management or Utilization Management experience… more
- Prime Healthcare (Montclair, CA)
- …Responsibilities The working Manager of the Case ... experience, education, credentials and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/162306/case- management - manager utilization - management /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306)… more
- Virginia Mason Franciscan Health (Bremerton, WA)
- …staff in support of the CommonSpirit Health Care Coordination model. The Utilization Management department processes authorizations, inpatient admission and ... annual bonus eligibility, and more! **Responsibilities** **Job Summary / Purpose** The Utilization Management (UM) Director is responsible for the market(s)… more
- Baptist Memorial (Memphis, TN)
- …+ Employee referral program Job Summary: Position: 18373 - System Manager - Utilization Review Facility: BMHCC Corporate Office Department : HS Case Mgmt ... years of clinical experience at least 2 of which involve Utilization Review or Case Management Preferred-RN with 7 years of clinical experience with … more
- LA Care Health Plan (Los Angeles, CA)
- Supervisor, Utilization Management RN Job Category: Clinical Department : Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: ... to achieve that purpose. Job Summary The Supervisor of Utilization Management (UM) RN is responsible for...responsible for executing the day-to-day operations of the UM department , and monitoring the Care Management (CM)… more
- Banner Health (AZ)
- …team format. PREFERRED QUALIFICATIONS Previous experience with behavioral health utilization management . Additional related education and/or experience ... **Primary City/State:** Arizona, Arizona ** Department Name:** Behavioral Health **Work Shift:** Day **Job...remote and hybrid work settings. As a Behavioral Health Utilization Care Manager , you will be assigned… 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 ... of National Committee for Quality Assurance (NCQA) requirements for Utilization Management or CM. Knowledge of Department of Health Care Services (DHCS)… more
- Sharp HealthCare (San Diego, CA)
- …to case management or quality management as appropriate for utilization or quality issues while maintaining department processes in compliance with the ... **Facility:** Corporate Offices **City** San Diego ** Department ** **Job Status** Regular **Shift** Day **FTE** 1...routine, urgent and expedited referrals as outlined in SCMG's Utilization Management Plan.Decisions will be communicated to… more
- The Mount Sinai Health System (New York, NY)
- The Utilization Review Manager for the Selikoff Centers for Occupational Health is responsible for the management of program operations within a particular ... records, and internal and external regulatory and survey requirements. + The Utilization Review Manager collaborates with multiple professionals to support and… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department : Utilization Management Location: Los Angeles, CA, US, 90017 Position ... implement a successful discharge plan. Works with the UM Manager and Physician Advisor on case reviews for pre-service,...for Utilization Management or Care Management (CM). Knowledge of Department of Health… more
- Dignity Health (Rancho Cordova, CA)
- …**Position Summary:** Under the guidance and supervision of the department Manager /Director, the Supervisor of Utilization Management is responsible and ... and assignments and adjusts workflow as needed to meet department goals. - Assists manager with performance...years UM experience with Charge/Lead/Supervisory/ Management experience in Utilization Management department preferred. -… more
