- Elevance Health (Columbia, MO)
- **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
- CVS Health (Jefferson City, MO)
- …unrestricted RN licensure in state of residence - Must possess 1+ years of clinical experience in acute or post acute setting - Must be willing and able to ... and external constituents in the coordination and administration of the utilization /benefit management function.- Typical office working environment with… more
- CenterWell (Jefferson City, MO)
- … management program development and implementation with a focus on care transitions, post - acute care and high-risk management and care coordination. * ... cost of care, and reducing acute care utilization ). * Familiarity in integrated care management ...care regulations and policies related to care transitions and post - acute care management . * Computer… more
- Humana (Jefferson City, MO)
- …teams focusing on quality management , utilization management , case management , discharge planning and/or home health or post - acute services such ... time to the Indiana Pathways program to assist the Utilization Management , Care Management , and.... The clinical scenarios predominantly arise from inpatient or post - acute care environments. Has discussions with external… more
- Humana (Jefferson City, MO)
- …teams focusing on quality management , utilization management , case management , discharge planning and/or home health or post acute services such ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a… more
- Humana (Jefferson City, MO)
- …teams focusing on quality management , utilization management , case management , discharge planning and/or home health or post acute services such ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a… more
- CVS Health (Jefferson City, MO)
- …+ Responsible for developing and carrying out strategies to coordinate and integrate post - acute and long-term care services to members to prevent exacerbations ... workers and community resources and utilizes available data to assure appropriate care management of catastrophic, acute , and chronically ill members with the… more
- CVS Health (Jefferson City, MO)
- …and external constituents in the coordination and administration of the utilization /benefit management function. + Typical office working environment with ... to promote quality effectiveness of Healthcare Services and benefit utilization + Consults and lends expertise to other internal...+ Must possess 1+ years of clinical experience in acute or post - acute setting +… more
- SSM Health (Jefferson City, MO)
- …opportunities for improvement in standard work. + May also be responsible for: utilization management process, ED case management process, admission process, ... and act as a case manager liaison with post acute providers (skilled nursing facilities, rehab, home health, etc.). + Applies the existing body of evidence-based… more
- Elevance Health (Columbia, MO)
- …pm CST. A proud member of the Elevance Health family of companies, Carelon Post Acute Solutions, formerly myNEXUS, is the leader in health resource optimization, ... and Experiences:** + Home health experience preferred. + 1 year of Utilization Management experience preferred. + Multi-State/Compact Nursing License strongly… more
- Sharecare, Inc. (Jefferson City, MO)
- …of the care enhancement program by providing telephonic care and resource utilization for members in an appropriate, efficient, and cost-effective manner while ... the health care team to support appropriate total healthcare management . RD colleague is supervised by an Operations Manager....in the orientation and to take the pre and post -test to review competency during orientation. Yearly competency test… more