- American Honda Motor Co Inc (Marysville, OH)
- …future spending to ensure adequate payment timings and available trainings. Makes the case for training funding.* Stay current with both internal Honda as well as ... vendor sourcing or internal content creation. Vendor sourced areas will require management from scope of work through the purchasing (PO issuance and invoicing… more
- AdventHealth (Tampa, FL)
- …Stroke Association as a Primary Stroke Center. **The role you'll contribute:** The Utilization Management (UM) Specialist works under the direction of ... the Utilization Management Manager and supports the Utilization ...each position may vary based on geographical location. **Category:** Case Management **Organization:** AdventHealth Tampa **Schedule:** Full-time… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN...in an acute hospital setting. At least 2 years Utilization Management / Case Management experience ... net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN...Works with the UM Manager and Physician Advisor on case reviews for pre-service, concurrent, post-service and retrospective claims… more
- Munson Healthcare (Traverse City, MI)
- …the State of Michigan. + Minimum of three years clinical experience required. Previous utilization review and/or case management in a hospital or insurance ... + Assists in developing and revising policies to support utilization management activities, including criteria and guidelines...external case managers Why work as a Utilization Review Specialist at Munson Healthcare? +… more
- BayCare Health System (Cotton Plant, AR)
- …+ Required 2 years in Utilization Review or + Required 2 years in Case Management + Preferred 3 years Registered Nurse in Critical Care or Emergency Service ... clinical excellence. **BayCare Health System** is currently seeking a ** Utilization Review Specialist Senior** to join our...Licensures:** + Required RN (Registered Nurse) + Preferred ACM ( Case Management ) + Preferred CCM ( Case… more
- Sutter Health (Berkeley, CA)
- …systems for the appeal/denial process, tracks and trends data, and coordinates utilization management activities for the assigned area. Collaborates with ... example, emergencies, staff changes, workload, or technical development)._ **JOB ACCOUNTABILITIES:** CASE MANAGEMENT : + Review all identified cases for potential… more
- Commonwealth of Pennsylvania (PA)
- Drug & Alcohol Case Management Specialist (Local Government) - Luzerne County D&A Print ... (https://www.governmentjobs.com/careers/pabureau/jobs/newprint/4393834) Apply Drug & Alcohol Case Management Specialist (Local Government) - Luzerne County… more
- Vanderbilt University Medical Center (Nashville, TN)
- …programs in patient care, education, and research. **Organization:** Pediatric Utilization Mgmt **Job Summary:** JOB SUMMARY Facilitates optimal reimbursement ... appropriate admission status is ordered. Conducts initial admission based on utilization review medical necessity criteria. Refers cases for secondary review when… more
- Spectrum Billing Solutions (Skokie, IL)
- …cycle management company for healthcare organizations. We are looking to add a Utilization Review (UR) Specialist to our growing team. The UR Specialist ... and clinical information to ensure medical necessity and compliance of utilization review guidelines. + Obtain initial and continuing authorization for treatment… more
- Catholic Charities Family Community Services (Rochester, NY)
- **RESTART Intake & Case Management Specialist ** **Job Details** **Job Location** Jones House - Rochester, NY **Position Type** Full Time **Education Level** ... Shift** Day **Description** Under general supervision, provides intake support, ongoing case management and referral coordination services to residential… more
- PeopleReady (CA)
- …and effective usage of agency applications such as Microsoft365, Teams, SharePoint, PowerBI, Case Management and Document Management systems. * Deliver ... on processes we are missing in conjunction with the Management staff. * Handle special projects as assigned by...staff. * Handle special projects as assigned by IT Management . * Travel to our other locations to conduct… more
- Dignity Health (San Bernardino, CA)
- …hospital experience required. A Masters degree in Nursing (MSN) with a concentration in Case Management can serve as a substitute for the experience requirement. ... program with a **Bachelor of Science in Nursing (BSN) or MSN required** . If a Case Management position has been posted for 30 days and no qualified candidates… more
- Virginia Mason Franciscan Health (Tacoma, WA)
- …bonus eligibility, and more! **Responsibilities** **JOB SUMMARY** Provides complex care management to patients and their families/designated decision makers who have ... of options available to patients. Promotes safety, quality and appropriate resource utilization . Advocates on behalf of patients and caregivers for service access… more
- Ascension Health (Indianapolis, IN)
- …the areas of utilization criteria, appeal and review process, and case management system documentation. + Conduct hiring, training, directing, development ... **Details** + **Department:** Utilization Management + **Schedule:** Full time, Mon-Fri 8am-5pm + **Hospital:** Ascension St Vincent + **Location:** Remote Must… more
- Universal Health Services (Newark, DE)
- …Rockford Center is searching for a talented and patient centric Utilization Review Specialist ! Key Responsibilities include: + Completes pre-certs ... facility in DE, offers an experienced and tenured senior management team, and serves New Castle County and northern...UR Worksheets and treatment team notes. Benefits for a Utilization Review Specialist include: + Challenging and… more
- Alameda Health System (San Leandro, CA)
- Care Management Clinical Appeals Specialist + San...ICU, telemetry or Five years of Case Management experience in an acute setting or utilization ... Preferred Education: Master's in Nursing. Preferred Licenses/Certifications: Certification in Case Management , CCMC or ACM. Required Education: Bachelor's… more
- Clark County, NV (Las Vegas, NV)
- …mental health; Identifies relative and/or foster care placements for children. Permanency Case Management (Out of Home, In-Home and Adoptions) Provides on-going ... of social services, Follows recognized and approved principles and practices of case management ; Possess and implements basic crisis intervention and counseling… more
- Covenant Health Inc. (Knoxville, TN)
- Overview Utilization Management Specialist Full...GED. Minimum Experience: At least two (2) years of utilization management , case management ... to be named a Forbes "Best Employer" seven times. Position Summary: The Utilization Management Specialist I will perform utilization management … more
- LA Care Health Plan (Los Angeles, CA)
- …Certification in Certified Professional in Utilization Review (CPUR), Certified Case Manager (CCM), Utilization Management or Compliance Salary ... Enhanced Care Management Clinical Specialist II (RN or...care with internal LA Care departments such as Care Management (CM), Utilization Management (UM),… more
- Ventura County (Ventura, CA)
- …for public assistance in a public human services agency or comparable case management experience. HS Client Benefit Specialist II: One (1) year of experience ... eligibility, activity, and services provided. + Provide client information to Agency case management staff in various departments, where appropriate, in an… more
