- MetroPlusHealth (New York, NY)
- …the supervision of the Director of Long Term Care Clinical Programs, the MLTC Care Manager Team Lead is responsible for the day-to-day supervision of a team ... keep our members safe and thriving at home. The Care Manager (CM) Team Lead provides comprehensive...oversees care management to members in long-term care and utilization management of MLTC and… more
- Valley Health System Consolidated Services (Las Vegas, NV)
- …minimum three years experience in varied clinical settings. Two years experience in Utilization Review , Utilization Management or Case Management preferred. ... by establishing a safe, individualized discharge and providing proficient timely utilization management services to ensure that maximum reimbursement is achieved for… more
- MetroPlusHealth (New York, NY)
- …us. You can come to work being proud of what you do every day. The HARP Care Manager develops, facilitates, and communicates a plan of care in partnership ... Disorder providers. In partnership with these parties, the HARP Care Manager assesses, plans, facilitates, and advocates...and other resources to assist in goal achievement. Conduct Utilization Review for designated Case Management members… more
- Jazz Pharmaceuticals (Philadelphia, PA)
- …visit www.jazzpharmaceuticals.com for more information. The Senior Oncology Account Manager is responsible for direct promotion of Jazz Pharmaceuticals' products, ... therapeutic specialists within an assigned geographical territory. The Senior Oncology Account Manager (OAM) is an integral part of the commercial team that includes… more
- Desert View Hospital (Pahrump, NV)
- …minimum three years experience in varied clinical settings. Two years experience in Utilization Review , Utilization Management or Case Management preferred. ... Responsibilities Desert View Hospital is a 25-bed, acute care hospital set in a rural community. Desert View provides safe and competent nursing care for… more
- Greenspring Village by Erickson Senior Living (Springfield, VA)
- …leadership meetings such as Wound Rounds, Clinical Operations Meeting, Utilization Review , and Performance Improvement/Risk Management/Safety (PI/RM/S) Committee ... Erickson Senior Living Join our team as the Nurse Manager , RN also known as the Clinical Manager...evaluation of the delivery of safe and effective person-centered care of our 32-bed Rehab neighborhood . The Clinical… more
- Houston Methodist Clear Lake Hospital (Nassau Bay, TX)
- … utilization criteria to monitor appropriateness of admissions, level of care , resource utilization , and continued stay. Participates in denial mitigation ... At Houston Methodist, the Case Manager (CM) position is a registered nurse (RN)...utilization management, case management, performance improvement and managed care reimbursement Understanding of pre-acute and post-acute venues of… more
- CoxHealth (Lake Spring, MO)
- …feedback for the following Committees: 1) Coding and Documentation Committee 2) Utilization Review Committee 3)SOI Scorecard Committee 4) Educational sessions ... Educator will be responsible for working closely with the CDI Manager , CDI Supervisor, CDI Team Lead, CDI Specialists, Medical Director-Coding/CDI, Inpatient… more
- Daiichi Sankyo, Inc. (Bernards, NJ)
- …creation and supply of innovative pharmaceutical therapies to improve standards of care and address diversified, unmet medical needs of people globally by leveraging ... involves working with suppliers and internal stakeholders to define scope and review of work orders and agreements, Mitigates supplier issues, develops action plans… more
- The George Washington University Hospital (Washington, DC)
- …Human Resources Recruiter at ###. Please allow two to three business days for the manager to review your application. Thank you for your interest! About GW ... to offer a range of advanced services and treatments. Our multidisciplinary care teams are dedicated to outstanding clinical services, research, and education to… more
- The George Washington University Hospital (Washington, DC)
- …Resources Recruiter at ###. Please allow two to three business days for the manager to review your application. Thank you for your interest! About Universal ... US News & World Report's 2025-2026 Best Hospitals edition for our specialty care in Neurology and Neurosurgery. We also received recognition as a "High Performing"… more
- The George Washington University Hospital (Washington, DC)
- …Resources Recruiter at ###. Please allow two to three business days for the manager to review your application. Thank you for your interest! About Universal ... Night Shift The George Washington University Hospital is a 395-bed tertiary care , academic medical center located in downtown Washington, DC. Featuring a Level… more
- Fox Run Village by Erickson Senior Living (Novi, MI)
- …loss, and dehydration. Participating in Wound Rounds, Operations Meetings, Utilization Review , and Performance Improvement/Risk Management/Safety (PI/RM/S) ... for clinical leadership and outcomes within our Skilled, Assisted Living, and Memory Care neighborhoods. What we offer A culture of diversity, inclusion, equity and… more
- Seabrook Village by Erickson Senior Living (Tinton Falls, NJ)
- …loss, and dehydration. Participating in Wound Rounds, Operations Meetings, Utilization Review , and Performance Improvement/Risk Management/Safety (PI/RM/S) ... -a role ideal for a clinical leader who is passionate about person-centered care and developing strong, cohesive teams. In this role, you'll partner closely with… more
- HealthCare Support (Houston, TX)
- Utilization Review RN HealthCare Support is actively seeking a Utilization Review RN to fill an opening with a Prestigious HealthCare Company in Remote ... Houston TX . Daily Responsibilities for Utilization Review RN: WIll need to use...clinical information to authorize medically necessary inpatient and outpatient care , utilizing nationally recognized evidenced based clinical criteria or… more
- Novo Nordisk Inc. (Plainsboro, NJ)
- …the marketplace, with targeted payer accounts that influence patient access and care . Targets include a range of influential stakeholders and decision makers, ... a self-starter who is self led and keeps their manager up to date on progress and ensures no...placement in the treatment continuum as well as appropriate utilization and treatment guidelines Proactively leverages detailed knowledge of… more
- Commonwealth Care Alliance (Boston, MA)
- …Knowledge, Skills & Abilities (must have): - Expertise in managing utilization review processes including prior authorization, concurrent and retrospective ... 013650 CCA-Auth & Utilization Mgmt Position Summary: Commonwealth Care ...facilities under the provisions of CCA's benefits plan. The Manager , Utilization Management is responsible for overseeing… more
- Commonwealth Care Alliance (Boston, MA)
- 013650 CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management (UM) Reviewer ... review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring...**Required Experience (must have):** + 2 to 3 years Utilization Management experience in a managed care … more
- Bethesda Health (Alton, IL)
- …staff. Analyzes and evaluates nursing and related services to improve the quality of care and plan better utilization of staff time and activities. Oversees the ... Responsible for making administrative decisions utilizing knowledge of long-term care policies and nursing standards. Ensures compliance with standards of… more
- OhioHealth (Columbus, OH)
- …a lifelong partnership, and that everyone could use an expert guide. We work hard, care deeply and reach further to help people uncover their own power to be ... JOB DESCRIPTION JOB CODE: 2906 JOB PROFILE NAME: Physician Practice Manager JOB SUMMARY Directs, coordinates, and manages all practice functions. Responsible… more
