- University of Maryland Medical System (Bel Air, MD)
- …of Maryland Upper Chesapeake Health owns and operates: University of Maryland Upper Chesapeake Medical Center ( UM UCMC), Bel Air, MD The Upper Chesapeake Health ... Company Description University of Maryland Upper Chesapeake Health ( UM UCH) offers the residents of northeastern Maryland...provides high quality care to all. Our commitment to service excellence is evident through a broad range of… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …support to internal partners including but not limited to Member Service , Medicare Operations, Compliance, Legal, Medical Directors, Sales/Marketing/Product and ... true colors to blue. The Pharmacy Operations Clinical Pharmacist Manager manages and directs clinical staff in the day...clinical staff in the day to day clinical operational UM activities to ensure that all Commercial (Pharmacy and… more
- Stony Brook Medicine (Stony Brook, NY)
- …and obtain medical clearance from Stony Brook Medicine's Employee Health Services * Complete electronic reference check with a minimum of three (3) professional ... Position Summary At Stony Brook Medicine, a Care Manager is a valuable member of our team,...a valuable member of our team, who provides clinical services to our patient population. Qualified candidates will demonstrate… more
- University of Maryland Medical System (Glen Burnie, MD)
- Company Description Experience the highest level of appreciation at UM Baltimore Washington Medical Center - named Top Workplace in the Baltimore area by The ... three ANCC Pathway to Excellence(R) designated hospitals in Maryland. UM BWMC features one of the state's busiest emergency... Center (UMBWMC) provides the highest quality health care services to the communities we serve. Our medical… more
- Oerlikon (Schaumburg, IL)
- Strategic Account Manager We are looking for a Strategic Account Manager , End-User & Defense for our Chicago facility. In this role you will be responsible for ... strategic goals. This position will collaborate with multiple stakeholders within Service Business, coordinate End-User targets and activities and generate business… more
- University of Maryland Medical System (La Plata, MD)
- … Charles Regional - La Plata, MD NOW OFFERING up to $5,000 Sign-On Bonus!! Join UM Charles Regional Medical Center, a proud member of the University of Maryland ... Medical System, where we combine the resources of a...make a real impact on patient care. Why Choose UM Charles Regional? Commitment to Excellence - Recognized as… more
- Astrana Health, Inc. (El Monte, CA)
- …into Company's customer service module & NMM Queue system Member/Provider Service /Representative assists Supervisor and Manager with other duties as assigned ... Customer Service Representative (Cantonese or Mandarin Speaking) Department: Ops...Members assigned to wrong PCP/with no PCP status Assisted UM / Medical Directors on urgent member… more
- University of Maryland Medical System (Bel Air, MD)
- …of Maryland Upper Chesapeake Health owns and operates: University of Maryland Upper Chesapeake Medical Center ( UM UCMC), Bel Air, MD The Upper Chesapeake Health ... Company Description University of Maryland Upper Chesapeake Health ( UM UCH) offers the residents of northeastern Maryland...provides high quality care to all. Our commitment to service excellence is evident through a broad range of… more
- Blue Shield of California (San Diego, CA)
- …substance use disorder treatment. The Operations Specialist, Experienced will report to the Sr. Manager , BH UM . In this role you will be the subject matter ... Job Description Your Role The Behavioral Health (BH) Utilization Management ( UM ) team manages prior authorization and concurrent review for members seeking mental… more
- HealthCare Partners (Garden City, NY)
- …Our network includes over 6,000 primary care physicians and specialists delivering services to our 125,000 members enrolled in Commercial, Medicare and Medicaid ... Garden City Team? We are currently seeking a Case Manager ! Position Summary : The role of the Nurse...all case management activities with members to evaluate the medical needs of the member to facilitate the member's… more
- IPG Mediabrands (Los Angeles, CA)
- …billion in marketing investment globally on behalf of its clients across its full- service agency networks UM , Initiative and Mediahub and through its ... organization that can offer you the career you crave, UM is your home. We are the destination of...integrated planning and 2-3 years experience in a people manager role; strong ability to delegate, train, and support… more
- Children's Health (Dallas, TX)
- …authorization process. This role will support Ambulatory clinics and Patient Access Service areas; assisting in reviewing medical records for appropriate ... appropriate authorization process. Responsibilities: * In collaboration with Patient Access Services , Ambulatory clinics and UM leadership planning and execution… more
- University of Maryland Medical System (La Plata, MD)
- Company Description At University of Maryland Charles Regional Medical Center ( UM CRMC), our talented and diverse groups of professionals represent our strength. ... and stimulating environment. Job Description IMMEDIATE SUPERVISOR POSITION TITLE: Manager , Cardiopulmonary Services SUMMARY: Under moderate supervision, performs… more
- Thomas Jefferson University Hospitals, Inc. (Philadelphia, PA)
- …to review clinical information provided by facilities and communicates UM determinations maintaining timeliness. Job Description Primary Responsibilities: Review and ... to identify appropriate level of care for acute and post-acute inpatient services . Perform concurrent review and/or admission review on all hospital admissions using… more
- IPG Mediabrands (Los Angeles, CA)
- …billion in marketing investment globally on behalf of its clients across its full- service agency networks UM , Initiative and Mediahub and through its ... from inception to completion with moderate oversight from the Manager . The Communications Designer should be able to work...Benefits We offer a Total Rewards package that includes medical and dental coverage, 401(k) plans, flex spending, life… more
- Franciscan Missionaries of Our Lady Health System (Jackson, MS)
- …followed by appropriate intervention as evidenced by documentation. e. Prompt notification of UM Manager or Director of possible quality or physician issues as ... changes occur to ensure the appropriate authorizations for the services rendered is secured. d. Physicians are notified of...Evaluation and Analysis: a. Patient cases are reviewed for medical necessity and intensity service /severity of illness… more
- Healthier Mississippi People (Jackson, MS)
- … medical necessity criteria. Reports quality of care issues identified during the um process to the appropriate manager . To perform job duties in accordance ... Full-time Description Job Summary: Accountable to perform utilization management services for designated patient case load, including prospective, concurrent,...with the medical center's purpose. Knowledge, Skills & Abilities Knowledge of… more
- Regal Medical Group, Inc. (San Bernardino, CA)
- …for medical necessity and appropriate utilization any ancillary professional services , ie (home health, infusion, PT, OT, ST, etc.). Demonstrates the ability ... Position Summary: The role of the Case Manager , Prior Authorization LVN is to promote the...is to promote the quality and cost effectiveness of medical care by applying clinical acumen and the appropriate… more
- Integra Partners (Troy, MI)
- …educator to join our Operations Training & Development team as an Operations UM Training Specialist, specializing in Utilization Management ( UM ) processes. The ... a strong nursing background combined with expertise in clinical documentation, medical necessity determination, regulatory compliance, and will be responsible for… more
- Dignity Health (Rancho Cordova, CA)
- …the Supervisor of Utilization Management is responsible and accountable for coordination of services for Mercy Medical Group and Woodland Clinic Medical ... of care. Promotes the quality and cost effectiveness of medical care by ensuring department staff are applying clinical...is responsible for coordinating the daily operations of the UM Pre-Authorization team in order to ensure requests are… more
