- 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
- 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
- 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
- Stanford Health Care (Palo Alto, CA)
- …complex needs in collaboration with other interdisciplinary team members; arranges follow up care as appropriate. + Utilization Review -- Reviews ... include coordinating all facets of a patient's admission/discharge; performing utilization review activities, including review ...Manager differs from other roles in professional nursing/health care practice in that it is not intended to… more
- Amherst College (Amherst, MA)
- Office Manager for Care and Accountability Amherst Campus Full Time JR6460 Amherst has taken a leadership role among highly selective liberal arts colleges and ... and staff. Job Description: Amherst College invites applications for the Office Manager for Care and Accountability position. The Office Manager… more
- Commonwealth Care Alliance (Boston, MA)
- …Long-Term Services Coordinators (LTSC) agencies, ensuring alignment with CCA's model of care and strategic objectives. The Manager fosters effective clinical and ... are met in a manner that supports quality, independence, and cost-effective community-based care . The Manager also ensures providers are educated on CCA… more
- Commonwealth Care Alliance (Boston, MA)
- …supporting high-quality, coordinated care for members. In this role, the Program Manager acts as an account manager , relationship manager , and ... teams to ensure a seamless provider experience and consistent delivery of quality care . The BH Provider Engagement Program Manager reports to the Director… more
- MVP Health Care (Schenectady, NY)
- …capability through the coordination of quality cost effective care . The Case Manager will also monitor and review cases with the Medical Director to ... At MVP Health Care , we're on a mission to create a...improvement. To achieve this, we're looking for a Case Manager , Medicaid Long Term Support Program to join #TeamMVP.… more
- Stony Brook University (Stony Brook, NY)
- …Department may include the following but are not limited to:** + Completes Utilization review screen for inpatient and observation cases. Activity includes UR ... RN Case Manager **Position Summary** At Stony Brook Medicine, a...our patient population. Qualified candidates will demonstrate superior patient care and possess outstanding communication skills while adhering to… 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
- Commonwealth Care Alliance (Boston, MA)
- …administrative support of Care Delivery. programs. Under the supervision of the Manager of Patient Access Operations and in direct partnership with Care ... patients enrolled in Care Delivery Programs The role reports to the Manager , Care Delivery Patient Access Operations Supervision Exercised: - Yes, which… more
- Providence Little Company of Mary Medical Center San Pedro-… (San Pedro, CA)
- …BLS - AHA Must-Have: Strong assessment, discharge planning, and utilization review skills Description: The RN Case Manager coordinates patient care ... Center San Pedro- Case Management Job Type Travel Offering Nursing Profession RN Specialty Case Manager Job ID 33531148 Job Title RN - Case Manager Weekly Pay… more
- University Health (San Antonio, TX)
- …(as a Staff nurse II or above). Work experience in case management, utilization review or hospital quality is preferred. LICENSURE/ CERTIFICATIONS Current ... POSITION SUMMARY/RESPONSIBILITIES The nurse case manager coordinates, in collaboration with the patient and...with the patient and interdisciplinary team, the treatment/plan of care for a patient within the acute episode of… more
- University Health (San Antonio, TX)
- …to five years nursing experience required. Work experience in case management, utilization review or hospital quality is preferred. LICENSURE/ CERTIFICATIONS ... POSITION SUMMARY/RESPONSIBILITIES The nurse case manager coordinates, in collaboration with the patient and...the patient and interdisciplinary team, the treatment/ plan of care for a patient within the acute episode of… more
- ERP International (Luke AFB, AZ)
- …and 5:00pm, including a one hour lunch **Core Duties:** - Participate in Utilization Management/Case Management meetings to review and identify opportunities to ... ERP International is seeking a **Licensed Clinical Social Worker/Case Manager ** for a Full-Time position in support of the...**Be the Best!** Join our team of exceptional health care professionals across the nation. Come discover the immense… more
- Alameda Health System (San Leandro, CA)
- SLH Case Manager RN + San Leandro, CA + San...Degree preferred. Minimum Experience: Two years related in acute care facility and/or utilization review ... SLH Social Services + Part Time - Day + Care Management + $58.74 - $97.91 per hour +...FTE:0.7 + Posted:Today **Summary** **JOB SUMMARY** The SLH Case Manager RN is responsible for providing comprehensive case management… more
- Alameda Health System (San Leandro, CA)
- …necessarily performed by each individual in the classification. + Coordinates all utilization review functions, including response to payor requests for ... and identifies cost-effective protocols. Care Management provides Care Coordination, Compliance, Transition Coordination, and Utilization ...experience in Case Management in an acute setting or utilization review at a medical group or… more
- Luke Staffing (Agana Heights, GU)
- …Government and professional clinical standards and clinical protocols. . Participate in Utilization Management/Case Management meetings to review and identify . ... **INDEPENDENT LICENSED SOCIAL WORKER CASE MANAGER ** **SITE OF SERVICE:** . US Naval Hospital,...to effectively communicate with all patients and other health care providers. . **Physical Capability:** Shall be physically capable… more
- Providence Little Company of Mary Medical Center - San Pedro (San Pedro, CA)
- …to perform discharge planning and utilize interqual criteria - Experience in utilization review and concurrent reviews Description: This position requires ... Medical Center - San Pedro Job Type Travel Offering Nursing Profession RN Specialty Case Manager Job ID 33531206 Job Title Registered Nurse - Case Manager @… more
- CSL Behring (King Of Prussia, PA)
- Job Description MidSouth Region: Birmingham, AL The Area Manager is responsible for promotion and utilization of CSL Behring products and for managing all ... aspects of territory business development. Area Manager will cultivate and maintain relationships with key customers to include: Health Care Professionals (HCP),… more
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