- Commonwealth Care Alliance (Boston, MA)
- …Management is responsible for overseeing and managing the daily operation of the Utilization Management Review Nurse and Specialist staff responsible for ... decisions and organizational determinations. Essential Duties & Responsibilities: The Manager , Utilization Management reports to... reports to the Director of Utilization Management - Oversees clinical decision review for… more
- Commonwealth Care Alliance (Boston, MA)
- 013650 CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management , the Nurse Utilization Management (UM) ... review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role...accurate documentation of clinical decisions and works with UM Manager to ensure consistency in applying policy + Works… more
- Stanford Health Care (Palo Alto, CA)
- …responsibilities include coordinating all facets of a patient's admission/discharge; performing utilization review activities, including review of patient ... delivery and quality of patient care. A hospital-based case management system has as its primary goal to ensure...team members; arranges follow up care as appropriate. + Utilization Review -- Reviews prospectively, concurrently and… 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 ... End Date 12/08/2025 Duration 13 Week(s) Job Description Job Title: Case Manager Profession: Registered Nurse Specialty: Case Management Duration: 13 weeks… more
- Integra LifeSciences (Princeton, NJ)
- …pathways to advance patient outcomes and set new standards of care. The Manager , Contracts and Vendor Management , is responsible for overseeing the Information ... System's contract lifecycle and software asset management strategy. This role ensures compliance with best practices, legal and regulatory requirements, optimizes… more
- Amherst College (Amherst, MA)
- …requests in a timely manner. Administratively supports the selection, training, and utilization of the Community Standards Review Board. Enters case information ... Office Manager for Care and Accountability Amherst Campus Full...and stewards case completion via Maxient (digital case management module). Implements logistics for Student Conduct Hearings. Assists… more
- Merck & Co. (Rahway, NJ)
- …the business.- - Working independently, the Protocol Clinical Supplies Project Manager (Protocol CSPM) designs strategic and operational plans for all activities ... and other supply chain areas to address clinical supply and/or change management related topics. Responsible and accountable for establishing the timelines for… more
- Daiichi Sankyo, Inc. (Bernards, NJ)
- …benefit the stakeholders, DSI and DS Group. Develops comprehensive global category management strategies to uncover strategic insights to help influence and inform ... involves working with suppliers and internal stakeholders to define scope and review of work orders and agreements, Mitigates supplier issues, develops action plans… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …from home opportunity! Please note this position aligns to PST business hours.** The ** Manager , Case Management ** Team is a Supervisor for Case Managers. This ... performance of job functions, which may include preauthorization, outpatient and inpatient management , case management , retrospective claim review , and… more
- Commonwealth Care Alliance (Boston, MA)
- …Work collaboratively with internal departments-including Clinical Operations, Contracting, Network Management , Utilization Management , and Business ... and improvement efforts. Through reporting, data analysis, and partnership management , the LTSS Program Manager ensures that...& Language (nice to have):** + Familiarity with care management and utilization management systems… more
- Commonwealth Care Alliance (Boston, MA)
- …member experience. - Address provider inquiries related to care coordination, utilization management , and program participation, collaborating with internal ... does not have direct reports. Essential Duties & Responsibilities: Provider Relationship Management - Serve as the primary relationship manager and point… 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...cases for authorization for in patient stay. + Staff review short stay, long stay and complex cases to… 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 plans ... ensure timely, efficient, and effective discharge planning and transitions. Supports utilization management and ensures compliance with payer guidelines.… more
- Home Depot (Richmond, VA)
- …+ Organized Retail Crime elements and law enforcement partnerships + Utilization / management of physical security and investigations systems (CCTV, Alarm, ... **Position Purpose:** The District Asset Protection Manager (DAPM) is responsible for teaching, coaching, and training associates to ensure the effective execution… more
- MVP Health Care (Schenectady, NY)
- …in every interaction Your key responsibilities: Utilize the essentials of an integrated utilization management and case management model that includes ... functional capability through the coordination of quality cost effective care. The Case Manager will also monitor and review cases with the Medical Director… more
- ERP International (Luke AFB, AZ)
- …including a one hour lunch **Core Duties:** - Participate in Utilization Management /Case Management meetings to review and identify opportunities to ... **Overview** ERP International is seeking a **Licensed Clinical Social Worker/Case Manager ** for a Full-Time position in support of the **56th Medical Group, Luke… more
- Red River (Hartford, CT)
- **Position Summary:** The Manager , Residency Services reports to Director of Professional Services. Responsibilities include: Identifying new Residency Services ... further our Corporate Mission, Values and Objectives. Red River's Residency Services Manager will be responsible for our residents' growth and operational … more
- JABIL CIRCUIT, INC (Salisbury, NC)
- The Inventory Control Manager is responsible for managing all aspects of Inventory Management at Jabil including, but not limited to: inventory accuracy, cycle ... count program management , annual physical inventories, monthly reporting, warehouse layouts, stocking/de-stocking strategies, bin location optimization, inventory… more
- University Health (San Antonio, TX)
- …experience required (as a Staff nurse II or above). Work experience in case management , utilization review or hospital quality is preferred. LICENSURE/ ... POSITION SUMMARY/RESPONSIBILITIES The nurse case manager coordinates, in collaboration with the patient and...Board of Nurse Examiners is required. An approved case management certification (ACM, CCM or ANCC) is preferred and… more
- University Health (San Antonio, TX)
- …preferred. Three to five years nursing experience required. Work experience in case management , utilization review or hospital quality is preferred. ... POSITION SUMMARY/RESPONSIBILITIES The nurse case manager coordinates, in collaboration with the patient and...Board of Nurse Examiners is required. An approved case management certification (ACM, CCM or ANCC) is preferred. Current… more
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