- LifePoint Health (Gallatin, TN)
- … management or related healthcare field. **Job:** **Nursing* **Organization:** ** **Title:** * Utilization Mgmt Case Manager FT* **Location:** ... Monitors adherence to the hospital's utilization review plan to ensure appropriate use of...admissions and extended hospitals stays. Reports to: Director - Case Management Minimum Education Associate's, Bachelor's degree… more
- Molina Healthcare (Bowling Green, KY)
- …the pharmacy benefit changes for the upcoming year. + Works with the Case Management department as part of a member-centered interdisciplinary care team. ... (such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and pharmacy costs management ), clinical pharmacy… more
- Molina Healthcare (Bowling Green, KY)
- …in Clinical Program Evaluation + Experience in building clinical targeting models for Case Management + Experience or strong desire to learn Python/PySpark + ... needs. + Creates reporting for strategic analysis, profitability, financial analysis, utilization patterns and medical management . + Interfaces and maintains… more
- Molina Healthcare (Bowling Green, KY)
- …Clinical Coder + Certified Medical Audit Specialist + Certified Case Manager + Certified Professional Healthcare Management + Certified Professional in ... Chief Medical Officer on denial decisions. + Resolves escalated complaints regarding Utilization Management and Long-Term Services & Supports issues. +… more
- AO Smith (Lebanon, TN)
- …production times, staffing requirements, and related costs to provide information for management decisions. + Confers with Manufacturing Engineering Manager to ... and time lines. + Analyzes and plans work force utilization , space requirements, and workflow, and designs layout of...vision and inspiration to peers and subordinates. + Change Management - Builds commitment and overcomes resistance; Prepares and… more
- CDM Smith (Bowling Green, KY)
- …of cloud technologies, including design patterns, planning, configuration, and resource management in Microsoft Azure and other cloud platforms. * Develop DevSecOps ... (AAD), RBAC, IAM configuring role assignments, conditional access, and identity management . * Incorporate security best practices into cloud architecture and ensure… more