- Martin's Point Health Care (Portland, ME)
- …Position Summary The Supervisor is responsible for day-to-day operations of the utilization review clinical team, in the areas of authorization requests, ... of medical management experience in a managed care setting including utilization review + RN experience in a clinical setting + Leadership and/or management… more
- Northern Light Health (Bangor, ME)
- …development, communication and successful execution of established objectives (financial and clinical ) within the service line. The AVP is responsible for ... monitoring, analysis, reporting, and adjusting the direction, allocation and utilization of available resources. + Collaborates with Physician Dyad Leadership… more
- CVS Health (Augusta, ME)
- …with transferring patients to lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC recognized accreditation preferred. + ... AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that support… more
- Cardinal Health (Augusta, ME)
- …currently have a career opening for a Reimbursement Solutions Analyst. **What Clinical Operations contributes to Cardinal Health** Clinical Operations is ... in the outpatient hospital setting. Reports to Reimbursement Solutions Supervisor , Individualized Care **Responsibilities:** + Evaluate data input schedules from… more
- Northern Light Health (Brewer, ME)
- …of the patient care team. We offer paid time off that may be taken with Supervisor 's prior approval. If you choose not to take paid time off, this time will be ... operation, care and troubleshooting of agency equipment independently. + Clinical Assessments - Performs and documents comprehensive and holistic assessments.… more
- Northern Light Health (Ellsworth, ME)
- …Assumes a leadership role with the interdisciplinary team to achieve optimal clinical and resource outcomes including supervision of care managers and swing ... both/or MCMH/BHMH. Liaison with referring hospitals to consider transfers. Manage utilization and quality metrics. Coordinates care to minimize the fragmentation of… more
- Northern Light Health (Bangor, ME)
- …dates, and times of conversations with businesses, insurances, managed care organizations, Utilization Review , and patients are documented, if appropriate. + ... understanding of benefit coverage and precertification/authorization, if appropriate. + Quality review procedures are followed to ensure accounts are brought to a… more