- Merck & Co. (Rahway, NJ)
- …a trusted business partner, playing a critical role in ensuring effective resource utilization , specifically to ensure our Company is spending the right amount on ... and distribution of project budgets, assurance of timely project closure and review of those related business cases from a strategic and governance compliance… more
- Novo Nordisk Inc. (San Francisco, CA)
- …policies, legal, regulatory, and compliance requirements Ensures effective administrative management of regional business as well as operational budgets Maintains ... budget expenditures as directed Records all activities within a customer response management system (eg VEEVA) and all expenses within Concur in accordance with… more
- Bon Secours Mercy Health (Batavia, OH)
- …for clinical and operational excellence. **Mercy Health Clermont Hospital** ** Utilization Review and Case Management for Adult Psychiatry Unit** **Full ... responsibility is assumed within the context of appropriate allocation and utilization of resources and quality of care, collaborating with professional hospital… more
- Houston Methodist (The Woodlands, TX)
- …and eligibility for state, local, and federal programs + Progressive knowledge of utilization management , case management , performance improvement, and ... At Houston Methodist, the Utilization Review Nurse (URN) PRN position...coverage determinations (LCDs & NCDs). This position collaborates with case management in the development and implementation… more
- Beth Israel Lahey Health (Burlington, MA)
- …team to ensure a timely process. Registered Nurses (RNs) with utilization review experience, case management experience, and med/surg experience are ... making a difference in people's lives.** Joint role of Case Manager and Utilization Review ...committees representing patient issues and department functions such as case management , utilization and CQI… more
- University of Utah Health (Salt Lake City, UT)
- …member. **Qualifications** **Qualifications** **Required** + **One year** ** Utilization Review or Case Management experience.** **Licenses Required** ... UR committee any case that surpasses expected LOS, expected cost, or over/under- utilization of resources. + Performs verbal/fax clinical review with payer as… more
- BriteLife Recovery (Englewood, NJ)
- …as assigned What we need from you? + Minimum of 2-3 years of experience in utilization review , case management , or insurance coordination in a behavioral ... What you will be doing? The Utilization Review (UR) Specialist is a...Maintain compliance with payer policies, HIPAA regulations, and internal utilization management protocols. + Monitor trends in… more
- Amergis (Canton, MA)
- …same to facility wide personnel. + Demonstrated understanding of external agency interface with Utilization Review , Case Management , Patient Safety and ... collection and related activities for Quality Improvement (QI) and Utilization Review as well as completion of...of all DME requests. This collaboration is primarily with Case Management , PT, OT, SLP, and Rehab… more
- US Tech Solutions (Columbia, SC)
- …mental health/chemical dependency, orthopedic, general medicine/surgery. OR, 4 years utilization review / case management /clinical/or combination; ... work independently, prioritize effectively and have critical thinking skills. Experience in case management or care coordination and telephonic care experience… more
- Prime Healthcare (Ontario, CA)
- …another relevant field + A minimum of seven (7) years' experience in Clinical Utilization Review or Case Management with a large Health Plan + An active ... Utilization Management (UM) provides comprehensive oversight of the Utilization Review process for the self-insured Employee Health Plans, according to… more
- Wellpath (Lemoyne, PA)
- …The Medical Director of Utilization Management leads and oversees utilization review , case management , quality improvement, and related ... appropriate utilization of medical services. The Medical Director of Utilization Management serves as a key liaison with external partners and stakeholders,… more
- Genesis Healthcare (York, PA)
- …2. Five to seven years of clinical nursing experience is required. Prior experience in utilization review , case management or discharge planning is ... a meaningful impact in the communities we serve. Responsibilities The Manager, Case Management is responsible for the clinical, administrative, and financial… more
- Henry Ford Health System (Detroit, MI)
- …skills. + Proficiency with computers, electronic health records (EHR), database systems, and utilization review / case management documentation systems. + ... sign on bonus available for qualified experienced candidates with current 2 years RN Case Management in a large acute care hospital setting. GENERAL SUMMARY: The… more
- Mohawk Valley Health System (Utica, NY)
- …and regulatory compliance. Education/Experience Requirements Required: + Minimum of two (2) years utilization review / case management experience or social ... RN Case Manager - Case Management - per diem Department: CASE MANAGEMENT Job Summary Reports to and is under direct supervision of Case … more
- Ellis Medicine (Schenectady, NY)
- …services provided by the Case Manager include, but are not limited to, utilization review , case management , care transition, collaboration with ... years of inpatient experience in a hospital environment preferred. + Previous case management , utilization review , and discharge planning experience… more
- University of Utah Health (Salt Lake City, UT)
- …healthcare or a related field. + One year of experience in a utilization review or case management environment. + Basic Life Support Health Care Provider ... plans prepared and delegated by social work or nurse case management by coordinating with home care...+ Documents activities and progress in medical charts, computer billing/ utilization systems, or in other ways as directed. +… more
- ChenMed (North Miami Beach, FL)
- …work experience required. + A minimum of 1 year of utilization review and/or case management , home health, hospital discharge planning experience ... to preferred providers. + Coordinates the integration of social services/ case management functions in the pre-acute, ER,...patients' progress and adjust and plan accordingly. + Understanding utilization review and how to leverage with… more
- Marshfield Clinic (Marshfield, WI)
- …One year of healthcare experience. **Preferred/Optional:** Discharge Planning, Utilization Review or Case Management experience in a clinic/hospital ... - Hospital - Casual **Cost Center:** 301081004 Care Delivery-Cross Region Support- Case Management **Scheduled Weekly Hours:** 8 **Employee Type:** Regular… more
- Henry Ford Health System (Detroit, MI)
- … skills. Knowledge of computers, Electronic Health Records, data base systems and utilization review / case management documentation systems. Desire to ... Worker (LMSW) with a valid, unrestricted State of Michigan license. Certification in Case Management (CCM) by the Commission for Case Management … more
- Henry Ford Health System (Detroit, MI)
- … skills. + Knowledge of computers, Electronic Health Records, data base systems and utilization review / case management documentation systems. + Desire to ... (LMSW) with a valid, unrestricted State of Michigan license. + Certification in Case Management (CCM) by the Commission for Case Management Certification… more
