- Providence (Seattle, WA)
- **Description** **THE ROLE** The Senior Director Utilization Management & Denials - Administration is 100% remote. The role requires a broad knowledge and ... focus on Utilization Management and Denials principles such as...meeting Federal and applicable State regulatory requirements and quality accreditation standards while managing risks and complaints related to… more
- Elevance Health (Miami, FL)
- …of associates and may be involved in process improvement initiatives within the utilization management function. Examples of such functions may include: review ... **Licensed Utilization Review Senior ** _Location:_ While remote,...medically appropriate, quality, cost effective care throughout the medical management process. + Educates the member about plan benefits… more
- Centene Corporation (Sacramento, CA)
- …ensure appropriate and effective utilization of healthcare services + Works with utilization management senior management team to provide updates ... accreditation standards, and industry best practices related to utilization management + Educates and provides resources...ensure adherence to quality and performance standards + Assists utilization management senior leadership with… more
- Centene Corporation (Columbia, SC)
- …knowledge of regulations, accreditation standards, and industry best practices related to utilization management + Works with utilization management ... a fresh perspective on workplace flexibility. + Collaborates with utilization management team to resolve complex care...applicable guidelines, policies, and procedures + Works with the senior management to develop and implement UM… more
- Veterans Affairs, Veterans Health Administration (El Paso, TX)
- …track service activities including visits, referrals, caregiver demographics, equipment utilization and caregiver and Veteran satisfaction Assisting in developing ... implementing and evaluating clinical guidelines and protocols to establish appropriate utilization of services Functioning in support of Caregivers, Veterans and… more
- Veterans Affairs, Veterans Health Administration (San Antonio, TX)
- …similar role or with population served-Clinical supervision certification-Quality or utilization management experience-Former VA Trainee References: VA HANDBOOK ... TX. The Spinal Cord Injury Center Acute Rehabilitation Program Clinic Coordinator Senior Social Worker works independently as an advance practice social worker. The… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …strategies. Your Day to Day: + With minimal oversight, leads CMS utilization management related compliance activities including: + Identify and implement ... interpret/ draw conclusions, identify gaps/ issues & analyze information from the utilization management medical management system: Care Prominence (ie… more
- Houston Methodist (The Woodlands, TX)
- …of the clinic network, assist in the development of regional strategic direction with Senior leadership, serve as the primary liaison with physicians in SPG and PCG ... secure compliance with ethical and legal business practices and accreditation /regulatory/government regulations. **PEOPLE ESSENTIAL FUNCTIONS** + Directs, develops and… more
- Veterans Affairs, Veterans Health Administration (Mcallen, TX)
- …augment current facility suicide prevention program initiatives by providing intensive case management to Veterans identified at increased risk of suicide due to ... identified Veterans with improved care coordination thereby increasing access and utilization , improved mental health, and decreasing their overall risk of suicide.… more
- Veterans Affairs, Veterans Health Administration (Brockton, MA)
- …and adjuntive staff both formally and informally as assigned for support, utilization , and management of caseloads. Work Schedule: 8:00am-4:30pm Telework: Ad-hoc ... of the open period stated in the announcement. The Assistant Program Coordinator/ Senior Social Worker (MSW) is assigned to the Psychosocial Rehabilitation and… more
- Akumin (St. Petersburg, FL)
- …+ Establishes and implements center policies and procedures in cooperation with senior management ; + Interprets and administers personnel policies and provides ... Reviews center activities and recommends changes in, or better utilization of facilities, services, and staff; + Authorizes purchase...+ Prepares and submits records, and statistical data to senior management ; + Oversees the operation of… more
- Sharp HealthCare (San Diego, CA)
- …Start Time** **Shift End Time** Six Sigma Yellow Belt Certification - Various-No accreditation board **Hours** **Shift Start Time:** 8 AM **Shift End Time:** 5:30 PM ... subject matter experience. + 3 Years system analyst role. + Project Management experience. + Six Sigma Yellow Belt Certification - Various-No accreditation… more
- Houston Methodist (Houston, TX)
- …/regulatory/ government regulations. **PEOPLE ESSENTIAL FUNCTIONS** + Performs management responsibilities of selection, scheduling, supervision, retention, and ... At Houston Methodist, the Senior Practice Manager position is responsible for independently managing and/or coordinating complex delivery of care within a large,… more
- MyFlorida (Daytona Beach, FL)
- SENIOR HUMAN SERVICES PROGRAM MGR-SES - 48007299 Date: Apr 13, 2024 Location: DAYTONA BEACH, FL, US, 32114 DAYTONA BEACH, FL, US, 32118 DAYTONA BEACH, FL, US, 32124 ... . Requisition No: 808708 Agency: Department of Education Working Title: SENIOR HUMAN SERVICES PROGRAM MGR-SES - 48007299 Position Number: 48007299 Salary:… more
- Battelle Memorial Institute (Egg Harbor Township, NJ)
- …critical challenges in security, human health, manufacturing, energy, and environmental management . Battelle's work is grounded in the belief that science, ... more competitive and the world a better place. We are currently seeking a ** Senior Chemist - Energetic Materials Synthesis** . This position is located in **Egg… more
- Veterans Affairs, Veterans Health Administration (Tuskegee, AL)
- …and counsel Veterans and families Serves as a role model for utilization of appropriate communication and conflict management techniques, effectively guiding ... Summary The Senior Social Worker (Compact Care Coordinator) is a...of the degree can be made by going to http://www.cswe.org/ Accreditation to verify that the social work degree meets… more
- Cleveland Clinic (Akron, OH)
- …clinical transformation in embodiment of Cleveland Clinic values. + Ability to engage senior management and apply critical thinking and decisive judgment. + ... to serving the community and treating our patients as family. As a Senior Safety, Quality, and Patient Experience Specialist you will be directing safety, quality,… more
- HCA Healthcare (Sugar Land, TX)
- …environment where diversity and inclusion thrive? Submit your application for our Senior EHR Suport Analyst -RN- Sugarland TX opening with HCA Houston Healthcare ... benefits may vary by location._** We are seeking a Senior EHR Suport Analyst -RN- for our ITG team...technologies and processes; + Ability to manage facility change management and ongoing operational processes around any new technology… more
- Southern Glazer's Wine and Spirits (Miramar, FL)
- …to fill your glass with opportunity, come join our FAMILY. **Overview** The Senior Director Workplace Strategy will lead the delivery of Southern Glazer's real ... estate portfolio analysis, occupancy planning, design, functional program, construction management and workplace standards development incorporating both traditional and… more
- WellSense (Boston, MA)
- Nurse Care Manager ( Senior Care Product) - Field Based WellSense Health Plan is a nonprofit health insurance company serving members across Massachusetts and New ... Plan is recruiting for motivated, compassionate, mission-driven nurses to join our Senior Care Options (SCO) program clinical team. The SCO program is designed… more