utilization review and how to leverage with inpatient staff for possible reduction of medical cost on long length of stay patients... required A minimum of one (1) year of utilization review and/or case management, home health, hospital discharge planning experience...
and Supports (LTSS) Review Utilization Management program and staff under the supervision of the Director, LTSS Clinical Services... more about us at www.amerihealthcaritas.com. This position manages all elements of the Community Health Choices Long Term Services...
: Utilization Management services supporting medical necessity and denial prevention Coordinating with payors to authorize... and critical illness insurance, long term care, elder & childcare, auto & home insurance. Note: Eligibility for benefits may...
. Promotes integration of services for members including behavioral health care and long term services and supports/home... Heart Association BLS Minimum of 2 years of nursing experience MUST HAVE UTILIZATION REVIEW EXPERIENCE Preferred Bachelor...
. Promotes integration of services for members including behavioral health care and long term services and supports/home... Heart Association BLS Minimum of 2 years of nursing experience MUST HAVE UTILIZATION REVIEW EXPERIENCE Preferred Bachelor...
. Promotes integration of services for members including behavioral health care and long term services and supports/home... Heart Association BLS Minimum of 2 years of nursing experience MUST HAVE UTILIZATION REVIEW EXPERIENCE Preferred Bachelor...
-by-case basis. This position integrates national standards for case management scope of services including: Utilization... experience a plus. Managed care payor experience a plus either in Utilization Review, Case Management or Appeals. Interaction...
-by-case basis. This position integrates national standards for case management scope of services including: Utilization... experience a plus. Managed care payor experience a plus either in Utilization Review, Case Management or Appeals. Interaction...
for all patients. Role Description Utilization Review Specialist (URS) reports to the Utilization Review Manager and serves as the...Company: Skyway Behavioral Health Title: Utilization Review Specialist (URS) FLSA Status: Exempt Location: Remote...
Behavioral Health Utilization Manager for Inpatient and 24-Hour Diversionary Services is responsible for overseeing the... appropriate and effective utilization of mental health and substance use disorder services across inpatient and residential care...
Anticipated End Date: 2026-01-24 Position Title: Utilization Management Representative II... Job Description: Utilization Management Representative II A proud member of the Elevance Health family of companies, Carelon Behavioral Health...
, Patient Review & Intake Services or Manager, Utilization Management to: Manage team responsible for completing utilization... Utilization Management Nurses and associated programs and processes, as directed by the Senior Manager, Patient Review and Intake...
state-of-the-art treatment and support services for more than 13,000 children, youth, families, and adults annually who... and Utilization Liaison will collaborate with the Utilization Manager and work closely with River Edge Behavioral Health’s clinical...
work and/or patient financial services for financial screening on patients requiring long term custodial placement... during hospital stay beginning with the admission review of the case manager and reviews with the Case Manager Lead, as needed. Keeps...
Overview: The Long-Term Care (LTC) Sales Account Manager is responsible for establishing access and demand... pharmaceutical industry, product launch strategies, and long-term care market and practices including pharmaceutical product review...
Overview: The Long-Term Care (LTC) Sales Account Manager is responsible for establishing access and demand... pharmaceutical industry, product launch strategies, and long-term care market and practices including pharmaceutical product review...
Reporting to Nurse Manager, Long-Term Care, the Long-Term Care (LTC) Coordinator provides administrative support. The... Coordinator also provides coordination and operational support to the Long-Term Care and Post-Acute Care teams within Clinical...
Duties and Responsibilities: Performs inpatient utilization management activities as determined by the utilization... clinical experience preferred. Previous utilization management experience preferred. Knowledge of Medicare/Medicaid...
across the enterprise to design and evolve utilization management and pharmacy strategies that support competitive benefit design.... What you will do: We are looking for a SENIOR DIRECTOR OF MEDICAL REVIEW who can help shape our vision and support our mission. Here is what the position will look...
long-term relationships. Able to have proactive conversations with customers and manage their feedback. 8. Establishes...) Basic term and optional term life insurance Short-term and long-term disability Pregnancy disability and parental leave...