identified with at risk or high utilization needs. Functions as an active team member of the Utilization Management Team. KEY...JOB SUMMARY: Responsible for clinical review of utilization requests and assessment and implementation of potential...
identified with at risk or high utilization needs. Functions as an active team member of the Utilization Management Team. KEY...JOB SUMMARY: Responsible for clinical review of utilization requests and assessment and implementation of potential...
performs comprehensive patient assessments and interviews, resource management, utilization management, discharge planning... preferred Case management / utilization review experience preferred Literate in software and information systems...
: Responsible for the quality and resource management of all patients that are admitted to the facility from the point... of their admission and across the continuum of the health care management. Works on behalf of the advocate, promoting cost containment...
experience in Case Management required. Local and national travel options are available depending on need. Candidates...
experience in Case Management required. Local and national travel options are available depending on need. Candidates...
experience in Case Management required. Local and national travel options are available depending on need. Candidates...
. Responsibilities: Your Work In this role, you will: Perform prospective, concurrent and retrospective utilization reviews... and intervenes or as clinically appropriate Support team through consistent and successful caseload management and workload...
. Performs utilization management (UM) activities in accordance with UM plan to assure compliance with accreditation/regulatory... authorization. Assists the department in monitoring the utilization of resources, risk management and quality of care for patients...
Job Title: Registered Nurse Utilization Management (RN-UM) Location: Colorado Military Health System (CMHS), Fort... of Utilization Review/Management experience. Minimum of 3 years of clinical nursing experience. Experience with TRICARE...
. Growing together. The Utilization Management (UM) Manager is responsible for the supervisory oversight and direction... of Idaho 5+ years of relevant experience in Utilization Management 3+ years of experience with Medicaid and Long-Term...
Recognition #PACE Position Summary Job Summary: The RN Utilization Management Nurse, under the general direction of the... policy. X Accept Cookies Utilization Management Nurse Job Details Job Location CB PACE - Virginia - Alexandria...
. Knowledge of utilization management principles preferred. License/Certification: RN - Registered Nurse - State Licensure... Utilization Management (UM) teams: Inpatient and Outpatient Total team scope: 2 direct reports and 19 indirect reports...
Inpatient Utilization Management Clinician is responsible for evaluating all inpatient medical treatments for medical necessity..., and collaborating with care management and medical directors to support members in achieving optimal health outcomes. Our Investment...
Review Clinical Review team to ensure appropriate care to members. Supervises day-to-day activities of utilization management... Collaborates with utilization management team to resolve complex care member issues Maintains knowledge of regulations...
Role Overview Under the supervision of the Manager for Utilization Management, this position is responsible... for providing daily oversight of Utilization Management Reviewers, Utilization Management Review Technicians and staff members...
California RN License Requires at least 5 years of prior relevant experience * Previous experience in utilization management... Concurrent Review Utilization Management Nurse will report to the FEP Utilization Management Manager. In this role...
in behavioral health and/or substance use disorder. Managed care and utilization management experience required. Licensure: RN...Role Overview: The After Hours Behavioral Health (BH) Utilization Management (UM) Reviewer is scheduled to work non...
Job Category: Utilization Management Job Description: HealthPartners is hiring a Utilization Management Prior... to Utilization Review Maintains a working knowledge of Medical Policy, Behavioral Health (Health Plan) and Case Management...
Job Category: Utilization Management Job Description: HealthPartners is hiring a Utilization Management Prior... to Utilization Review Maintains a working knowledge of Medical Policy, Behavioral Health (Health Plan) and Case Management...