- Intermountain Health (Murray, UT)
- …service lines of business(s). The position requires an understanding of utilization management industry benchmarks, best practices and regulatory environment ... impact trends. + Uses a data-driven approach to assess utilization management and care management ...foster a sustainable culture of wellness that encompasses living healthy , happy, secure, connected, and engaged. Learn more about… more
- Intermountain Health (Las Vegas, NV)
- **Job Description:** The Utilization Review Care Management Director is responsible for providing leadership and administrative direction for Utilization ... and attainment of financial goals. Reporting to the Sr. Director /AVP/VP Utilization Management , the role...foster a sustainable culture of wellness that encompasses living healthy , happy, secure, connected, and engaged. Learn more about… more
- CommonSpirit Health Mountain Region (Centennial, CO)
- …resources to help you flourish and leaders who care about your success. The Utilization Management (UM) Director is responsible for the market(s) ... development, implementation, evaluation and direction of the Utilization Management Program and staff in support of the CommonSpirit Health Care Coordination… more
- AmeriHealth Caritas (Newtown Square, PA)
- …Discover more about us at www.amerihealthcaritas.com. **Responsibilities:** The Medical Director , Utilization Management provides organizational leadership ... about helping people get care, stay well and build healthy communities. As one of the nation's leaders in...and practice initiatives in collaboration with the Corporate Medical Director (s), Utilization Management and the… more
- Intermountain Health (Las Vegas, NV)
- … management , claims, network management , and finance. As the Medical Director for Utilization Management , you are responsible, in partnership with ... + Demonstrated timely documentation and reporting. + Demonstrated knowledge of case management , utilization management , quality management , discharge… more
- Stanford Health Care (Palo Alto, CA)
- …practice. Here, your leadership, coaching, and mentoring would further develop our robust, Utilization Management team. Are you driven by health care innovation, ... an RN - 3+ years of experience in case management / utilization review Why work at Stanford Medicine...Facilities, Durable Medical Equipment vendors) in collaboration with Contract Management and Legal Affairs. + Assists Director … more
- AmeriHealth Caritas (Newtown Square, PA)
- …Under the direction of a supervisor, the Clinical Care Reviewer - Utilization Management evaluates medical necessity for inpatient and outpatient services, ... about helping people get care, stay well and build healthy communities. As one of the nation's leaders in...in a fast-paced environment. ;The Clinical Care Reviewer - Utilization Management will also be counted upon… more
- AmeriHealth Caritas (Charleston, SC)
- …**Responsibilities:** Under the direction of the Supervisor, the Behavioral Health Utilization Management Reviewer is responsible for completing medical ... about helping people get care, stay well and build healthy communities. As one of the nation's leaders in...of behavioral health and substance use disorder experience.; + Utilization management experience in a managed care… more
- Penn Medicine (Princeton, NJ)
- …day. Are you living your life's work? Schedule: Full Time Summary: Conducts Utilization Management reviews for Princeton House patients, assigned by the ... Department Director . Documents in the facility-wide computer system the results...SQL Database as per department policies and procedures. Conducts Utilization Management reviews for assigned patients, regardless… more
- The Cigna Group (Bloomfield, CT)
- …Summary** Provides advanced professional input to complex Nurse Case Management assignments/projects. Plans, implements, and evaluates appropriate health care ... facilitate appropriate healthcare outcomes for members. Ensures that case management program objectives are met by evaluating the effectiveness...level of care. + Consults with manager and medical director to resolve any issues related to delay of… more