- Humana (Jefferson City, MO)
- **Become a part of our caring community and help us put health first** The Manager , Utilization Management Behavioral Health utilizes behavioral ... documentation, and communication of medical services and/or benefit administration determinations. The Manager , Utilization Management Behavioral Health… more
- Beth Israel Lahey Health (Burlington, MA)
- …of three years of medical/surgical nursing care experience. -Two years of Case Management or Utilization Management experience desirable. - Demonstrated ... a difference in people's lives.** Joint role of Case Manager and Utilization Review Nurse **Job Description:**...to ensure a timely process. Registered Nurses (RNs) with utilization review experience, case management experience, and… 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, ... and Abilities** + Knowledge of principles and best practices of case management , utilization review, social work, care coordination and discharge planning.… more
- Helio Health Inc. (Syracuse, NY)
- …to track, review, and analyze data relating to continuous quality improvement. The Utilization Case Manager will work on a Full-Timebasis supporting our ... Educate program staff on current principles and standards of practice surrounding utilization and denials management . + Use effective relationship management… more
- Prime Healthcare (Anaheim, CA)
- …and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/199249/case- manager utilization - management ... and surgical inpatient care and treatment, emergency services, surgical services, behavioral health, comprehensive heart center, and diagnostic imaging. For more… more
- McLaren Health Care (Indianapolis, IN)
- We are looking for a Utilization Management RN, to join us in leading our organization forward. McLaren Integrated HMO Group (MIG) is a fully owned subsidiary of ... Inc. at https://www.mdwise.org/ . **Position** **Summary:** This position is responsible for utilization management functions. This includes but is not limited… more
- Covenant Health Inc. (Louisville, TN)
- …budgeted targets. + Provides medical/psychiatric leadership/consultation to Provider Relations, Medical Utilization Management , and Quality Management Staff ... of physicians on updated utilization review guidelines. + Participates in Utilization Management Committee. + Performs other related duties as required.… more
- Behavioral Center of Michigan (Warren, MI)
- …all state mandated regulations. Maintains compliancy with regulation changes affecting utilization management . Reviews patient recrods and evaluates patient ... programs and advises physicians and other departments of regulations affecting utilization management . Consults with Social Services Department regarding the… more
- Elevance Health (Indianapolis, IN)
- …Skills, Capabilities and Experiences** : + Experience in Utilization Management preferred. + Board Certified Behavioral Analyst (BCBA) or Licensed ... and insightful analytics to improve the delivery of care._ ** Behavioral Health Care Manager Lead** **Location** :...review. **How you will make an impact:** + Coordinating utilization management process including appropriate use of… more
- Prime Healthcare (Lynwood, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/200415/case- manager %2c-rn utilization ... services in specialties including Cardiovascular, Surgical, Orthopedics, Maternal-Child Health, Behavioral Health and Emergency and Trauma Care. In addition, the… more