- Independent Health (Buffalo, NY)
- …enjoying first-class perks, benefits and commitment to diversity and inclusion. **Overview** The Program Manager - Utilization Management (UM) will be ... they will be responsible for identifying recommended changes to the UM Medical Management program and seeking approval from Medical Directors and Heathcare… more
- UNC Health Care (Raleigh, NC)
- …through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management staff to ... Utilization Management Plan. In addition, the Utilization Manager is responsible for revenue protection...October 1, 2015, must be enrolled in an accredited program within four years of employment, and obtain a… more
- Veterans Affairs, Veterans Health Administration (Hines, IL)
- Summary The Utilization Management (UM) Nurse Manager (NM) is a registered professional nurse responsible for the assessment, planning, provision and ... evaluation of UM Program . The UM NM serves as a role model,...of utilization management . Responsibilities The Utilization Management (UM) Nurse Manager … more
- VNS Health (Manhattan, NY)
- …and updates through on-going training, coaching and educational materials. + For Utilization Management Only: + Issues Determinations, Notices of Action, and ... health care services. Manages providers, members, team, or care manager generated requests for medical services and renders clinical...by state or federal regulations are saved in the Utilization Management System. + Reviews, evaluates and… 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 Onsite at...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
- Mount Sinai Health System (New York, NY)
- **Job Description** The Utilization Review Manager for the Selikoff Centers for Occupational Health is responsible for the management of program ... a particular department/unit. This includes, but is not limited to, the management of: + Program -specific applications, quality improvement, staff education,… more
- Veterans Affairs, Veterans Health Administration (Washington, DC)
- …BSN with five years of acute/critical care experience preferred. 3 years of case management , utilization management , disease management , auditing or ... achieving desired outcomes for discharge. Advocates for fiscal responsibility in the management of care through effective utilization of resources. Provides… more
- Helio Health Inc. (Syracuse, NY)
- …take into account information provided by the hiring manager and program Job LocationsUS-NY-Syracuse Category Case Management Position Type Full-Time Work ... To support the mission of Helio Health, theUtilization Case Manager will enhance the program 's efforts to...staff on current principles and standards of practice surrounding utilization and denials management . + Use effective… more
- Sutter Health (Sacramento, CA)
- …SHSO-Sutter Health System Office-Valley **Position Overview:** This position facilitates utilization management (UM) processes to support that the ... care delays/issues as necessary; in collaboration with the Facility Acute Care Manager (CM). This position provides third-party payers clinical information to assure… more