on addressing performance improvement metrics, resolving operational issues, including but not limited to utilization management... compliance. · Develop goals and objectives that align with Network Management Director's performance metrics to ensure...
Francisco, CA Salary: $140000 - $154000 Per Year Reporting to the Director, Care Management, the Manager, Care Management... requirements for the dual eligible membership (DHCS, CMS, NCQA, and others), which include care management, utilization management...
plan for patients. Performs overall utilization management, resource management, discharge planning and post-acute care... requirements. Takes leadership role in concurrent denial process. Works with Care Management Director, Physician Advisor...
Job Description: Position Summary: This is an integrated Case Management and Utilization Review position. The Acute... on assessed needs and available resources. The Acute Case Manager also performs Utilization Management throughout the continuum...
) years of experience in an acute care setting with strong care management, utilization review, and payer knowledge. A Case... healthcare team to provide appropriate medical management and resource utilization utilizing established/approved criteria. b...
Discuss with client/client teams any potential utilization management programs under evaluation to ensure that all modeling...POSITION SUMMARY: The Program Management Advisor (Financial Analyst) provides financial, rebate, and modeling support...
Discuss with client/client teams any potential utilization management programs under evaluation to ensure that all modeling...POSITION SUMMARY: The Program Management Advisor (Financial Analyst) provides financial, rebate, and modeling support...
of the healthcare team to provide appropriate medical management and resource utilization utilizing established/approved... those which are regularly assigned. Has an understanding of the regulatory requirements relative to the case management process. Certified...
Job Description: Overview The complexity of Digital and Technology management requires specialized knowledge... and experience to effectively plan, analyze, and manage financial accountabilities and information. The IT Financial Management...
/utilization management/disease management, education, quality improvement, clinical practice and health care trends...Department: Jackson Memorial Hospital - JM Case Management Acute Address: 1611 NW 12 Ave, Miami, FL 33136 Shift...
of utilization management, quality management, discharge planning assessment, and coordination of post-hospital care services... information. • Participates in InterQual competency testing as requested by department director. Outcomes Management...
of utilization management, quality management, discharge planning assessment, and coordination of post-hospital care services... information. • Participates in InterQual competency testing as requested by department director. Outcomes Management...
Collaborate with Optum Enterprise Clinical Services Medical Directors on performing utilization management Participation... that is seriously shaping the way health care services are delivered. As an Inpatient Care Management Nurse, you will be responsible...
in case management which includes but is not limited to utilization review, discharge planning (home infusions, wound vacs... Health has an opening for a part-time (32 hours every 2 weeks) Case Management & Education RN. This position will work...
Strategy will report to and directly support the Managing Director of Investment Strategy for the Chief Investment Office (CIO... impact of CIO advice on client outcomes and will design methods to maximize utilization levels of investment recommendations...
: Performs Minimum Data Set (MDS), case management, utilization review, quality assurance (QA), and discharge planning duties... Center (JC: 013501) [with delegation (as needed) to RN/Director, Rehabilitation (JC: 030101)] Supervises: None...
in utilization management, managed care, and payer issues that may impact the course of care. Timely response to screening...Munson Healthcare Traverse City, Michigan Patient Care Management Day shift Requisition #: 61040 Total hours worked...
Description : Job Summary: Identify labor needs for the park and ensure the efficient utilization of the workforce...: Work with park management teams to ensure the park is maximizing guest service and profitability through the efficient...
of utilization management, quality management, discharge planning assessment, and coordination of post-hospital care services... information. • Participates in InterQual competency testing as requested by department director. Outcomes Management...
of utilization management, quality management, discharge planning assessment, and coordination of post-hospital care services... information. • Participates in InterQual competency testing as requested by department director. Outcomes Management...