Utilization management jobs in Elmwood Park, NJCreate job alerts

Accountable for a designated patient caseload; the Care Coordinator, Utilization Management plans effectively in order to manage length of stay, promote efficient utilization of resources and ensure that care meets evidence-based practice standards and regulatory/payor requirements and follows th...

Assists all departments with the resolution of members’ problems related to utilization management issues. Performs all Utilization Management activities in compliance with all regulatory agency requirements. Conducts medical record reviews as appropriate to case management functions.

Precertification: Utilization Management Nurse Consultant.

Active New York State Licensed Practical Nurse (LPN) or Registered Nurse (RN) license. Utilization Management Nurse (MLTC Focus). Remote, New York (Active NY nursing license required).

We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. CVS Health also offers numerous well-being programs, education ...

Nurse Medical Management II - Utilization Management. Requires minimum of 3 years acute care clinical experience or case management, utilization management or managed care experience; or any combination of education and experience, which would provide an equivalent background. Consults with clini...

As a new Director of Utilization Management at VillageCare, you can expect to oversee the utilization review process, collaborate with interdisciplinary teams to optimize patient care, and develop strategies to enhance operational efficiency. To excel as the Director of Utilization Management at ...

Case Management (Utilization Review).

This Case Management (Utilization Review) in RN (Registered Nurse) job in Bronx, NY could be the next chapter in your story of personal and professional growth.

The Director of Utilization and Case Management will spearhead the strategic direction, management, continuous improvement, and overall maintenance of the Utilization and Case Management Services Unit. Lead the Utilization and Case Management Department at University Hospital, a prestigious healt...

Accountable for a designated patient caseload; the Care Coordinator, Utilization Management plans effectively in order to manage length of stay, promote efficient utilization of resources and ensure that care meets evidence-based practice standards and regulatory/payor requirements and follows th...

Accountable for a designated patient caseload; the Care Coordinator, Utilization Management plans effectively in order to manage length of stay, promote efficient utilization of resources and ensure that care meets evidence-based practice standards and regulatory/payor requirements and follows th...

The Care Manager under the direction of the Vice President of Clinical Services, is primarily responsible for managing both simple and complex medical cases to achieve high-quality patient care outcomes and minimize unnecessary medical expenses, through the coordination of services, both outpatie...

The Case Management Care Coordinator, Utilization Management is a member of the healthcare team and is responsible for coordinating, communicating, and facilitating the clinical progression of the patient's treatment. Accountable for a designated patient caseload; the Care Coordinator, Utilizatio...

Precertification: Utilization Management Nurse Consultant - SCPU.

Licensed as a Registered Nurse (RN) or Advanced Practice Registered Nurse (APRN) in the State of Florida. The Registered Nurse independently plans, implements, and evaluates nursing care in patient care situations using standards of care, policy, and procedure.

Under the direction of the Business Office Manager, is responsible for covering any aspect of the ... Utilization of various collection strategies and methodologies to contact consumers in order to ...

This person will be responsible for supporting the development and management of products from ... seamless adoption and utilization of these technologies. * Take a hands-on approach to ...

Experience Minimum five years experience in utilization review management and/or case management preferred. Minimum of 5 years experience as a registered nurse required. Special Skills Registered ...

Adheres to and participates in the agency's utilization management model. License Requirements * Current RN licensure in state of practice * Current CPR certification * Current Drivers License ...

... and utilization management that promotes positive patient outcomes (for example but not limited to, therapy utilization, client no visit, missing TIF OASIS, agent visit time, missed visit ...

This partnership will provide a comprehensive clinical resource management program that includes utilization management, progression of care management, social work services, and complex discharge ...

... and utilization of warehouse management systems. Qualifications: • Bachelor's degree in industrial engineering, business administration, supply chain management, logistics, or a related field

... and management; integrated behavioral health services. * Residents and Fellows are encouraged to ... care, to utilization of data to individually tailor our services for continual improvement in ...