Utilization management focuses on engaging payers and providers to improve the quality of care, and optimize operational efficiencies in the rapidly changing healthcare environment…Under the direction of the VP of Care Transitions, the Manager of Utilization Management will be responsible for the daily operational activities of utilization management, with oversight over…

Participates as needed in revenue cycle and utilization management-related meetings in a supporting role to the Executive Director to ensure proper payment for services rendered while maximizing…Assists in the resolution of variances and escalated utilization management disputes…

Manager of Utilization Management Havenwyck Hospital is a Joint Commission-accredited and licensed psychiatric hospital, overlooking Lake Galloway in Auburn Hills, Michigan…Havenwyck Hospital is seeking a dynamic and talented Manager of Utilization Management to join our team of compassionate, dedicated professionals…

: meet standards of productivity demonstrates OASIS competency demonstrates clinical competency elicits positive patient satisfaction demonstrates effective care planning and utilization management 8…: The Director of Clinical Operations is responsible for the clinical management of First Call Home Health, overseeing the clinical direction, supervision, and management of patient care services provided by First Call…

adherence to Plan of Care and to ensure effective utilization. …Oversees management of medical supplies, including ordering, distributing, and utilization… and quality of patient care services, employee satisfaction, customer satisfaction and financial management. …

for the development, implementation and leadership oversight of the case management department including Case Management, Utilization Management, and Social Work… years’ leadership experience in utilization management, case management, discharge planning or other cost…

highest possible quality and lowest possible cost (best value) with appropriate utilization, case management and emphasis on prevention. …Guides the development of the overall leadership structure and strategic plan, creates goals and plans for mission effectiveness, for quality and financial management and works to ensure…

, to include a combination of 3 years Utilization Management and Managed Care experience, including Case Management…Oversees Discharge Planning, Utilization Review, Case Management, Social Services, Transitional Care processes and personnel…

) year of clinical experience in post acute care setting preferred Prior case management, utilization review, and discharge planning experience preferred Certified Case Manager (CCM…) or Board Certification in Nursing Case Management (RN BC) preferredSpecific Job Requirements…

Today, we provide best-in-class housekeeping, culinary, patient flow, linen utilization management, facilities management, and clinical engineering services to a wide range of hospitals and healthcare providers…Our approach to services management is patient-focused and performance-driven. …

Responsible for the provision of the overall administration, operation, direction, design, financial performance, human resource management, regulatory compliance, quality, utilization management…Develops and mentors a high performing management team for all areas of responsibility…

, coordination of care across the continuum; promotion of cost-effective care within the allotted time frame; assuring payments of hospital-based services meeting patient-related utilization management…Overview: Kessler Institute for Rehabilitation Select Medical West Orange, NJ Director of Case Management ($5,000 Sign-On Bonus) Responsibilities…

Position Summary The Utilization Review Specialist will ensure regulatory compliance with CMS Conditions of Participation with regard to Utilization Management… and gynecology, surgery, pain management and psychiatry. …

-level providers, utilization management, and other ancillary and support services departments as required to identify and resolve issues that affect patient progression and the team. 2… (inpatient, outpatient, and observations) and length of stay (LOS) targets for changes and confers with staff nurses, physicians, utilization management…

Serves as a resource to the hospital for utilization management issues. …Functions as the lead member and supervisor of the care coordination team to ensure high quality patient care, appropriate length of stay, excellent resource utilization, and ensure reimbursement…

of case management, utilization management, discharge planning, social work, and clinical… offices to facilitate timely patient flow, safe and effective patient care, documentation, and appropriate reimbursement Facilitates Utilization Management Committee meetings on a quarterly plus as needed basis…

Work with Compliance Officer and actively participates in the Utilization Management Committee…

Improvement, Risk Management and Utilization Management programs. …Our supportive programs include behavioral health, nutrition counseling, acupuncture, urgent care, peer support, and case management…

Examples include: understanding and educating consumers about healthcare benefits; navigating utilization management processes; and adjusting the delivery…; matching the type and intensity of services to consumers’ needs; providing patient navigation services; and implementing symptom management. …

Participates in the development, implementation, and monitoring of all patient care programs including Utilization Management…ESSENTIAL FUNCTIONS Leads the clinical activities of the utilization management team by direct supervision of Care Managers, leads and administrative staff Conducts clinical peer reviews of UM…

Provides medical expertise in the operation of approved quality improvement and utilization management programs in accordance with regulatory, state, corporate, and accreditation requirements…Assists the Chief Medical Officer to direct and coordinate the medical management, quality improvement and staffing functions for the Pediatrics Department…

for receiving product, equipment utilization, inventory management, and shipping Meets warehouse operations financial objectives by forecasting requirements; preparing an annual budget; scheduling…Management of employees to ensure operational expectations are met for Insight’s internal and external customers…

Calls insurance companies for authorizations and ongoing utilization management…

supervision of and instruction regarding age-appropriate independent living skills, such as laundering, personal money management, utilization of community…Prepare incident reports as directed Implements behavior management and / or level system protocols as directed by the Residential Director in consultation…

VARIABLE SHIFT FULL TIME BENEFITED Summary: The Utilization Management Specialist demonstrates excellent customer service performance in that his…The Utilization Management Specialist provides support for the Clinical Resource Management Department by serving as a liaison with external agencies and third party payers…

Director of Regulatory, Quality and Utilization Management Havenwyck Hospital is a Joint Commission-accredited and licensed psychiatric hospital, overlooking Lake Galloway in Auburn Hills, Michigan…Havenwyck Hospital is seeking a dynamic and talented Director of Regulatory, Quality and Utilization Management to join our team of compassionate and dedicated clinical professionals…

of behavioral health reimbursement systems including managed care contracts, utilization management processes, EMTALA, Confidentiality Act and HIPPA, Medicare… of information; follow up with Utilization Review Department as needed, and resolves any issues with insurance companies to determine eligibility…

Position- Utilization Management RN Department- Referrals Schedule-Monday- Friday Hours 8:00am-5…: Under the general direction of the Referrals Director, the Utilization Management Nurse is responsible for concurrent…

and procedures, as well as standards of practice; responsible for mental health quality improvement and utilization management program…Qualifications Five (5) years’ experience in an inpatient psychiatric treatment setting, including management and supervision preferred…

Responsible to oversee the management and delivery of patient care, including utilization management, episode management and patient outcomes…What You Will Do Responsible for the supervision, management, coordination…