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Description: Job Summary:Develops, coordinates and manages the administrative and operational activities that are directly associated with the utilization management of medical services provided to Kaiser members.
$168,100 - $217,470 a yearFull-timeExpandApply NowActive JobUpdated 10 days ago - UpvoteDownvoteShare Job
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The Manager, UM Regulatory & Compliance - CCA is responsible for the coordination, implementation, and oversight of the IEHP’s overall Utilization Management Out-Patient Operations departmental clinical and operational compliance with regulatory requirements and quality assurance initiatives related to utilization management out-patient activities (e.g., Prior Authorization, UM Call Center operations.
ExpandApply NowActive JobUpdated 9 days ago - UpvoteDownvoteShare Job
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Performs clerical duties efficiently and accurately (See Unit Secretary Job Description) This position will routinely perform Unit Secretary duties for the unit as assigned (see Unit Secretary Job Description.
Part-timeExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
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Under the direction of the Assistant Director of Utilization Management, the UM Coordinator works as a team member of the UM Department. Experience within high volume HMO or IPA/MSO utilization management /prior authorization department is highly preferred.
Full-timeExpandUpdated 6 days ago - UpvoteDownvoteShare Job
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By continuously reviewing and auditing participant treatment files, the Utilization Management Nurse will ensure that participants receive necessary procedures, effective treatment through collaboration with external hospital and skilled nursing facilities teams reducing the opportunity for readmission.
$79,040 a yearFull-timeExpandApply NowActive JobUpdated Yesterday - UpvoteDownvoteShare Job
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Working in an operating room, cardiac cath lab or similar healthcare facility, you'll prepare equipment, assist surgeons, monitor patient vitals, help maintain sterile conditions and more.
$2,190 a weekExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
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Monitors inpatient and/or outpatient level of care services related to mental health and substance abuse treatment to ensure medical necessity and effectiveness. Monitors residential level of care services related to mental health and substance abuse treatment to ensure medical necessity and effectiveness.
Full-timeRemoteExpandApply NowActive JobUpdated 18 days ago - UpvoteDownvoteShare Job
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Must have working knowledge of discharge planning, utilization management, case management, performance improvement, and managed care reimbursement. The Care Manager (CM) PRN works in collaboration with the patient/family, physicians, and multidisciplinary team members to ensure patient progression through the continuum of care and to develop a plan of care for each assigned patient from admission through discharge.
ExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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Duties involve planning, coordinating, and implementing the DWI program; and coordinating with other departments to ensure the maximum utilization of resources available for the chemical dependency treatment and rehabilitation in compliance with Management & Training Corporation (MTC) and Texas Department of Criminal Justice (TDCJ) directives.
$22 an hourExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
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Reviews disbursement reports to ensure appropriate billing and monitors monthly utilization report to optimize utilization for the legal assistant department. Effectively utilizes the Firm's performance management process to communicate performance expectations, monitor performance, coach employees, and manage unsatisfactory performance.
$120,000 - $140,000 a yearFull-timeExpandApply NowActive JobUpdated 21 days ago - UpvoteDownvoteShare Job
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Job Description available upon request, o Telemetry Monitor Technician would be monitoring all patients on telemetry on 2 ½ units within the Heart Hospital at Edward Hospital – all the 2nd floor, ½ of 3rd floor, and all the 8th floor for a maximum of 70 patients (if every patient on the 2nd & 8th floor & ½ of 3rd floor were on telemetry.
Full-timeExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
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The UM Nurse Specialist provides organizational support in the Utilization Management Department; efficiently processes Pre-Service Authorization Requests. The organization is nationally recognized for excellence in patient care and patient experience, and the College of Healthcare Information Management Executives (CHIME) has identified PIH Health as one of the nation’s top hospital systems for best practices, cutting-edge advancements, quality of care and healthcare technology.
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The position’s emphasis will be on care coordination, communication and collaboration with utilization management, nursing, physicians, ancillary departments, insurers and post acute service providers to progress the care toward optimal outcomes at the appropriate level of care.
$46.96 - $74.63 an hourFull-timeExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
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Compass Healthcare Consulting & Placement is conducting a search for an experienced UM RN, Utilization Management, Registered Nurse for a large Managed Care Plan located in New York. Position is fully remote, work from home.
$102,000 - $107,000 a yearFull-timeRemoteExpandApply NowActive JobUpdated 21 days ago - UpvoteDownvoteShare Job
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University of Maryland Upper Chesapeake Health owns and operates: University of Maryland Harford Memorial Hospital (UM HMH), Havre de Grace, MD University of Maryland Upper Chesapeake Medical Center (UM UCMC), Bel Air, MD The Upper Chesapeake Health Foundation, Bel Air, MD The Patricia D. and M. Scot Kaufman Cancer Center, Bel Air, MD The Senator Bob Hooper House, Forest Hill, MD Job Description: Registered Nurse -ICU Bel Air, MD We are offering up to $15,000 Sign-On Bonus.
ExpandApply NowActive JobUpdated 2 days ago
utilization management job description patient ensure monitors um monitor duties facility analyzes conducts jobs
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