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Participates in collaboration with the Clinical Laboratory Director and/or Blood Bank Laboratory Director, sets the department’s objectives operational and financial performance goals, monitors staff and resource utilization, overtime, and laboratory workload on an ongoing basis, and makes staffing adjustments to achieve departmental goals and objectives.
$59.53 - $86.32 an hourFull-timeExpandApply NowActive JobUpdated 3 months ago - UpvoteDownvoteShare Job
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Performs exams by lab protocol using lab diagnostic criteria; completes required information on PACS. Promotes the smooth and efficient operation of the Cardiovascular Ultrasound Department through the appropriate utilization and management of all clerical functions within the department including document handling and disposition, interpersonal relationships and information gathering and dispersion.
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Registered Nurses (RNs) with utilization review experience, case management experience, and med/surg experience are encouraged to apply. -Two years of Case Management or Utilization Management experience desirable.
Full-timeExpandApply NowActive JobUpdated 1 month ago - UpvoteDownvoteShare Job
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In addition, the role assists the Care Manager and interdisciplinary team with access and utilization management improvements, proactive patient panel management, care facilitation and treatment coordination functions.
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Perform annual reviews for providers based in home office and collaborate, communicate and coordinate with the Program Medical Director, providers, and other teams in responsibilities which include but are not limited to Continuous Quality Improvement, Healthcare-related patient grievances, Infection control, and Utilization management of inpatient and outpatient services, laboratory, and deploying clinical initiatives.
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Works as a team with other members of care management, including but not limited to: RN care managers, assistants, coordinators, utilization management staff, and director. Proactively considers options such as palliative care, homecare and other services that work to keep the patient as healthy as possible in the outpatient setting, minimizing the risk of readmissions.
Full-timeExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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Provides focused support to various areas such as utilization management, emergency department, acute, ambulatory and specialty care. Preferred: Acute care and 1 year Care Management experience; five years’ nursing experience; palliative care clinical experience with patients with serious illness and end of life care needs.
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The Outpatient Therapist is responsible for providing support to the day-to-day operations of the Partial Hospitalization and Intensive Outpatient programs including, but not limited to: administrative functions, utilization review, assessment, discharge planning, group/individual therapy, case management, and other duties related to delivering a successful program.
Full-timeExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
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Candidate with previous experience with utilization management and managed care. The Care Coordinator as part of the interdisciplinary team coordinates and monitors the plan of care to achieve optimal resource utilization and discharge planning outcomes.
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Utilization management, quality management, network management and claims. The fully integrated network is comprised of PIH Health Downey Hospital, PIH Health Good Samaritan Hospital, PIH Health Whittier Hospital, 37 outpatient medical office buildings, a multispecialty medical (physician) group, home healthcare services and hospice care, as well as heart, cancer, digestive health, orthopedics, women’s health, urgent care and emergency services.
$144,206.41 - $237,931.2 a yearFull-timeExpandApply NowActive JobUpdated Yesterday - UpvoteDownvoteShare Job
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Establish and maintain knowledge on the local and national payer landscape this includes Specialty Pharmacy and Utilization Management criteria for assigned products. + Subject matter expert on Bausch + Lombs patient support programs, payer utilization management, access issue resolution, financial assistance and Company approved alternative funding options.
ExpandApply NowActive JobUpdated 7 days ago - UpvoteDownvoteShare Job
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Certifications Required - Registered Nurse in the state of Louisiana Certification as a Case Manager (CCM) required within 2 years of hire Other Required - Three years experience in managed care, utilization or quality management, regulatory compliance, medical management or other related MCO departments/functions with BSN Knowledge Skills and Abilities (KSAs) Must have computer skills and dexterity required for data entry and retrieval of patient information.
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The RN Care Manager is knowledgeable of post-hospital care and services available to the patient including, but not limited to the following: Home Health, Infusion Services, Durable Medical Equipment, Palliative Care, Hospice, Outpatient Services, Transitions of Care Clinics, Transitional Care supportive programs and clinics, follow up appointments, Skilled Nursing Facilities, Rehabilitation Services and Facilities and Community-based Organizations.
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Case management, utilization review, or discharge planning experience in an acute, rehabilitation, skilled nursing or outpatient setting is required. Health plan experience in utilization review and case management will be considered.
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The Social Work Care Manager is knowledgeable of post-hospital care and services available to the patient including, but not limited to the following: Home Health, Infusion Services, Durable Medical Equipment, Palliative Care, Hospice, Outpatient Services, Transitions of Care Clinics, Transitional Care supportive programs and clinics, follow up appointments, Skilled Nursing Facilities, Rehabilitation Services and Facilities and Community-based Organizations.
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