- UpvoteDownvoteShare Job
- Suggest Revision
Collaborate with other organizational departments responsible for functional aspects of the HIV Special Needs Plan, including, but not limited to Integrated Care Management, Behavioral Health, Managed Long-Term Care, Utilization Management, Quality Management, Credentialing, Regulatory Affairs, Compliance, Corporate Affairs, Provider Network Operations, Medicare Services, Information Systems, Finance, Claims, and Member Services and Eligibility.
$150,000 - $157,236 a yearFull-timeExpandApply NowActive JobUpdated 3 months ago - UpvoteDownvoteShare Job
- Suggest Revision
Temporary/Relief Primary Care Physician shall agree that, as required by law, excluding emergency and primary care services, prior authorization must be obtained in writing from the respective CDCR/CCHCS Institution/Facility CEO/CME or designee, in accordance with CCHCS's Utilization Management Plan. Temporary/Relief Primary Care Physician shall complete and return all forms required by CDCR regarding treatment of patient/youth.
Full-timeExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
- Suggest Revision
UTILIZATION REVIEW / CASE MANAGEMENT RN - Part Time, Weekends. LifeBridge Health includes Sinai Hospital of Baltimore, Northwest Hospital, Carroll Hospital, Levindale Hebrew Geriatric Center and Hospital and Grace Medical Center, as well as our Community Physician Enterprise, Center for Hope, Practice Dynamics, and business partners: LifeBridge Health & Fitness, ExpressCare and HomeCare of Maryland.
Part-timeExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Position Summary: Conducts concurrent and retrospective chart review for clinical, financial and resource utilization information. Candidates must have Utilization Review and Discharge Planning experience.
Part-timeExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Must possess strong critical thinking skills, have an ability to perform clinical/chart review and abstract information efficiently. Additional Information Please note: As a condition of employment, if not already completed, all new hires are required to receive the first dose of the COVID-19 Vaccination Series prior to their Occupational Health pre-employment assessment, and scheduled to complete the Vaccine Series within the first thirty (30) days of employment.
Part-timeExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Works with the Landmark Health Medical Director, Director of Health Services, Corporate Director of Health Services, and UM staff in the development and/or implementation of medical management policy, clinical protocols, utilization management guidelines, and quality management programs.
ExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Works collaboratively with the CDI team to facilitate documentation with physician, case manager, utilization reviewer, nurse or other healthcare professionals, utilizing appropriate querying tools to capture needed documentation.
$119,900 - $155,100 a yearFull-timeExpandApply NowActive JobUpdated 8 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Supervises: RN/Case Management; Social Worker/Case Management; Case Management/Referral Coordinator (JC: 244802, 242002) Insure TMH compliance with federally mandated Utilization Review functions.
Full-timeExpandApply NowActive JobUpdated 3 months ago - UpvoteDownvoteShare Job
- Suggest Revision
Duties will include, but are not limited to budget development for physician practices in partnership with finance manager, physician compensation support, capital equipment procurement and disposition, space utilization in the clinical space, and staff supervision.
Full-timeExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Experience and demonstrated ability to assess clinical needs and work in an integrated, holistic approach to care, including case management, disease management and/or population health programs.
Full-timeExpandApply NowActive JobUpdated 20 days ago - UpvoteDownvoteShare Job
- Suggest Revision
These activities include, but are not limited to, strategic business planning, budgetary and financial oversight, human resource management, operations management, quality oversight, process/performance improvement activities, accreditation and regulatory compliance oversight, evidence-based system practice standardization, and utilization activities.
Full-timeExpandApply NowActive JobUpdated 3 months ago - UpvoteDownvoteShare Job
- Suggest Revision
May process complex lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review.
Full-timeExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
- Suggest Revision
The charge nurse assists the Clinical Manager and/or Nursing Director with the management of the unit including participating in employee evaluation, staffing and scheduling, patient and preceptor assignments, oversight of resource utilization, and initiating and overseeing quality improvement activities.
ExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
- Suggest Revision
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.
ExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
- Suggest Revision
St. Luke’s Health System in is seeking a Utilization Management Nurse for St. Luke's Health Plan to join our team. Write and send notification to members and providers regarding utilization management determinations, using plain language that is easy for a layperson to understand.
Full-timeExpandApply NowActive JobUpdated 2 days ago
utilization management physician jobs
FEATURED BLOG POSTS
How to Prepare to Be Fired - What You Need to Do
If you’re reading this, let me be the first to tell you how sorry I am. Getting fired feels crappy, disheartening, hurtful, and all the other bad, sad words. But here’s what I want you to do. First, let yourself fumble for a minute. Then, pick your head up — sometimes getting fired is a blessing in disguise. If you think termination is around the corner, we’ll teach you how to prepare to be fired and what to do next so you land somewhere even better.
How to Find a Job That Makes You Happy - 11 Concerning Facts
Do you ever feel like your life is like one of those rom-com movie scene openers? You know, the ones where the main character rolls out of bed, awakened by a casually upbeat theme song, sulks their way to the coffee pot, and then trudges toward their computer to begin yet another boring day at work?
How to Decline a Job Offer You Already Accepted
When you think about it, turning down a job offer is not the worst position you could be in. If you’ve been lucky enough to consider multiple job offers, well, then you’re lucky enough.
What Makes a Good Boss? The Top 12 Qualities & Attributes
Think back to the best boss you’ve ever had—does someone come to mind? We hope so! Okay, now think back to the worst boss you’ve ever had. I’m sure you can conjure up a few faces.
How to Recruit and Retain Gen Z Employees
As Boomers and the oldest Gen X are exiting the workforce, younger Millennials and Gen Z are flowing in. While the younger generations seem to be completely different than the older generations, many care about some of the same things- financial security, working conditions, etc. However, due to social and cultural differences in the era that Gen Z has grown up in, they have concerns that were never even workplace topics of discussion 20 years ago.
How Does Temp to Hire Work? Benefits, Concerns, & More
Whether you’re just starting out your career or are looking for the next opportunity, the job market has never been more burgeoning with opportunities. From flexible work options and freelancing gigs to seasonal and temp-to-hire work, people today are spoiled for choice when it comes to finding engaging and fulfilling work.
Explore Your Skill and Find the Best Way to Make Money From Home
When you just can’t stomach another drive-thru coffee on your morning commute, close your navigation app on your phone and search for easy ways to make money from home instead. With a computer and some niche skills, there are countless opportunities for you to earn a living from your couch. (Okay, fine, your home office.) Below, we’ll explore 30 different ways to make money from home, as well as a few “too-good-too-be-true" warning signs to know to keep you from booking the wrong remote gig.