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Experience in a behavioral health or other healthcare organization that reflects knowledge of Case Management/Utilization Review techniques or has certification as a Case Manager and/or Utilization Review Specialist.
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Preferred:-Leadership experience in a utilization management clinical operations business inside a health plan or a UM/benefits management firm-Utilization management or clinical experience with post-acute care, especially home health and DME-Experience managing productivity with operational tools such as WFM software, Excel, Tableau, Smartsheet, dashboard and report-buildingFor candidates working in person or remotely in the below locations, the salary.
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Three to Five (5) years experience in Case Management/Utilization Review (as either CADC, LAADC, LCSW, LMHC, LMFT, or Utilization Review Coordinator). The Utilization Review Specialist will also perform pre-certification reviews, concurrent reviews and will perform appeal reviews as needed.
$48,000 - $52,000 a yearRemoteExpandApply NowActive JobUpdated 7 days ago - UpvoteDownvoteShare Job
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Ensure effective utilization and optimization of the Epic Tapestry system to support managed care operations and population health management. Epic certification in one of the following Tapestry modules: AP Claims and Contracts, Enrollment and Eligibility, Referrals and Authorization, Utilization Management.
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A passionate advocate for improving clinician and patient experience through population health management. Accountability to key population health metrics, including quality, utilization and financial measures.
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The Clinical Care Coordinator will play a vital role in overseeing Case Management, Utilization Review, and Infection Preventionist functions within this small hospital. Experience in Case Management, Utilization Review, and Infection Preventionist roles within a healthcare setting.
Full-timeExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
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Experience in leadership and oversight of segment leaders and strategic direction of clinical, quality, and population health programs across care management, utilization management, quality, and value based care.
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Understand how utilization management and case management programs integrate. Utilization Review RN - remote position. Two (2) years of acute hospital clinical experience or a Masters degree in Case Management or Nursing field in lieu of 1 year experience.
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Interact with insurance companies for pre-certification and utilization management. ounselor, social worker, marrage and family therapist, inpatient, counseling, therapy, LMHC, registered, behavioral health professional, LPCC, LPC, LMFT, MFT, QMHA,licensed.
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The Registered Nurse or LCSW Director's responsibilities include developing local care and utilization management systems, monitoring hospital department activities related to discharge planning and clinical quality improvement, and addressing resource utilization matters.
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UTILIZATION REVIEW / CASE MANAGEMENT RN - Part Time, Weekends. Position Summary: Conducts concurrent and retrospective chart review for clinical, financial and resource utilization information.
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Landfill gas and LFG utilization (or other biogas management) Work with multidisciplinary teams to undertake solid waste management and other infrastructure projects related to planning, design, and construction.
Full-timeExpandApply NowActive JobUpdated 10 days ago - UpvoteDownvoteShare Job
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Other turf management duties as required, such as herbicide sprayer application, small mower utilization, trimmer applications, etc. Description :Position SummaryThis position assists in turf management for our clients with professional level quality mowing, maintenance & upkeepPrimary Duties and ResponsibilitiesTurf maintenance such as large machine, slope and small machine mowing, via the use of heavy equipment/mowing machinery.
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Demonstrates knowledge of utilization review and collaborates with the Utilization Management Specialists to insure the ongoing, comprehensive monitoring and evaluation of patient care, by concurrent and retrospective review to assure appropriate reimbursement.
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Minimum of six (6) years in a managed care operations, working with one or more of the following areas: Utilization Management, Claims, Pharmacy Operations, Compliance, FDR oversight activities, Quality Management, Care Management, and/or Grievances and Appeals.
$38.37 - $48.93 an hourFull-timeExpandApply NowActive JobUpdated 4 days ago
utilization management jobs Title: health services Company: Association For Community Affiliated Plans
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