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Understands key aspects of discharge planning, transitional care management and drivers of readmissions when coordinating care for complex, vulnerable populations. We use population health management tools to employ a holistic approach to caring for the highest utilizers of healthcare services in our comprehensive care centers and in the community.
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Masters in Social Work Care Management discharge planning experience Knowledge of state and federal guidelines pertinent to care management Current working knowledge of discharge planning, utilization management, care management, performance improvement and managed care reimbursement Knowledge of state and federal guidelines pertinent to Care Management.
$24.661 - $36.991Full-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Assist ECM Providers with the coordination of member care with internal L.A. Care departments such as Care Management (CM), Utilization Management (UM), Managed Long Term Services and Support (MLTSS), Social Services, Behavioral Health, Community Health, Health Education, as well as external providers such as Participating Physician Groups (PPGs) and Primary Care Physicians (PCPs.
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The Director of Utilization Management (UM) provides comprehensive oversight of the Utilization Review process under the Knox Keene license and Department of Health Care Services contract.
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The Southwest Healthcare Regional office in Temecula, CA is seeking a Full-Time LVN Central Utilization Review Nurse who will be responsible for carrying out utilization management functions by planning, coordinating, and managing patient needs during hospitalization and throughout the continuum of care.
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Responsibilities of the Remote Utilization Management Nurse:Responsible for performing medical reviews to assess, and coordinate quality care for patientsDetermine medical necessity utilizing MCG criteria and medical policy/contractual benefits.
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Experience with Utilization Management in a managed care environment; basic procedures utilized in claims processing in a managed care environment; medical reimbursement methodologies; supervisory and training techniques.
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RN Coordinator - Utilization Management & Discharge PlanningSummaCare - 1200 E Market Ave, Akron, OHPart-Time / 20 Hours / Days (2 days one wk / 3 days next wk)RemoteSummary:While taking direction from the Manager of UM, the UM Coordinator helps daily to prioritize, coordinate, and implement utilization, discharge planning, regulatory and compliance activities with the UM team.
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Current working knowledge of discharge planning, utilization management, case management, performance improvement, disease or population management and managed care reimbursement.
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From admission to post-discharge, our Care Management team is there to assure care is appropriate, timely, cost-effective, and of high quality. Our Care Management team provides stream-lined coordination of patient care services to Hoag patients and families.
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The RN Care Manager provides education to nurses, physicians and the interdisciplinary team on issues related to utilization of resources, medical necessity, CMS CoP for Discharge Planning and care coordination.
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Provide care coordination using specific criteria and guidelines as mandated by DOD and TRICARE directives, coordinating with the local MHP clinic, utilization and Referral Management policies, and obtains additional clinical data as required.
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Based in Nashville, TN, the Urgent Team Family of Urgent Care & Walk-in Centers delivers care in five states through eight distinct brands: Ascension Saint Thomas Urgent Care, Baptist Urgent Care, Washington Regional Urgent Care, Huntsville Hospital Urgent Care, Physicians Care, Urgent Team, Sherwood Urgent Care, and Baptist Health Urgent Care.
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Other turf management duties as required, such as herbicide sprayer application, small mower utilization, trimmer applications, etc. This position assists in turf management for our clients with professional level quality mowing, maintenance & upkeep.
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Reporting to the Director of Library Special Collections, the Team Leader for Collection Management is the Librarian who manages a team responsible for acquiring, accessioning, and cataloging special collections materials.
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care team utilization management jobs Title: care team management in Phenix-city, Alabama
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