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Monogram’s innovative, in-home approach utilizes a national nephrology practice powered by a suite of technology-enabled clinical services, including case and disease management, utilization management and review, and medication therapy management services that improve health outcomes while lowering medical costs across the healthcare continuum.
Full-timeExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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Preferably hospital nursing, utilization management, and/or case management. Summary: Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing client members with the right care at the right place at the right time.
ExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
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The Physical Therapist w/Lymphedema Certification in this position will be responsible for recommending and administering basic and advanced quality patient care including screening and evaluation of patients, development of initial and ongoing treatment plans of care, discharge plan, supervision of assistants and Rehab Techs, and case management responsibilities.
Full-timeExpandApply NowActive JobUpdated 14 days ago - UpvoteDownvoteShare Job
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3-5 years of experience in case management, disease management or utilization management in managed care, medical or behavioral health settings. Performs monthly auditing of registered nurse and other clinical functions in Utilization Management (UM), Case Management (CM), Member Assessment Team (MAT), Health Management (HM), and/or Disease Management (DM.
$23.76 - $51.49 an hourFull-timeRemoteExpandApply NowActive JobUpdated 14 days ago - UpvoteDownvoteShare Job
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Certification/Licensure: RN license required; Certification in Case Management (CCM) strongly preferred. Experience (Type & Length): Three to five years of acute medical/surgical experience plus three to five years of Case Management experience.
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At least 4 years Pediatric nursing, Case Management, Care Management, Care Coordination, Utilization Review, or Community-based nursing required. Accredited Case Manager (ACM) or Certified Case Manager (CCM) or Care Coordination and Transition Management (CCTM.
Full-timeExpandApply NowActive JobUpdated 2 months ago - UpvoteDownvoteShare Job
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Our Ethos Risk team is seeking a full-time Utilization Management (UM) Nurse for a hybrid schedule (2-3x in the Dallas, TX office) to coordinate all components of the utilization review process, ensuring timely review of treatment requests for medical necessity, promoting cost-effective treatment, and achieving the best patient outcomes.
Full-timeWork from homeExpandApply NowActive JobUpdated 12 days ago - UpvoteDownvoteShare Job
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Collaborates with medical and nursing leadership, resource management, case management/social work, discharge planning and utilization management to develop and implement methods to optimize use of hospital services.
$201,136 a yearTemporaryExpandApply NowActive JobUpdated 18 days ago - UpvoteDownvoteShare Job
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ResponsibilitiesAnalyze case documents and prepare immigration applications for filing with the appropriate government agencyCommunicate with clients and foreign nationals regarding procedural and case processing issues, assisting with the review of casesOversee status of cases through utilization of case management and billing systems.
Full-timeExpandApply NowActive JobUpdated 10 days ago - UpvoteDownvoteShare Job
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The QMHP-CS will deliver case management and skills-based interventions targeted increasing the youth's natural supports and strengths, fostering resilience and recovery. All services are delivered in compliance with the Texas Medicaid Provider Procedures Manual, the Texas Resilience and Recovery Utilization Management Guidelines, YAP standards, and all state and federal regulations governing the delivery of service.
$42,334 a yearFull-timeExpandApply NowActive JobUpdated 14 days ago - UpvoteDownvoteShare Job
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Enhances the quality of patient management and satisfaction, to promote continuity of care and cost effectiveness through the integration of functions of case management, utilization review and management and discharge planning.
Part-timeExpandApply NowActive JobUpdated 14 days ago - UpvoteDownvoteShare Job
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Leadership skills required for role include effective mentoring, coaching, counseling, time management, problem solving, and strategic planning. Collaborates with the multidisciplinary team to assist patient with benefits management.
Full-timeRemoteExpandApply NowActive JobUpdated Yesterday - UpvoteDownvoteShare Job
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Knowledge of utilization management principles and healthcare managed care. 2+ years of clinical nursing experience in a clinical, acute care, or community setting and 1+ years of case management experience in a managed care setting.
Full-timeExpandApply NowActive JobUpdated 18 days ago - UpvoteDownvoteShare Job
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This individual will ensure the achievement of field sales goals to include: evaluating current business, leveraging data analysis, identifying new sales opportunities, developing strategy, developing action plans and executing the plan, within the prospected sales of managed care services to Non-subscribers, Maritime Accounts, Insurance Companies, TPA. Managed Care Services include: Medical Bill Review, Utilization Review, Case Management, Negotiations, PPO, and Pharmacy.
Full-timeExpandApply NowActive JobUpdated 2 months ago - UpvoteDownvoteShare Job
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This position utilizes knowledge of Medicare and state HMO guidelines in order to facilitate and comply with the Utilization Management plan in data entry and to prepare letters utilizing standard templates.
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management case utilization jobs in Dallas, Peoria, Arizona
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