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The Utilization Review Specialist manages daily operations, which include supervising the staff performing benefit enrollments and utilization management activities. The Utilization Review Specialist review functions as the internal resource on issues related to the appropriate utilization of resources & services, coordination of care across agency and utilization review and management.
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The Biosolids Practice Leader will lead the development and implementation of business strategies across North America in coordination with Wastewater Market Sector leadership and other technical Business Class Directors (e.g. wastewater treatment, biogas utilization, conveyance, asset management, etc.
$130,410 - $242,190 a yearFull-timeExpandApply NowActive JobUpdated 5 months ago - UpvoteDownvoteShare Job
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Is prepared to conduct PPS meetings maintaining MDS assessments per Medicare schedule and maintains PPS board for monitoring of Medicare days and RUGs utilization in the absence of the Care Management Coordinator.
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Family Experience: Partners For Kids Website: The Care Coordination Nurse is responsible for ensuring the provision of quality patient care in the appropriate setting through care coordination, case management, utilization management of inpatient admissions, and transitions of care to different levels of care.
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Defines, designs, develops, monitors and refines effective utilization of predictive and other non-destructive testing methodologies designed to identify and isolate inherent reliability problems.
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As the Director of Case Management , you will use your clinical knowledge and contribute to the overall functions and professional growth of the department, including, but not limited to: Utilization Review (UR) and resource management, discharge planning, treatment plan management and financial management effectiveness.
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Oversee the implementation and accurate utilization of the Maintenance Department’s Computerized Maintenance Management System (CMMS). A keen ability to interact with other departments (i.e. Production, Technical Services, Quality Assurance, Shipping & Receiving, Clerical, and Management) is mandatory to achieve team planning and scheduling.
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The Care Coordination Nurse is responsible for ensuring the provision of quality patient care in the appropriate setting through care coordination, case management, utilization management of inpatient admissions, and transitions of care to different levels of care.
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Experience: Minimum of 5 years acute care medical or surgical experience required; Utilization/Case Management, managed care, or Clinical Documentation with experience in ICD-10 coding conventions and DRG methodology preferred.
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Fully leverages our CRM in the management of SC’s sales planning, prospecting, and daily customer engagement and expects productive utilization of Sysco 360 among all SC’s. The District Sales Manager (DSM) role requires exceptional management of sale performance among Sales Consultants (SCs.
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MD Ph. D; Psy. DBoard Certified Psychiatrist or Board Certified Psychologist in Ohio3+ years of behavioral health experience 10+ years post-graduate clinical experience Public sector program management experience desiredExperience in crisis intervention, utilization management and benefit plans.
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Performs basic chart review activities with appropriate staff for outcome utilization, infection control and medical CQI indicators. Requires experience in at least one of the core areas of responsibility: Quality, Survey Readiness, Risk Management, Infection Control, Employee Health and Education.
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The role functions as a part of a large, integrated care team alongside the Primary Care Provider, Social Work, Nurse Care Management, Behavioral Health and others with the goal of providing whole-person care in the outpatient setting in order to avoid Emergency Room and hospital utilization by supporting our members to overcome their multiple barriers to care and self-management.
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The Care Coordinator maintains an awareness of local and regional substance use treatment and harm reduction services and state and national addiction care trends, and proactively responds with initiatives to enhance provision of care and ensure efficient resource utilization.
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The Case Management Coordinatorwould work under the direction of the RN Care Managers, Utilization Review Care Manager and the Social Workers. The person in this position also coordinates, oversees, records and transmits information pertinent to the resource management of patients.
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utilization management jobs in Columbus, OH
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