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The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and independent critical thinking skills towards interpreting criteria, policies, and procedures to provide the best and most appropriate treatment, care or services for members.
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Knowledge of the functional operations of utilization management, care coordination and transitions of care. In collaboration with providers and the Medical Director, the Utilization Review Nurse ensures medical appropriateness and effective utilization of health care resources.
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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.
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The Field Reimbursement Manager will be responsible for the management of defined accounts in Urology and Oncology area, specifically supporting our client’s product. The Reimbursement Manager will also work on patient level reimbursement issue resolution, and thus will need access to be knowledge of and have had experience with patient health information (PHI), navigating access issues, and working with payer and NCCN guidelines for product utilization.
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Knowledge of general banking operations, including deposit operations, loan administration, treasury management and/or other commercial banking products and services. Qualifications:A demonstrated understanding of Controls Testing, Issue Management and Risk and Control Self Assessments within areas such as information technology, general banking operations including deposit operations, loan administration, treasury management and/or other commercial and consumer banking products and services.
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The RN Case Management Director will enjoy a thriving community spirit and endless possibilities for fun and adventure in central Ohio. Whether you enjoy urban, suburban, or more rural environments, there is something for everyone in this beautiful area.
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Assists the Community Director in maximizing revenue potential of the property through the management of lease expirations and timely turnover. Assists the Community Director with the management of monthly rent collections and delinquency to include timely deposit and security of funds according to FPI policies.
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The Wealth Management Analyst focuses on servicing clients by understanding their investment objectives and working in partnership with the Financial Advisor / Private Wealth Advisor to deliver solutions.
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The Anesthesiology and Pain Management Service is located within the comprehensive Veterinary Medical Center which includes state-of-the-art facilities with equipment such as endoscopy, laparoscopy, digital radiography, ultrasonography, computed tomography, 3 Tesla MRI, and 24-7 small and large animal emergency and critical care units.
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15+ years of related project experience in Civil Design, CCR, Environmental Infrastructure or Geotechnical Engineering projects related to CCR management, solid waste management, remediation construction, water resources, dams and impoundments.
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Good working knowledge of cash management, FX, Debt capital markets and interest rate risk management. Hands-on expertise with any of the SAP Treasury core components (i.e. Cash management, Transaction manager, In-house cash, Risk analyzers, Liquidity planner, Hedge management and accounting, SWIFT integration, BCM, integration with financial accounting and other applications.
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Self-motivated, proactive approach in the application of GSOC, Crisis Management, and Global Security practices. Experience as a meteorologist supporting private or public sector crisis/emergency management teams preferred.
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The Wealth Management (WM) Credit Risk team is seeking a Lead Credit Officer - Vice President to manage credit exposure for WM clients, with a primary focus on credit risk management for International Private Bank clients covered by the WM Latin America & Global Families Group businesses.
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This role will be the senior leader responsible for first line of defense risk management and oversight activity for the Technology and Cybersecurity organizations and serve as the primary risk partner for the Chief Information Security Officer and Chief Technology Officer’s organizations.
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The Case Management Coordinator utilizes critical thinking and judgment to collaborate and inform the case management process, in order to facilitate appropriate healthcare outcomes for members by providing care coordination, support and education for members through the use of care management tools and resources.
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utilization management jobs Company: Metroplus Health Plan in Columbus, OH
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