services. Manages providers, members, team, or care manager generated requests for medical services and renders clinical... notification detailing clinical decisions. Coordinates with management, subject matter experts, physicians, member representatives...
services. Manages providers, members, team, or care manager generated requests for medical services and renders clinical... notification detailing clinical decisions. Coordinates with management, subject matter experts, physicians, member representatives...
services. Manages providers, members, team, or care manager generated requests for medical services and renders clinical... notification detailing clinical decisions. Coordinates with management, subject matter experts, physicians, member representatives...
services. Manages providers, members, team, or care manager generated requests for medical services and renders clinical... notification detailing clinical decisions. Coordinates with management, subject matter experts, physicians, member representatives...
services. Manages providers, members, team, or care manager generated requests for medical services and renders clinical... notification detailing clinical decisions. Coordinates with management, subject matter experts, physicians, member representatives...
services. Manages providers, members, team, or care manager generated requests for medical services and renders clinical... notification detailing clinical decisions. Coordinates with management, subject matter experts, physicians, member representatives...
services. Manages providers, members, team, or care manager generated requests for medical services and renders clinical... notification detailing clinical decisions. Coordinates with management, subject matter experts, physicians, member representatives...
programs and clinical activities that impact service delivery. Responsible for utilization review, risk management... of Utilization Management (concurrent review, discharge planning, Pre cert) 7+ years of clinical and disease management experience...
services. Manages providers, members, team, or care manager generated requests for medical services and renders clinical... notification detailing clinical decisions. Coordinates with management, subject matter experts, physicians, member representatives...
escalated problems that arise within clinical utilization management/case rate operations. Identifies trends and makes... recommendations to management to take corrective action to remedy issues. Oversees clinical utilization to ensure visits are made...
. Communicates changes in patient status regarding clinical, insurance, travel and transportation issues to the disease management... personnel and to ensure the delivery of maximum quality care to all patients. • Must complete Clinical Manager training modules...
. Communicates changes in patient status regarding clinical, insurance, travel and transportation issues to the disease management... personnel and to ensure the delivery of maximum quality care to all patients. • Must complete Clinical Manager training modules...
Overview: Oversees the completion and approval of all clinical utilization documentation, including Start of Care, Re... visit utilization using evidence-based practices to provide positive clinical outcomes and efficient use of resources...
Overview: Oversees the completion and approval of all clinical utilization documentation, including Start of Care, Re... visit utilization using evidence-based practices to provide positive clinical outcomes and efficient use of resources...
utilization of services across the continuum of care. Assist the entire Care Management interdisciplinary team in managing... required, with current active RN license. CCM certification preferred. Certification in utilization or care management preferred...
coordination slips, prior authorizations submitted, ongoing PA log activity and proactive management care utilization... processes, exhibit strong technical and clinical skills, excellent leader and manager of people, constant focus on legal...
Job Description: Description The Nurse Manager I is responsible for the management of nursing practice... and operations on a designated unit/service. This includes, but is not limited to, the management of: clinical nursing practice...
, Physician Advisors, and the clinical staff, the Appeal Manager is responsible to develop a strong appeal letter that will result... Denial Manager will assist the department’s leadership develop strategies for denial prevention, improved utilization...
on resource utilization, resolving performance management issues, as well as managing clinical activities. Collaborates with the... more about , and interact with us on and . Position Summary: We have an exciting opportunity to join our team as a Technical Manager...
and participants; Contribute to grant proposals and program design strategies involving clinical components or case management... opportunity, and reduce reliance on the justice system. BCJC is seeking a Program Manager, Social Work. Reporting to the Project...