The Director of Case Management and Utilization Review is responsible for overseeing the efficient and effective... developing and implementing case management programs, conducting utilization review processes to ensure appropriate resource...
all inpatient hospital case management and utilization review activities in a single hospital. Coordinates closely with the hospital..., CFO, CCO and Regional Office. Case Manager, Case Management, CM, Utilization Review, CCMC, RN, Registered Nurse...
. Communicating with the Medical Director and Peer Reviewer(s) for cases requiring review of medical necessity, appropriate treatment... Maintaining confidentiality of member information, case records and file entries Participating in quality management activities...
AND RESPONSIBILITIES: Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity... and workers’ compensation claims. Meets (when required) with Concentra Physician Review Medical Director to discuss quality...
of Utilization Management, Inpatient Care Management, and Admission Coordinator with the goal of being a clinical liaison... oversees functions of pre-authorization, utilization review, and quality assurance related to utilization review for compliance...
Transitions’ products and services Ensure appropriate management/resolution of local queries regarding patient case management... daily utilization oversight and external communication with network physicians and hospitals Daily UM reviews...
of resources. 11. Refers cases to the Case Management Medical Director as needed and documents the referral. 12. Identifies... activities and functions to others involved with discharge planning; Case Management associates or other non-licensed personnel...
integration of functions of case management, utilization review and management, and discharge planning. Partners with external... acute or LTACH. Prefer prior experience in case management, utilization review, or discharge planning. Knowledge/Skills...
and all other regulatory and accreditation standards. The Director, Operations is accountable for planning, direction, management... for better? Job Description The Nursing Director of Operations-Inpatient Oncology reflects the mission, vision, and values of NM, adheres to the...
standards. The Director, Operations is accountable for planning, direction, management and supervision of a team or teams... Career Areas Growth and Expansion Nursing Director of Operations-Inpatient Oncology Full-Time Days Location Chicago...
for better? Job Description The Advanced Practice Provider Clinical Director reflects the mission, vision, and values of Northwestern Medicine..., procedures, guidelines and all other regulatory and accreditation standards. The APP Clinical Director will provide strategic...
Associate Medical Director Carelon Medical Benefits Management Radiology Benefit Management/Utilization Review Schedule... decisions. Brings to their supervisors attention, any case review decisions that require Medical Director review or policy...
“Add” to create your job alert. Category Location Add Executive Management, Chicago, Illinois, United States Confirm... Email Submit Career Areas Growth and Expansion APP Clinical Director-Critical Care Full-Time Days Location Chicago...
and accreditation standards. The Director, Operations is accountable for planning, direction, management and supervision of a team... for better? Job Description The Director, Operations reflects the mission, vision, and values of NM, adheres to the organization’s Code of Ethics...
Career Areas Growth and Expansion Director of Operations-Cell Therapies Program Full-Time Days Location Chicago..., Illinois Business Unit Northwestern Memorial Hospital Job REQID 159523 Job Function Management - Inpatient Nursing Shift Day...
Director for Quality Management in these endeavors. The position oversees 9 FTE primary care providers, including MDs... for Student Wellness (AVP), the Medical Director will partner with the AVP in shaping and defining the vision for Medical Services...
clinical criteria. Performs physician-level case review of musculoskeletal utilization requests. Conducts peer-to-peer... fellowship training preferred. Extensive orthopedic surgery experience preferred. Experience with utilization management...
for Advanced Science and Engineering (UChicago CASE) and coordinating with the UChicago Office of Science and Innovation. The.... Job Summary The Director of Administration and Operations will play a pivotal role in advancing the strategic objectives for the...
Utilization Management team to review medical and payer records to ensure appropriate length of stay and identify any barriers...; and managing efficient resource utilization. Core Responsibilities: Transitions Management Manage patients through...
will screen clients applying for services and either provide short term case management or transition clients with higher acuity... to meet client and community needs at point of intake (i.e. expansion of case management services to other site locations...