Medical Director - Case Management and Utilization Review
Memorial Healthcare System
Complexity of Work: Essential Competencies and Skills: Excellent customer service and interpersonal skills. Able to effectively present information, both formal and informal. Strong written and verbal communications skills with all levels of internal and external customers. Strong analytical skills. Strong organizational skills and the ability to set priorities and multi-task. Demonstrated flexibility, teamwork, and accommodation to change in the healthcare environment.· Ability to drive results and produce outcomes. Required Work Experience: Extensive experience in one or more branches of medicine or surgery; at least, five (5) post-training years of medical staff organization/administrative experience in a large acute care hospital. Other Information: Additional Education Info: Graduate of a medical school approved by the Council on Medical Education of the American Medical Association.
Memorial Healthcare System is a community of caregivers dedicated to delivering quality patient- and family-centered care. This passion for caring extends to our teammates, who support one another and create heartfelt connections that last a lifetime. We are one family at the heart of exceptional care. Join us as we elevate the well-being of everyone we touch. #teamMHSflorida- ...The Medical Director of Case Management and Utilization Review leads the hospital specific execution of the Case Management (CM) and Utilization Management (UR) and related activities. The Medical Director functions as the primary physician advisor for the hospital and...SuggestedFull timeWork experience placement
- ...Required Work Experience: Extensive experience in one or more branches of medicine or surgery; at least, five (5) post-training years of medical staff organization/administrative experience in a large acute care hospital. Other Information: Additional Education Info:...SuggestedWork experience placement
- .... Starting with Valley Hospital Medical Center in 1979, the Valley Health... ...and providing proficient timely utilization management services to ensure that maximum reimbursement... ...years experience in Utilization Review, Utilization Management or Case Management preferred. Applicant...SuggestedDaily paidLocal area
- ...Healthcare Case Manager Provide comprehensive healthcare management... ...clinical issues. Determines medical necessity/appropriateness Facilitates... ...Program enrollees. Utilizes critical thinking and judgment... ...management tools and information/data review. Coordinates and implements...SuggestedWork at officeRemote work
- ...older adults with complex medical needs. We have four... ...: Social Services Case Manager (Florida PACE Centers)... ...the supervision of the Director of Social Services or... ...requires supervisory review and co-signature prior... ...information Identifies and utilizes appropriate channels...SuggestedFull timePart timeLocal area
- ...Case Manager Opportunity Recognized for your abilities as a Case... ...have access to: Affordable medical, dental, and vision plans for... ...and department operations. Review/analyze case management reports... ...patient record Participate in utilization review process: data...Full timeContract workPart timeFlexible hours
- ...purpose helping military veterans? The Case Manager is a support member of a Senior Advocate... ...client files and records, as directed.Reviews completeness of client files within the... ...regulatory deadlines are met.Proficiency in utilizing office technology and software programs...Work at officeMonday to Friday
- ...Licensing Foreign Medical Graduate or Registered Nurse... ...preferred) CCM (Certified Case Manager) (preferred) ACM (Accredited... ...portals Performs concurrent reviews Contacting all HMO's on... ...appropriate level of care and utilization of services needed...Full timeWork at office
- ...of Every One. Job Title PRN RN Case Manager Location Weston... ...Weston Hospital Department Utilization And Quality Assur-Weston Hospital... ...years of recent experience in utilization review, quality or care management Knowledge...ReliefWork at officeShift work
$1,688 - $1,796 per week
...Case Manager Job #1939587 Fort Lauderdale, FL $1688-1796 /week* 40 hrs /week * Estimated... ...Healthcare Job Details: Fusion Medical Staffing is seeking a Case Manager RN... ...access to services Conduct utilization reviews and manage length of stay, ensuring adherence...Temporary workShift work- ...Commission-certified staffing agency, is seeking a quality Case Manager Registered Nurse (RN) for a travel assignment with one of our... ...Contract, Travel Nursing, Case Manager, Case Management, Utilization Review, Case Manager RN *Weekly payment estimates are intended...Hourly payWeekly payContract workImmediate start
- ...Assistant Medical Director The Broward County Board of... ...detoxification and withdrawal management, Medication Assisted... ...outpatient, and case management... ...to impact the rates; reviews program overviews and... ...regarding cost management, utilization, quality assurance, medical...Work at officeImmediate startShift workNight shiftWeekend work
- ...as a(an) Registered Nurse Case Manager? At HCA Florida Westside Hospital... ...with the Rehab Program Director and Facility Case... ...Certification in case management or utilization review preferred InterQual experience... ...benefits for medical, prescription drug, dental,...Temporary workFlexible hours
- ...RN Case Manager Location: Hollywood, Florida The RN Case Manager... ...care coordination and utilization of healthcare resources to achieve... .... Performs ongoing chart review to identify actual or... ...status and appropriateness of medical care, including admission, length...Work experience placementRelocation packageShift work
- ...and resources relevant to the effective progression of care, utilization of services, appropriate level of care, and safe patient... ...Experience: Minimum one (1) year experience in hospital-based Case Management practice or five (5) years in Healthcare. Other Information...Daily paidWork experience placement
- ...English/Spanish) Personal Injury Intake Case Manager This is a full-time position on-site... ...client communications and case activity Medical Treatment Coordination Monitor and... ...cases eligible for escalation, attorney review, demand preparation, or transfer to the...Full timeTemporary workWork at officeImmediate startMonday to Friday
- ...Job Title: Per Diem Case Manager Job Type: Direct Care Staff Department: Residential Position Reports to: Program... ...duties. EQUIPMENT USED: Must be able to utilize basic word processing, email, and internet programs. Must be able...Daily paidShift work
- ...Case Manager The University of Miami's Department of Psychology has an exciting opportunity for a full-time Case Manager... ...skills, and a dynamic presentation style. Independently reviews diagnostic and other medical and social service reports to determine eligibility for...Full timeWork experience placementLocal areaNight shiftWeekend workAfternoon shift
- ...Lead Case Manager Would you like to make a difference in the lives of those in the greatest... .... Participates in staff file peer reviews of care plans and client file, performs... ...~ Paid Time Off ~ Health Insurance (Medical, Dental, Vision, Disability, GAP and Health...Permanent employmentLocal area
- ...Job Title Broward Health Medical Center Sign On/Retention Bonus: $10000 - 1 yr of... ...Description Facilitates coordinates and manages an assigned caseload to promote evidence... ...clinical focused outcomes. Manages utilization management supporting medical necessity...Relocation package
$60k - $80k
...personal injury law firm in Aventura looking for an experienced Case Manager who can hit the ground running. This is a full-time, in-... ...on case status, timelines, and next steps Gather, review, and analyze medical records, bills, and treatment summaries Coordinate...Full timeWork at officeMonday to Friday- ...highest standards of medical practice. You will... ...for complex cases. Provide 24/7/365 on... ...support regulatory reviews. Participate actively... ...care and medication management. Monitor pharmacy utilization, ensuring appropriate... ...or Hospice Medical Director Certification Board...Daily paidFull timePart timeLocal area
- ...Licensed Practical Nurse (LPN) Case Manager The Licensed Practical... ...Registered Nurse (RN) and/or Director of Nursing. The LPN Case... ...scope of practice. Provide medication management, treatment administration... ...in audits, chart reviews, and corrective action plans...
- ...Work: Responsible for day-to-day oversight and coordination of case management and discharge planning functions ensuring patient care meets... ...processes. Strong background in clinical decision making, medical criteria, and discharge planning. Must be proficient with Interqual...Work experience placement
- ...Description The Personal Injury Case Manager plays a critical role within... ...to monthly engagement with medical providers to ensure thorough... ...client support. The Case Manager utilizes specialized software tools... ...effectively Review medical records for completeness...
- .... As a(an) Registered Nurse Case Manager with HCA Florida Aventura Hospital... ...with the Rehab Program Director, Facility Case Management... ...Comprehensive benefits for medical, prescription drug, dental,... ...that invests in you! We are reviewing applications for our Registered...Temporary workFlexible hours
$50k - $89.6k
...Case Manager, Crew Relations Position Summary The Case Manager, Crew Relations will be responsible for an investigation caseload... ...or Case Management Tool. Ability to work independently and utilize resources to problem solve a variety of complex, highly sensitive...Full timeTemporary workWork at officeLocal areaImmediate startFlexible hoursNight shift$248.5k - $373k
...Growing together The Associate Medical Director for UnitedHealthcare Community & State... ...role offers the opportunity to shape utilization management, quality improvement, provider collaboration... ...rounds, conduct peer-to-peer reviews, and represent the health plan in Medicaid...Minimum wageWork experience placementLocal areaRemote work$248.5k - $373k
...Reporting Structure Reports to: Chief Medical Officer, Community & State Florida Works... ...Provide clinical leadership for utilization management, prior authorization, appeals and grievances... ...clinical rounds, conduct peer-to-peer reviews, and represent the health plan in...Minimum wageWork experience placementLocal areaRemote work- ...coordination of care and disease management for patients with... ..., optimizing APP utilization, and supporting timely... ..., age-specific, medical, behavioral, pharmacy,... ...certification Prior case management experience... ...Administration: Please review the Equal Employment Opportunity...Shift work
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