Manager Utilization Management
2 weeks ago
Job Summary:
Manages the day-to-day operations of the Utilization Management Program in the Service Area or a Medical Center.
Ensures cost effective and quality patient care by appropriate utilization of resources.
Provides direction to staff which may include Outside Utilization, Extended Care, Bed Placement, Discharge Planning, Transportation and others as assigned.
Essential Responsibilities:
Assists in developing and maintaining policies and procedures for the Service Area or Medical Center related to Utilization Management.
Collaborates with the multi-disciplinary teams to plan and coordinate care across the continuum.
Coordinates and manages members care with non-KFH hospital facilities and providers. Identifies risk management and quality of care issues across the continuum.
Surfaces issues and any suggestions to the appropriate multi-disciplinary team members.
Manages transportation program to ensure appropriate utilization of resources which meet Health Plan guidelines and patient needs.
Assures compliance with Federal, State, TJC, NCQA, other regulatory agencies and internal standards and requirements.
Provides direction to staff regarding utilization review, care coordination, discharge planning, and other services across the continuum of care.
Assists in conducting statistical studies in utilization trends, patterns, and outcomes.
Hires, trains coaches, disciplines professional and clerical support staff.
Basic Qualifications:
Experience
Minimum three (3) years of experience in utilization management and discharge planning in an acute care setting to also include supervisory or management experience.
BSN or bachelors degree in healthcare related field such as management, health services administration.
License, Certification, Registration
Registered Nurse License (California)
Additional Requirements:
Demonstrated knowledge of operations and healthcare management; TJC, Title XXII, Medicare, MediCal and other local, state and federal regulations.
Knowledge of managed care operations.
Demonstrated interpersonal, negotiation, and management skills.
Good oral and written communication skills.
Must be able to work in a Labor/Management Partnership environment.
Preferred Qualifications:
N/A.
#J-18808-Ljbffr
-
Onsite District Manager
2 weeks ago
California, Missouri, United States Beach Front Property Management Full timeOur team members demonstrate excellent Leadership, and proactively manages their team with accountability. These individual shares our core values with a passion for property management and enjoys the fast pace, grow or die work environment This self- motivated individual makes the team excel and has a strong desire to learn. This individual also...
-
Manager of Case Management
2 weeks ago
California, Missouri, United States ConcertoCare Full timeAll Jobs > Manager of Case Management - California The ConcertoCare Manager of Case Management supports the daily activities of Case Managers for ConcertoCare. This position will ensure that case management processes and programs are implemented and serves as a resource and subject matter expert for the Case Managers working in their assigned geography. Key...
-
Marketing Manager
2 weeks ago
California, Missouri, United States Hubstaff Full timeBoo is a leading dating and social networking platform committed to innovation, quality, and excellence.We are looking for a dynamic and experienced Marketing Manager to join our team and help elevate ourbrand to new heights.Position Summary:The Marketing Manager will play a pivotal role in developing and executing comprehensive marketingstrategies that...
-
Technical Knowledge Manager
2 weeks ago
California, Missouri, United States Nomadgao Full timeApr 19, Material Security is hiring a remote Technical Knowledge Manager. Salary: $150,000 to $185,000.Location: Americas.Material Security is looking for a highly skilled, detail oriented, and experienced Technical Knowledge Manager to join our team. You will be a founding member of the Technical Writing team and play a pivotal role in maturing our product...
-
Project Manager
2 weeks ago
California, Missouri, United States Northern Impact Full timeOverview National multidisciplinary design firm is seeking a talented Project Manager to join either their San Francisco or Sacramento office. In this role, you will be actively managing project teams and building long-term relationships with the company's growing higher education, civic, and cultural practice. This role requires excellent time management,...
-
Senior Marketing Manager
2 weeks ago
California, Missouri, United States Gradbay Limited Full timeSenior Marketing ManagerSalary: $105k-125kLocation: Inglewood, CAA leading Dental Service Organization (DSO) managing 160+ practices across eight states. We prioritize exceptional oral healthcare and are dedicated to enhancing patients' lives. Our dynamic team focuses on patient care, operational excellence, and innovation.Job Description:As the Senior...
-
General Manager
2 weeks ago
California, Missouri, United States Inspire Communities Inc Full timeCompany:For more than thirty years, Inspire Communities and its predecessor companies have developed, acquired, and managed manufactured housing communities nationwide. Today we are one of the countrys largest owners and operators of manufactured housing communities and recreational vehicle resorts. We create vibrant, affordable communities for working...
-
logistics management specialist
2 weeks ago
California, Missouri, United States Naval Air Systems Command Full timeNaval Air Systems Command LOGISTICS MANAGEMENT SPECIALIST Naval Air Station San Diego , California Apply Now Summary You will serve as a Foreign Military Sales (FMS) LOGISTICS MANAGEMENT SPECIALIST in the E-2/C-2 Fleet Support TeamFLEET READINESS CENTER SOUTHWEST. Responsibilities You will be responsible for Logistics and aspects/phases, from Concept...
-
Manager Capital and Risk Management
2 weeks ago
California, Missouri, United States Medavie Blue Cross Full timePress Tab to Move to Skip to Content LinkSelect how often (in days) to receive an alert:Select how often (in days) to receive an alert:Location:Prince Edward Island, CA Quebec, CA NL, CA Nova Scotia, CA ON, CA New Brunswick, CABlue Cross Life Insurance Company of Canada is a federally licensed company that distributes its products through a network of Blue...
-
Materials Management Director
2 weeks ago
California, Missouri, United States LAJHealth Full timeOur hearts and prayers are with Israel upon the recent unprovoked surprise attacks by the terrorist organization Hamas.We stand with Israel as she confronts this most devastating war and pray for the families of the victims and for all of Israel with hope that peace comes swiftly.We value our employees We offer long term employment opportunities with job...
-
Care Manager RN Full Time Day
2 weeks ago
California, Missouri, United States Providence Health & Service Full timeCare Management is a collaborative practice model including the patients, nurses, social workers, physicians, other practitioners, caregivers and the community. The care management process encompasses excellent communication, both verbal and written, and facilitates care along a continuum through effective resource coordination.The goal of the Care Manager...
-
FLEX Senior Manager, Change Management
2 weeks ago
California, Missouri, United States Marriott Full timeMarriott FLEX Senior Manager, Change Management Bethesda , Maryland Apply Now Schedule Part-TimeLocated Remotely? NRelocation? NPosition Type ManagementThis is a flex position. Please apply for the position at FLEX Talent Community | Home ) )The Senior Manager, Change Management is responsible for leading the design and execution of effective people-focused...
-
Senior Strategic Alliance Manager
2 weeks ago
California, Missouri, United States Dialpad Full timeRole:You are a visionary who thrives on connecting concepts to possibilities. You possess a growth mindset that persistently explores fresh and innovative approaches to bring Partnerships into existence. A natural bridge-builder and rapport cultivator, adept at guiding intricate, multi-faceted organizations towards a unified objective of forging exceptional...
-
Section Chief of Lifecycle Management
2 weeks ago
California, Missouri, United States City of New York Full timeThe NYC Department of Environmental Protection (DEP) enriches the environment and protects public health for all New Yorkers by providing 1.1 billion gallons of high quality drinking water, managing wastewater and stormwater, and reducing air, noise, and hazardous materials pollution. DEP is the largest combined municipal water and wastewater utility in the...
-
City Manager
2 weeks ago
California, Missouri, United States ICMA Services Full timeThe City of Watsonville, California is seeking a dynamic and accomplished executive to become its new City Manager. The selected City Manager will also need to have an inclusive management style combined with a hands-on approach to day-to-day operations. Additionally, a thorough understanding of community development, economic development, and finance is of...
-
Content Manager
2 weeks ago
California, Missouri, United States ARCH SOLAR C&I INC Full timeVideo Marketing Sr. Manager - I oversee content strategy across our key video distribution channels (Salesforce+ and YouTube). Our team works with cross-functional partners to manage content development, paid promotion and merchandising of video content and owned channels to drive viewership engagement and upper funnel awareness of the Salesforce brand and...
-
Content Manager
2 weeks ago
California, Missouri, United States ARCH SOLAR C&I INC Full timeResponsibilities:Work with other members of the localization team to continually improve existing product localization and delivery, with a focus on upstream ease of development Support your assigned product team(s) to ensure that all releases are executed in an efficient and timely manner, and that all of the international customers get the best possible...
-
Marketing Manager
2 weeks ago
California, Missouri, United States JLL Full timeJLL supports the Whole You, personally and professionally. Our people at JLL are shaping the future of real estate for a better world by combining world class services, advisory and technology to our clients. We are committed to hiring the best, most talented people in our industry; and we support them through professional growth, flexibility, and...
-
Software Development Manager, Stores
2 weeks ago
California, Missouri, United States Amazon Full timeSoftware Development Manager, Amazon Stores Job ID: | Services LLCAs an Amazon Manager, Software Development, you will solve unique and complex problems at a rapid pace, utilizing the latest technologies to create solutions that are highly scalable. You will find that there is an unlimited amount of opportunities within Amazon, where developing your career...
-
Affiliate Manager
2 weeks ago
California, Missouri, United States Martech Record, LLC Full timeIdeal Living is a purpose-driven consumer goods company that is based in Sherman Oaks CA. We are a mighty team full of compassionate citizens, people caring, product-perfecting, science-driven stewards of a thriving life for all. We put heart and research behind everything we do, creating the most accessible technology and products to promote health and...