Health Utilization Management

Selected news for the healthcare topic - Health Utilization Management, collected since 11/2017. Recent stories appear in ridgwayrecord.com and killerapps.tv. This healthcare topic shares news with Behavioral Health, URAC, UnitedHealth Group and many others.

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Date Headline (link) Source Relevant Snippet
3/23/2021 The Ridgway Record ridgwayrecord.com The Designation Demonstrates the Highest Level of Commitment to Quality HealthcareNASHVILLE, TN Shearwater Health is proud to announce it has renewed its URAC Accreditations in Health Utilization Management and Workers' Comp Utilization Management at its three Philippine Healthcare Delivery Centers.URAC is the independent leader in promoting healthcare quality through leadership, accreditation, measurement, and innovation. By achieving this status, Shearwater has demonstrated a comprehensive commitment to quality care, improved ...
3/22/2021 HealthSmart® Earns URAC Reaccreditation for Health Utilization Management killerapps.tv HealthSmart® Earns URAC Reaccreditation for Health Utilization Management HealthSmart® Earns URAC Reaccreditation for Health Utilization Management releases/healthsmart-earns-urac-reaccreditation-for-health-utilization-management-301252640.htmlIRVING, Texas, — HealthSmart, one of the nation’s largest third party administrators of health plans for self-funded employers and plan sponsors, announced it has earned full URAC reaccreditation in Health Utilization Management based on its application score… Share ...
2/9/2021 Brighton Health Plan Solutions Achieves URAC Reaccreditation in Health Utilization Management tncontentexchange.com Brighton Health Plan Solutions Achieves URAC Reaccreditation in Health Utilization Management By Brighton Health Plan Solutions, URAC Feb 9, 2021Brighton Health Plan Solutions is a healthcare enablement company that is transforming the healthcare landscape. (PRNewsfoto/Brighton Health Plan Solutions) By Brighton Health Plan Solutions, URAC TownNews.com Content Exchange SaveNEW YORK , Feb. 9, 2021 /PRNewswire/ -- New York -based healthcare enablement company Brighton Health Plan Solutions has once again earned ...
2/9/2021 Brighton Health Plan Solutions Achieves URAC Reaccreditation in Health Utilization Management PR Newswire NEW YORK , Feb. 9, New York -based healthcare enablement company Brighton Health Plan Solutions has once again earned national accreditation in Health Utilization Management from URAC, an independent leader in promoting healthcare quality through leadership, accreditation, measurement and innovation. The in-house Health Utilization Management program at Brighton has continuously held this accreditation since its inception. Its current accreditation is valid through February 2024 .Brighton helps self-insured clients, their ...
2/9/2021 MagnaCare's Health Utilization Management Program Once Again Achieves URAC Accreditation magnacare.com February 9, 2021NEW YORK, NY (Feb. 9, 2020) – New York-based healthcare enablement company Brighton Health Plan Solutions, parent company to MagnaCare, has earned national accreditation in Health Utilization Management from URAC, an independent leader in promoting healthcare quality through leadership, accreditation, measurement and innovation. The in-house Health Utilization Management program used by Brighton and MagnaCare clients has continuously held this accreditation since its inception. Its current ...
1/26/2021 SendaRide Hires Dan Shivers as Chief Operating Officer ask.com ... team, where he led implementations of operations in Oklahoma, Kansas, Ohio, and Idaho. He also served as the client delivery executive for APS Healthcare, simultaneously leading operations for the Oklahoma EQRO, managing a behavioral health utilization management program for the Oklahoma Medicaid agency, and implementing a utilization management program for the Oklahoma State Educators and Employees Group Insurance Board.His provider operations experience includes the start-up and management of ...
10/30/2020 Magellan Rx Achieves URAC Reaccreditation BioSpace Magellan Rx Achieves URAC ReaccreditationPublished: Oct 30, 2020 Oct. 30, 2020 10:30 UTC Magellan Rx Management LLC, Earns Full Accreditation in Health Utilization Management (HUM) Magellan Rx Pharmacy LLC, Earns Full Specialty Pharmacy Distribution (SPD) AccreditationPHOENIX--( BUSINESS WIRE )-- Magellan Health, Inc . (NASDAQ: MGLN) today announced that Magellan Rx , the pharmacy benefits management division of the company, has earned two re-accreditations from URAC demonstrating the highest level of ...
10/30/2020 Magellan Rx Achieves URAC Reaccreditation gurufocus.com ... pharmacy benefits management division of the company, has earned two re-accreditations from URAC demonstrating the highest level of commitment to quality healthcare.“These accreditations underscore Magellan Rx’s commitment to excellence in administering health utilization management and specialty pharmacy benefits for our customers, in accordance with industry best practices and standards, and with a focus on the members we support,” said Mostafa Kamal, chief executive officer of Magellan ...
8/20/2020 (USA-NY-Melville) Utilization Management Nurse Consultant RN nyworks.jobs CVS Health Utilization Management Nurse Consultant RN Job Description Utilizes clinical skills to coordinate, document, and communicate all aspects of the utilization/benefit management program. Requires an RN with unrestricted active license. Fundamental Components Utilizes clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor and evaluate options to facilitate appropriate healthcare services/benefits for members. Gathers clinical information and applies the appropriate clinical criteria/guideline ...
8/2/2020 VP Clinical Performance & Transformation - Telecommute - UnitedHealth Group - Cypress, CA insurancejobs.com Apply Now Description Enterprise Clinical Services is an interconnected set of clinical capabilities supporting medical and behavioral health utilization management , disease management and care services for UnitedHealth Group. The teams support members and providers along the care continuum to deliver on the Quadruple Aim; better care, lower per capita costs and improved clinical outcomes. ECS will transform health care, through modernized solutions to support high performing systems of care while ...
11/26/2019 (USA-UT-Murray) Utilization Management Coordinator- Pended Claims ihs.jobs ... referral?iniframe=1&hashed=-435801949" class="iCIMSAnchor iCIMSActionButton iCIMS_SecondaryButton" title="Refer this job to a friend" Refer this job to a friend /a I Job Information University of Utah Health Utilization Management Coordinator- Pended Claims in Murray , Utah Overview As a patient-focused organization, University of Utah Health exists to enhance the health and well-being of people through patient care, research and education. Success ...
11/15/2019 (USA-SD-Sioux Falls) Utilization Management Coordinator ihs.jobs Sanford Health Utilization Management Coordinator in Sioux Falls , South Dakota Job Title: Utilization Management Coordinator City: Sioux Falls Department : Utilization Management - Sioux Falls Job Schedule: Full Time Hours Per Shift: 8 hr JOB SUMMARY Monitors the utilization of resources, risk management and quality of care for patients in accordance to established guidelines and criteria for designated setting and status. Collection of clinical information necessary to initiate commercial payor authorization. Obtain ...
11/4/2019 (USA-UT-Murray) Utilization Management Coordinator ihs.jobs ... a I btarget-jssdk')); a class="iCIMSFaqLink" title="Application FAQs (Opens new window)" href="http://icims.help" target="blank" Application FAQs /a p class="iCIMSLogo_Text" br Job Information University of Utah Health Utilization Management Coordinator in Murray , Utah Overview As a patient-focused organization, University of Utah Health exists to enhance the health and well-being of people through patient care, research and education. Success in this ...
10/31/2019 (USA-CA-Anaheim) Utilization Management Assistant ihs.jobs Job Information St. Joseph Health / Covenant Health Utilization Management Assistant in Anaheim , California Job Summary: Under the direction of the Utilization Supervisor/ Manager, this position is responsible for the distribution, review, accurate and timely processing of SJHH patient referrals requested from providers. Essential Functions: Responsible for verification of member’s eligibility (reporting to enrollment if not in IDX) and checks benefits of members for services requested per evidence of coverage guidelines ...
10/31/2019 (USA-CA-Anaheim) Utilization Management Assistant ihs.jobs Job Information St. Joseph Health / Covenant Health Utilization Management Assistant in Anaheim , California Job Summary: Under the direction of the Utilization Supervisor/ Manager, this position is responsible for the distribution, review, accurate and timely processing of SJHH patient referrals (DME referrals) requested from providers. Essential Functions: Responsible for verification of member’s eligibility (reporting to enrollment if not in IDX) and checks benefits of members for services requested per evidence of ...
10/22/2019 Case Manager - Roseburg, OR, , USA #jobs #Roseburg pls RT climber.com ... to create a Person-Centered Service Plan, provide information about eligibility and referrals, resources, services and supports covered under the 1915i State Plan Home and Community Bases Services benefit. Additionally, there will be Behavioral Health Utilization Management done by reviewing necessary clinical information, conducting the Level of Care Utilization System (LOCUS) and the Level of Service Inventory (LSI) as well as conducting eligibility redeterminations at least every 12 months. The ...
10/22/2019 Case Manager - Medford, OR, , USA #jobs #Medford pls RT climber.com ... to create a Person-Centered Service Plan, provide information about eligibility and referrals, resources, services and supports covered under the 1915i State Plan Home and Community Bases Services benefit. Additionally, there will be Behavioral Health Utilization Management done by reviewing necessary clinical information, conducting the Level of Care Utilization System (LOCUS) and the Level of Service Inventory (LSI) as well as conducting eligibility redeterminations at least every 12 months. The ...
10/9/2019 (USA-LA-Baton Rouge) Behavioral Health Utilization Management Review ihs.jobs AmeriHealth Caritas Behavioral Health Utilization Management Review in Baton Rouge , Louisiana Behavioral Health Utilization Management Review Location: Baton Rouge, LA ID : 18034 Your career starts now. We’re looking for the next generation of health care leaders. At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact ...
9/13/2019 (USA-ND-Fargo) Utilization Management Specialist RN - Patient Access ihs.jobs Sanford Health Utilization Management Specialist RN - Patient Access in Fargo , North Dakota Job Title: Utilization Management Specialist RN Patient Access Multi-City City: Fargo State: ND Department : Patient Access Specialist - Sioux Falls or Fargo Job Schedule: Full Time, 40 hours a week, Monday-Friday weekday hours. Position can sit in either Sioux Falls or Fargo market. Shift: Days Hours Per Shift: 8 hr JOB SUMMARY Conduct level of care medical ...
9/9/2019 Behavioral Health Utilization Management Care Advocate - Atlanta, GA - UnitedHealth Group - Atlanta, GA insurancejobs.com Share Description You're looking for something bigger for your career. How about inventing the future of health care? UnitedHealthcare is offering an innovative new standard for care management. We're going beyond counseling services and verified referrals to behavioral health programs integrated across the entire continuum of care. Our growth is fueling the need for highly qualified professionals to join our elite team. Bring your skills and talents to a role ...