Utilization Management

Selected news for the healthcare topic - Utilization Management, collected since 10/2017. Recent stories appear in medacura.com and Yahoo News. This healthcare topic shares news with Prior Authorization, UnitedHealth Group, UnitedHealth, Case Management, Behavioral Health and over a hundred others.

Please provide a valid email address.

Selected Headlines

Date Headline (link) Source Relevant Snippet
5/8/2021 Utilization Management Care Manager – Riverside Health System – Hampton, VA medacura.com Utilization Management Care Manager – Riverside Health System – Hampton, VA Overview:Riverside Behavioral Health Center in Hampton, Virginia is currently seeking a labor pool (as needed) Utilization Management Care Manager. Job Summary: This position must demonstrate by education and/or training a background in the assessment and treatment of adolescents and adults seeking psychiatric and/or chemical dependency treatment. The position performs Utilization Review activities to include pre-authorizations ...
5/4/2021 AllMed Announces Kathryn Kolonic as Medical Director Yahoo News Bolstering the company's commitment to its industry leading clinical peer panelsPORTLAND, Ore. , May 4, 2021 /PRNewswire/ -- AllMed Healthcare Management, Inc., a leading provider of utilization management (UM) and independent review (IRO) services, today announced that Dr. Kathryn Kolonic , DO, MPH, CPHQ, has joined its executive leadership team as Medical Director and Vice President.We make decisions like lives depend on them (PRNewsfoto/AllMed Healthcare Management, Inc.) "At AllMed, we ...
4/21/2021 Care Management Solutions Market worth $19.28 Billion by 2023 express-press-release.net ... disease management solutions are expected to account for the largest share of the market in 2018 On the basis of applications, the care management solutions market is broadly segmented into disease management, case management, utilization management , other applications. In 2018, the disease management segment is expected to account for the largest share of this market. The high growth in this segment can be attributed to the ability of these solutions ...
4/19/2021 Cigna's Evernorth completes purchase of MDLive Becker's Hospital Review ... with a focus on connecting the patient care experience for health plans, employers and government organizations.3. MDLive will operate within Evernorth, which also runs pharmacy benefits manager Express Scripts, specialty pharmacy Accredo and utilization management company eviCore.4. Financial details for the transaction weren't disclosed.5. The deal was announced Feb. 26.Click here to read about what Evernorth's President and COO Eric Palmer envisions for the deal.More ...
4/17/2021 Registered Nurse needed PRN hours at Northern Regional Jail & Correctional Center! – Wexford Health Sources, Inc. – Moundsville, WV medacura.com ... and technologically advanced services, combined with programs that control costs while ensuring quality. For nearly two decades, Wexford Health has consistently delivered proven staffing expertise and a full range of medical, behavioral health, pharmacy, utilization management , provider contracting, claims processing, and quality management services.At Wexford Health our philosophy is that health care should not be considered a luxury for anyone. We simply care for those in need and the ...
4/17/2021 Study: Step Therapy Contributes to Biosimilar Utilization centerforbiosimilars.com ... April 17, 2021 conference AMCP: Academy of Managed Care PharmacyStudy authors measured savings, conversions to biosimilars, and payer policies for 3 originator brandsUsing commercial and public payer data, investigators observed that payer utilization management policies such as step therapy contributed to a sizeable movement toward biosimilar use, according to a poster presentation at AMCP 2021.“Payers equipped with proactive utilization management strategies for oncology biosimilars were able to ...
4/17/2021 Essential Work: Keeping Families Safe westorlandonews.com Essential Work: Keeping Families Safe By - April 17, 2021 Amy Moncion is a Licensed Clinical Social Worker (LCSW) and Clinical Utilization Management Manager with Embrace Families. She has worked with youth in and out of foster care for 15 years.I’ll be honest: It’s been a long year for social workers.As advocates for child welfare, we know how to handle a full plate. In a good year ...
4/13/2021 How employers are rethinking the pharmacy benefit to address specialty drugs FierceHealthcare ... rising premiums. This report from California shows whyThe WTW analysis groups potential solutions in financial and clinical responses, with financial options focusing on costs directly and clinical solutions focusing on utilization. For instance, utilization management tools like prior authorization can ensure patients are taking drugs appropriately, while copay assistance programs can manage individual costs.In addition, according to the report, employers are finding ways to deploy multiple solutions in ...
4/13/2021 Cohere Health Raises $36M to Automate Prior Authorization Between Payers & Providers HIT Consultant ... goal of driving care journeys with greater collaboration between payers and providers.– Cohere then uses authorization as a trigger to engage plans, providers, and patients in episode-based care paths that merge traditional utilization management , care management, and patient engagement functions ...
4/13/2021 Less Than a Year After Official Company Launch, Cohere Health Lands Additional $36 Million in Series B Funding healthcareittoday.com ... guidance that drives better care decisions without having to delay or deny care. Cohere then uses authorization as a trigger to engage plans, providers and patients in episode-based care paths that merge traditional utilization management , care management and patient engagement functions.“Our clients have recognized an immediate time to value from our digital solutions, compared to processes based on outdated technology that previously took much longer and caused aggravation ...
4/13/2021 Cohere Health Pulls In $36M Series B Round vcnewsdaily.com ... investors Flare Capital Partners and Define Ventures. The round comes less than a year after the company's launch and only three months since Cohere Health's Series A extension.Cohere's digital health plan solutions fundamentally transform utilization management in order to drive truly collaborative care journeys. Our solutions not only automate provider and payer preauthorization functions, but also generate clinical policy guidance that drives better care decisions without having to delay or ...
4/13/2021 WellSky® Introduces Advanced Home Health Visit Management Solution, Enabling Patient-Centered Care Planning at Scale wellsky.com ... Introduces Advanced Home Health Visit Management Solution, Enabling Patient-Centered Care Planning at Scale Home Health , News Leading home healthcare provider Intrepid USA leverages WellSky’s new predictive data analytics capabilities for enhanced visit utilization management OVERLAND PARK, Kan. — April 13, 2021 — WellSky , a leading health and community care technology company, today announced new enhancements to its data analytics solution for home health. The new addition to the ...
4/11/2021 Tri-state people in business: New hires, promotions, achievements telegraphherald.com ... a client service representative.Michael Garside as a service representative.Randy Timmerman as an IT operations analyst I.Jessica Hames as a service representative.Jaymis Hoffmann as a mail center associate.Cynthia Sherwood as utilization management nurse.Elly Whiteman as a service representative.Tori Maiers as a client service representative.•Diamond Jo Casino announced the promotion of Louis Cram to executive sous chef and Quentin Milroy to line cook ...
4/10/2021 Colwell, Ann Florence legacy.com ... graduate of Susquehanna Community School District and then graduated from Marywood University in 1996 with a Bachelor of Arts in English. She had intention to teach elementary school, but instead used her skills in utilization management for Cognizant. She enjoyed reading, painting, her dogs and cats, and gardening. Her greatest joy was raising her children and seeing the adults they became.There will be an outdoor memorial at a later ...
4/8/2021 Nurse sues Highmark, accuses insurer of failing to pay OT Becker's Hospital Review ... salaried employee, accuses the company of violating the Fair Labor Standards Act by not adequately paying nurses for time spent reviewing health insurance authorization requests beyond 40 hours per week.The class-action includes utilization management nurses, utilization review nurses, medical management nurses, nurse reviewers or care management nurses who worked at Highmark in the last three years, according to the lawsuit.In an emailed statement to Becker's , a Highmark spokesperson ...
4/7/2021 Care Management Solutions Market worth $19.28 Billion by 2023 express-press-release.net ... disease management solutions are expected to account for the largest share of the market in 2018 On the basis of applications, the care management solutions market is broadly segmented into disease management, case management, utilization management , other applications. In 2018, the disease management segment is expected to account for the largest share of this market. The high growth in this segment can be attributed to the ability of these solutions ...
4/5/2021 Nominations Open for 2021 Fleet Manager of the Year government-fleet.com ... questionnaire for judges, and a group of public sector fleet managers from around the country judges the award.Candidates are judged on the following criteria: business plan, technology implementation, productivity, policies, preventive maintenance program, utilization management , replacement program, customer service, fuel management, and recent accomplishments.The recipients of these awards will be recognized at The Honors Celebration during the Government Fleet Expo & Conference (GFX) . The winner and finalists will be ...
4/2/2021 Relief Utilization Manager – Integral Care – Austin, TX medacura.com ... you. Join us and together we can help improve the quality of life for the people we serve. Imagine your career at Integral Care!Job Summary: The primary functions of this relief position are utilization management , conducting utilization reviews, granting authorizations, and monitoring compliance with and for various contracts entered into by Integral Care and Tejas Behavioral Health. Contracts include, but are not limited to, those with departments of the ...
4/2/2021 363811 Primary Therapist - North Brunswick, NJ hound.com ... considered for either of these roles. • To provide high quality comprehensive clinical services that include: clinical triage, psychosocial evaluations, individual group and family treatment, treatment plan development and coordination, referent relations, discharge planning, utilization management with insurance companies, and case management with social service support systems, schools and other relevant external entities. The above services shall be provided under supervision of the appropriate clinical discipline.ESSENTIAL JOB DUTIES AND RESPONSIBILITIES1 ...
3/31/2021 3 Great Strategies From The Revenue Cycle Ideas Exchange allzonems.com ... Here’s what they had to say.Although root cause data showed that 47% of its hospital billing denials were related to some case management opportunity, the staff that was tasked with working on utilization management (UM) denials didn’t have much background in case management.“It wasn’t their expertise, so we were not being effective in appealing these denials,” says Abongwa.That’s why in 2019, they ...