Manager Utilization Management Jobs in Kentucky (NOW HIRING)

The role. The Director of Case Management is responsible for overseeing and directing the hospital's case management department, ensuring effective coordination of patient care, utilization ...

This position supports the physician, patient/family, and interdisciplinary care team by coordinating discharge planning, utilization management, resource coordination, and patient advocacy ...

This position supports the physician, patient/family, and interdisciplinary care team by coordinating discharge planning, utilization management, resource coordination, and patient advocacy ...

This position supports the physician, patient/family, and interdisciplinary care team by coordinating discharge planning, utilization management, resource coordination, and patient advocacy ...

Utilization Management Conducts medical necessity review for appropriate utilization of services from admission through discharge. * Promotes effective and efficient utilization of clinical resources.

Utilizes clinical criteria, case management tools, and documentation systems to support utilization management, regulatory compliance, and quality initiatives. * Advocates for patients while ...

Accredited Case Manager (ACM) certification through ACMA, or ability to obtain the required certification within two (2) years of hire. * Strong understanding of care coordination, utilization ...

Collaborate with Care Management and HIM Coding managers on feedback for denials related to utilization management/coding as appropriate with escalation as needed. Ensure Audit Recovery claims from ...

Collaborate with Care Management and HIM Coding managers on feedback for denials related to utilization management/coding as appropriate with escalation as needed. Ensure Audit Recovery claims from ...

Serves as a resource to Utilization Management by initiating the patient intake, insurance verification and authorization processes to ensure that care is provided in the correct setting with proper ...

Oversee daily case management operations, driving clinical care coordination, utilization review, and discharge planning. * Strategic Planning: Develop and implement departmental goals, policies, and ...

Job Title Serves as a resource to Utilization Management by initiating the patient intake, insurance verification and authorization processes to ensure that care is provided in the correct setting ...

Serves as a resource to Utilization Management by initiating the patient intake, insurance verification and authorization processes to ensure that care is provided in the correct setting with proper ...

Oversee utilization management, including prior authorization criteria, medical necessity determinations, concurrent review, and appeals, ensuring evidence based and compliant decision making. * Lead ...

Oversee utilization management, including prior authorization criteria, medical necessity determinations, concurrent review, and appeals, ensuring evidence based and compliant decision making. * Lead ...

Oversee utilization management, including prior authorization criteria, medical necessity determinations, concurrent review, and appeals, ensuring evidence based and compliant decision making. * Lead ...

Oversee utilization management, including prior authorization criteria, medical necessity determinations, concurrent review, and appeals, ensuring evidence based and compliant decision making. * Lead ...

Oversee utilization management, including prior authorization criteria, medical necessity determinations, concurrent review, and appeals, ensuring evidence based and compliant decision making. * Lead ...

Collaborate with physicians, nurses, and utilization-management teams on complex cases. * Document recommendations and decisions according to health-plan and regulatory requirements. * Participate in ...

Oversee utilization management, including prior authorization criteria, medical necessity determinations, concurrent review, and appeals, ensuring evidence based and compliant decision making. * Lead ...