Top 25 Utilization management Jobs in Cullman Al

CASE MANAGER FT
CULLMAN REGIONAL —Cullman, AL
- Full-time
- Microsoft Word
- Nursing
- Microsoft Excel
Registered Nurse - Full Time
Hometown Medical Group —Cullman, AL
- From $30 an hour
- Full-time
- Vital signs
- Medication administration
- RN License
- AD&D insurance
- Paid holidays
Quick Apply
11d
Hospital - Clinical Pharmacist Specialist (Bone Marrow Transplant)
UT Health Science Center at San Antonio —United States
- Hospital
- Outpatient experience
- 3 years
Quick Apply
Remote Physician (MD/DO), PMR or Neurology, Outpatient Prior Authorizations (REMOTE/FT) (IC to FTE)
Virtix Health —United States
- $125 an hour
- 8 hour shift
- Remote
- Background check
- Medicine
- Doctoral degree
- Work from home
Quick Apply
Family Medicine Medical Director Utilization Management
Amerihealth Caritas —United States
- Weekends as needed
- Hybrid work
- Medicine
- Physical & Rehabilitation Medicine
- 3 years
- Paid holidays
- Health insurance

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Utilization Management Behavioral Health Professional
Humana —Ohio
Bachelor's degree in nursing OR a master's degree in a Human Services field with a professional individual or compact licensure in the state of Kentucky without…
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1d
Medical Office Administrator
OHG —Columbus, OH
Supervise front-office staff and clinical support personnel, providing leadership in office management, human resources functions, and staff training.
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utilization management jobs near cullman al

CASE MANAGER FT

CULLMAN REGIONAL -
Cullman, AL

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Job Details

Full-time

Qualifications

Microsoft Word
Customer communication
Microsoft Excel
Medicare
Word embeddings
Cerner
Acute care facility experience
InterQual
Utilization management
Resource utilization in healthcare

Full Job Description

Job Summary:

Coordinate with physicians, nurses, social workers and other health team members to expedite medically appropriate, cost-effective care.
Support physician provision of patient care with accountability for designated patient case load.
Facilitate precertification and payor authorization processes and facilitate collaborative management of patient care across the continuum, intervening as necessary.
Promote effective utilization and monitoring of healthcare resources and assumes a leadership role with the multidisciplinary team to achieve optimal clinical and resource outcomes.
Apply process improvement methodologies in evaluating outcomes of care.
Maintain and ensure adherence to clinical guidelines, tools and protocols based on evidence-based medicine related to quality measure indicators.
Assume leadership role in coordinating quality improvement activities related to quality measure initiatives.
Demonstrate and encourage team behavior and exceptional patient/guest experiences.
Uphold and promote patient safety and quality.

Education:
Associate's degree in nursing or higher degree is required. Currently licensed by the state of Alabama. BSN preferred.

Experience:
Five years' clinical experience in acute care setting i.e., medical surgery critical care, ER, OR required.

One year experience in Utilization Review with JIVA, Interqual, Cerner, Medicare, HMOs, and other payors.

Additional Skills/Abilities:
Skill and proficiency in applying highly technical principles, concepts and techniques that are central to case management. Advanced communication and interpersonal skills with all levels of internal and external customers. Must be proficient in Microsoft Word and Excel. Excellent organizational skills are required. Must be able to set priorities appropriately and handle multiple issues concurrently.

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utilization management jobs in cullman al

CASE MANAGER FT

Registered Nurse - Full Time

Hospital - Clinical Pharmacist Specialist (Bone Marrow Transplant)

Remote Physician (MD/DO), PMR or Neurology, Outpatient Prior Authorizations (REMOTE/FT) (IC to FTE)

Family Medicine Medical Director Utilization Management

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