Top 26 Utilization management Jobs in Lavale Md

Discharge Planner
PVH Potomac Valley Hospital —Keyser, WV
- Weekends as needed
- Nursing
- Hospital
- Inpatient
Case Manager- IDD Services
Linx Community Services —Fort Ashby, WV
- $19 an hour
- Full-time
- Experience working with individuals with developmental disabilities
- Experience working with individuals with disabilities
- HIPAA
- Health insurance
- Dental insurance
Quick Apply
Paramedic Field Supervisor
Valley Health —Keyser, WV
- $29.40 - $44.10 an hour
- Full-time
- PALS Certification
- Inventory management
- Customer service
- Wellness program
- Health savings account
Alcohol and Drug Trainee (ADT)
Potomac Community Services —Cumberland, MD
- $41,600 - $47,840 a year
- Spanish
- Microsoft Outlook
- Word processing
Quick Apply
Manager Ambulatory Services
PVH Potomac Valley Hospital —Keyser, WV
- Full-time
- OSHA
- Hospital
- Mid-level
Certified Supervised Counselor – Alcohol and Drug (CSC-AD)
Potomac Community Services —Cumberland, MD
- $43,680 - $49,920 a year
- Spanish
- Microsoft Outlook
- Word processing
Quick Apply
Unit Director, Inpatient Behavioral Health
UPMC —Cumberland, MD
- $51.08 - $71.49 an hour
- Full-time
- Acute care
- Nursing
- RN License
Unit Director, OR
UPMC —Cumberland, MD
- $51.08 - $71.49 an hour
- Full-time
- Nursing
- RN License
- Bachelor of Science
4d
Patient Access Specialist Per Diem
Ensemble RCM LLC —Romney, WV
- $17.00 - $18.15 an hour
- Full-time
- Acute care
- Hospital
- Customer service
- Tuition reimbursement
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
Appeal Analyst RN | Remote | Contract
Walker Healthforce, LLC —United States
- Contract
- Remote
- Nursing
- Microsoft Outlook
- RN License
- Health insurance
- Dental insurance
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

Discover related jobs

Based on your search for utilization management jobs.

Case Manager- IDD Services
Linx Community Services —Fort Ashby, WV
Develop and implement personalized care plans that incorporate medical, behavioral, social, and community resources tailored to each client’s unique…
$19 an hour
Quick Apply
Discharge Planner
PVH Potomac Valley Hospital —Keyser, WV
Bachelor’s degree in Social Work, Psychology, Sociology, Nursing, or related field. Assists patients and families in achieving a satisfying and productive…

Show more related jobs

Explore jobs in cities nearby

Check out jobs in cities near your current location, Columbus

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…
$65,000 - $88,600 a year
3d
Utilization Management Specialist
ST VINCENT FAMILY SERVICES —Columbus, OH
Associate's Degree required; Bachelor's Degree preferred in Healthcare Administration, Business Administration, Social Work, Public Health, or related field.
Quick Apply
1d

Show more jobs in cities nearby

I want to receive the latest job alert for utilization management in lavale md

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Explore jobs in more locations

utilization management jobs near lavale md

Discharge Planner

PVH Potomac Valley Hospital -
Keyser, WV

Apply Now

Job Details

Full-time

Qualifications

Bachelor's degree

Full Job Description

Welcome! We’re excited you’re considering an opportunity with us! To apply to this position and be considered, click the Apply button located above this message and complete the application in full. Below, you’ll find other important information about this position.

Functions as a member of the interdisciplinary treatment team with primary responsibility for initial assessments, discharge planning and other case management responsibilities. Will perform case management tasks with minimal supervision consistent with the developmental age of the patients served.

MINIMUM QUALIFICATIONS:

EDUCATION, CERTIFICATION, AND/OR LICENSURE:

1. Bachelor’s degree in Social Work, Psychology, Sociology, Nursing, or related field.

2. State criminal background check and Federal (if applicable), as required for regulated areas.

PREFERRED QUALIFICATIONS:

EXPERIENCE:

1. One (1) year experience in a healthcare setting.

CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned.

1. Participates as an integral professional member of an interdisciplinary team.

2. Collects and records data that is comprehensive, accurate, and systematic in the assessment form and in progress notes.

3. Assesses and documents in the medical record the discharge planning needs of the patient.

4. Contacts the referral source(s) and appropriate health professionals involved in the patient’s discharge status and to obtain any additional information that might facilitate the treatment process.

5. Advocates on behalf of the patient to maximize available services.

6. Assists treatment team by coordinating planning effort. Assists in determining appropriateness of admissions and receives referrals for discharge planning intervention.

7. Establishes and maintains a collaborative environment in coordination with the patient and other healthcare providers.

8. Assists patients and families in achieving a satisfying and productive discharge plan through health teaching and documents teaching according to hospital policy.

9. Performs discharge planning as developed with the treatment team from day of admission. Acts as liaison for patients and their families to various community agencies, hospital consultants and services.

10. Participates in improving organizational performance and other means of evaluation to assure quality of nursing and discharge planning services provided for patients.

11. Attends continuing education seminars and in-services as necessary to maintain professional licensure, competency, and to satisfy hospital-required educational standards.

12. Coordinates post-acute care planning including referrals to skilled nursing, rehabilitation, home health, or durable medical equipment providers.

13. Provides education to patients and families to support discharge readiness and ensure understanding of post-discharge instructions and available services.

14. Demonstrates working knowledge of Medicare, Medicaid, and private insurance guidelines relevant to post-acute services and transitions of care.

15. Provides timely documentation of discharge planning activities, patient/family communications, and care coordination in accordance with hospital policy and regulatory standards.

16. Collaborates with case managers, utilization review, and third-party payors to support timely transitions and resolve coverage or authorization issues.

17. Assists patients and families in navigating community-based resources, including transportation, housing, or medical support programs.

18. Participates in weekend or holiday rotations as needed to ensure continuity of discharge planning services if applicable for your assigned unit.

PHYSICAL REQUIREMENTS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. Frequent walking, standing, stooping, kneeling, reaching, pushing, pulling, lifting, grasping are necessary body movements utilized in performing duties through the work shift.

2. When working on inpatient units must be able and willing to participate in physical restraint of patient if needed.

WORKING ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. Healthcare setting.

SKILLS & ABILITIES:

1. Must have independent decision-making ability.

2. Ability to work with multi-disciplinary groups and facilitate meetings.

3. Ability to work independently or cooperatively as a team member.

Additional Job Description:

Scheduled Weekly Hours:

Shift:

Exempt/Non-Exempt:

United States of America (Non-Exempt)

Company:

PVH Potomac Valley Hospital

Cost Center:

403 PVH Care Management

Address:

100 Pin Oak Lane

Keyser

West Virginia

Equal Opportunity Employer

West Virginia University Health System and its subsidiaries (collectively "WVUHS") is an equal opportunity employer and complies with all applicable federal, state, and local fair employment practices laws. WVUHS strictly prohibits and does not tolerate discrimination against employees, applicants, or any other covered persons because of race, color, religion, creed, national origin or ancestry, ethnicity, sex (including gender, pregnancy, sexual orientation, and gender identity), age, physical or mental disability, citizenship, past, current, or prospective service in the uniformed services, genetic information, or any other characteristic protected under applicable federal, state, or local law. All WVUHS employees, other workers, and representatives are prohibited from engaging in unlawful discrimination. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, training, promotion, discipline, compensation, benefits, and termination of employment.

Apply Now

Refine Your Search

utilization management jobs in lavale md

Discharge Planner

Case Manager- IDD Services

Paramedic Field Supervisor

Alcohol and Drug Trainee (ADT)

Manager Ambulatory Services

Certified Supervised Counselor – Alcohol and Drug (CSC-AD)

Unit Director, Inpatient Behavioral Health

Unit Director, OR

Patient Access Specialist Per Diem

Hospital - Clinical Pharmacist Specialist (Bone Marrow Transplant)

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

Appeal Analyst RN | Remote | Contract

Family Medicine Medical Director Utilization Management

Discover related jobs

Explore jobs in cities nearby

I want to receive the latest job alert for utilization management in lavale md

Explore jobs in more locations

Welcome! We’re excited you’re considering an opportunity with us! To apply to this position and be considered, click the Apply button located above this message and complete the application in full. Below, you’ll find other important information about this position.

Job Seeker Tools

Employer Tools

Browse

Stay Connected