Top 5135 Ocean project management Jobs

Director of Utilization Management
OCEANS HEALTHCARE —Shreveport, LA
- Full-time
- CPR Certification
- Nursing
- Microsoft Outlook
- Health insurance
- Dental insurance
Quick Apply
5d
Preschool Lead Teacher
Ocean Breeze School —Marblehead, MA
- $23,000 - $25,000 a year
- Part-time
- Background check
- Classroom
- CPR Certification
- 401(k)
- Paid time off
Quick Apply
System Administrator
Ocean State Credit Union —Coventry, RI
- Weekends as needed
- Background check
- Software troubleshooting
- Research
- Health insurance
- Dental insurance
Quick Apply
Fleet Mechanic I or II
Big Creek Lumber Company —Davenport, CA
- $23.25 - $35.75 an hour
- Overtime
- Clean driving record
- Mechanic experience
- CDL A
- Profit sharing
- Paid holidays
Quick Apply
10d
Outpatient Mental Health Therapist
Oceans Healthcare —DeRidder, LA
- Part-time
- LMFT
- Psychiatry
- Working with individuals with disabilities
Quick Apply
Police Captain
City of Coronado, California —Coronado, CA
- $81.45 - $109.15 an hour
- Full-time
- Clean driving record
- Bachelor of Science
- Writing skills
- AD&D insurance
- Loan repayment program
Senior Manager, Finance (Cost Accounting)
ATI —Monroe, NC
- Oracle
- CPA
- 5 years
Quick Apply
Registered Nurse RN Full Time Days
Haven Behavioral Health —Meridian, ID
- Full-time
- Nursing
- RN License
- Writing skills
- Disability insurance
- Health insurance
Quick Apply
11d
Talent Staffing Coordinator Stores-Temporary Position (On-Site)
Ocean State Job Lot —North Kingstown, RI
- $21 - $23 an hour
- Temporary
- Sales
- Customer service
- Mid-level
Real Estate Development Manager
New Empire Corp —Brooklyn, NY
- $150,000 - $200,000 a year
- Full-time
- Mid-level
- Residential
- 3 years
Quick Apply
Behavioral Therapist
Oceans Healthcare —Tupelo, MS
- Full-time
- LMFT
- CPR Certification
- Psychiatry
- Health savings account
- Disability insurance
Quick Apply
4d
Maintenance Manager- BC
Lemonjuice Solutions —Ocean City, MD
- From $70,000 a year
- 8 hour shift
- Background check
- Mid-level
- High school diploma or GED
- Health savings account
- Disability insurance
Quick Apply
6d
Server
Ocean House Management —Westerly, RI
- $16 - $25 an hour
- Part-time
- Writing skills
- English
- Computer skills
- Health insurance
- Dental insurance
Quick Apply
14h
Supervisor, Security (Sabine Pass)
Cheniere Energy, Inc. —Cameron, LA
- Weekends as needed
- Microsoft Excel
- Construction site
- Military
FPGA Design Manager / Section Lead
BAE Systems Inc. —Totowa, NJ
- $153,377 - $260,743 a year
- Full-time
- Hybrid work
- Microsoft Word
- Computer Science
- Master's degree
- Health savings account
- Paid holidays
3PW and Ocean Manager
ND Paper —Wisconsin Rapids, WI
- Full-time
- Inventory control
- Project management
- Bachelor's degree
- Paid holidays
- Disability insurance
Quick Apply
Director of Facilities Management
OCEANS HEALTHCARE —Shreveport, LA
- Full-time
- CPR Certification
- Hospital
- Engineering
- Disability insurance
- Health insurance
Quick Apply
5d
Manufacturing Engineer (Required 3 YR experience minimum)
METALEX MANUFACTURING INC —Cincinnati, OH
- Full-time
- Microsoft Excel
- Engineering
- Mid-level
- Disability insurance
- Health insurance
Quick Apply
Nurse Supervisor Nights
Haven Behavioral Health —Dayton, OH
- On call
- Nursing
- RN License
- Hospital
- Disability insurance
- Dental insurance
Quick Apply
4d
Maritime Systems Engineer
Battelle —Columbus, OH
- Full-time
- Hybrid work
- 7 years
- Bachelor of Science
- Travel
- Wellness program
- Health insurance

I want to receive the latest job alert for ocean project management

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

ocean project management jobs near

Director of Utilization Management

OCEANS HEALTHCARE -
Shreveport, LA

Quick Apply

Job Details

Full-time
5 days ago

Benefits

Health insurance
Dental insurance
401(k)
Flexible spending account
Tuition reimbursement
Paid time off
Employee assistance program
Vision insurance
401(k) matching
Life insurance
Referral program

Qualifications

Appeals
CPR Certification
Microsoft Outlook
Overseeing health insurance pre-certification
Psychiatry
Managed care organization experience
Team leadership
Overseeing healthcare denial management
Writing skills
BLS Certification
Patient advocacy
De-escalation techniques
Supervising experience
Case appeal in utilization management
Cultural competency
Bachelor's degree
Utilization management
Substance abuse
Healthcare team management
Concurrent review in utilization management
Working with individuals from diverse cultural backgrounds
Patient interaction
Working with individuals with substance use disorders
Insurance claims appeal handling

Full Job Description

Director of Utilization Management
The Director Utilization Management is responsible for oversight and management of all utilization review/case management activities for the facility’s inpatient, partial hospitalization, and outpatient programs. This position oversees all aspects and daily processes of the Utilization Management department. Conducts audits of all medical records to ensure criteria for admission and continued stay are met and documented and ensures timely discharge planning. Coordinates information between third party payers and medical/clinical staff members. Interacts with members of the medical/clinical team to provide a flow of communication and a medical record which documents and supports level and intensity of service rendered. All duties to be done in accordance with Joint Commission, Federal and State regulations, Oceans' Mission, policies and procedures and Performance Improvement Standards.

Essential Functions:

Identifies and reports appropriate use, under-use, over-use and inefficient use of services and resources to ensure high quality patient care is provided in the least restrictive environment and in a cost-effective manner.
Oversight of daily reviews of all inpatient, partial hospitalization, and outpatient records as outlined in the Utilization Review/Case Management plan to (1) determine appropriateness and clinical necessity of admissions, continued stay, and or rehabilitation, and discharge; (2) determine timeliness of assessments and evaluations; i.e. H&Ps, psychiatric evaluation, CIA formulation, and discharge summaries; and (3) identify any under-, over-, and/or inefficient use of services or resources.
Reports findings to appropriate disciplines and/or committees; notifies appropriate staff members of any deficiencies noted so corrective actions can be taken in a timely manner; submits monthly report to PI Coordinator of findings and actions recommended to correct identified problems.
Coordinates flow of communication between physicians/staff and third-party payers concerning reimbursement requisites; oversight of daily concurrent reviews and the follow through with documentation requests from third party payers; maintains abstract with updates provided to third party payers.
Attends mini-treatment team and morning status meetings each weekday to obtain third-party payer pre-certification and ongoing certification requirements and to share with those attending any pertinent data from third-party payer contracts; also attends weekly treatment team meeting.
Oversight of the notification to physicians/staff/patients of reimbursement issues; initiates and completes appeals process for reimbursement denials; notifies inpatients of denials received; reports monthly all Hospital Issued Notices of Non-coverage (HINN letter) to QIO.
Upon notification by business office that potential exists to be included on a new managed care contract, makes contact with the managed care company and coordinates communications between Oceans Payer Engagement department, administration and the managed care company to obtain contractual arrangements. Maintains coordination of information requests from third party payers and Oceans Payer Engagement team for all annual renewal or update of existing contracts. Communicates to staff status of new/existing contracts.
Working knowledge of case management duties as required and coordinates flow of communication among staff involved in the patient's care; completes paperwork for judicial commitments and state bed packets.
Working knowledge of the referral process and necessary paperwork for all other levels of care and make follow-up appointments; including follow-up letters needed by the patient.
Working knowledge and experience to conduct special retrospective studies/audits when need is determined by M&PS and /or other committee structure.
Performs other duties and projects as assigned.

Requirements

Educational / Experience Requirements:

Bachelor's degree in social services or nursing field or equivalent work experience.
At least two years psychiatric/chemical dependency experience with good working psychiatric/medical knowledge.
At least two years of supervisory experience.

Qualifications / Skills:

Must have excellent assertive communication, management and leadership skills.
Must have working knowledge of Outlook, Excel, PowerPoint, and other Word programs.
Must have good writing and composition skills. Must be able to organize and prioritize high volume workload.
Must have strong working knowledge of UM processes to include pre-certification, concurrent review, appeals and denials, single case agreements, and payer processes.
Knowledge and in-depth understanding of CD/psych treatment and discharge planning process.
Must have good understanding of regulatory and fiscal reimbursement and utilization review as a primary component of patient care.
Must demonstrate strong patient advocacy skills.
Must be able to analyze and utilize data and systems to provide individualized quality treatment in a cost-effective manner.
Must have ability to maintain overall good work attitude and interact cooperatively and professionally with other staff members and third-party payers to achieve mutually beneficial outcome.
Must possess basic competency in age/disability/cultural diversity needs of patients served and ability to relate to patients in a manner sensitive to those needs.
Must successfully complete CPR certification and an Oceans approved behavioral health de-escalation program.

Work Environment:

Subject to many interruptions. Occasional pressure due to multiple calls and inquiries. This position can be high paced and stressful; must be able to cope mentally and physically to atmosphere. Work requires spending approximately 90% or more of the time inside a building that offers protection from weather conditions but not necessarily from temperature changes.

It is the policy of Oceans Healthcare to provide equal employment opportunity in employment to all associates and applicants for employment. No person is to be discriminated against in employment because of race, religion, color, sex, age, genetic information, national origin, pregnancy, disability, military status or any other classification protected by applicable local, state or federal law. This policy applies to all terms, conditions, and privileges of employment. Although the company does not discriminate on the basis of citizenship, it is required to comply with federal laws to ensure that its workforce is legally eligible to work in the United States.

Job Type: Full-time

Benefits:

401(k)
401(k) matching
Dental insurance
Employee assistance program
Flexible spending account
Health insurance
Life insurance
Paid time off
Referral program
Tuition reimbursement
Vision insurance

Education:

Bachelor's (Required)

Experience:

supervisory: 2 years (Required)
Psychiatric : 2 years (Required)

Work Location: In person

Quick Apply

Refine Your Search

ocean project management jobs

Director of Utilization Management

Preschool Lead Teacher

System Administrator

Fleet Mechanic I or II

Outpatient Mental Health Therapist

Police Captain

Senior Manager, Finance (Cost Accounting)

Registered Nurse RN Full Time Days

Talent Staffing Coordinator Stores-Temporary Position (On-Site)

Real Estate Development Manager

Behavioral Therapist

Maintenance Manager- BC

Server

Supervisor, Security (Sabine Pass)

FPGA Design Manager / Section Lead

3PW and Ocean Manager

Director of Facilities Management

Manufacturing Engineer (Required 3 YR experience minimum)

Nurse Supervisor Nights

Maritime Systems Engineer

I want to receive the latest job alert for ocean project management

Related Searches

Explore jobs in more locations

Job Seeker Tools

Employer Tools

Browse

Stay Connected