2 risk manager jobs found

About this Job: General Summary of Position The RN Utilization Manager will have 1-2 years of Utilization review- responsible for evaluating the necessity, appropriateness and efficiency of the use of medical services procedures and facilities. Responsible for clinical review of acute care services based on Medically Necessity criteria the management of quality health care resources for achievement of desired outcomes and coordination of alternative levels of care in a timely and in the most cost-effective manner.We recruit retain and advance associates with diverse backgrounds skills and talents equitably at all levels. Primary Duties and Responsibilities   Contributes to the achievement of established department goals and objectives and adheres to department policies procedures quality standards and safety standards. Complies with governmental and accreditation regulations. Acts as a liaison to MedStar Family Choice (MFC) contracted vendors to facilitate care....

About this Job: General Summary of Position Serves as a member of the interdisciplinary care management team capable of furnishing an array of care coordination services to Medicare FFS beneficiaries attributed to practices that the Care Transformation Organization (CTO) supports. Responsible for the care management and care coordination of Medicare beneficiaries attributed to a medical practice(s); Serves as the liaison between the medical practice and the CTO's interdisciplinary care team. Primary Duties and Responsibilities Contributes to the achievement of established department goals and objectives and adheres to department policies procedures quality standards and safety standards. Complies with governmental and accreditation regulations.In collaboration with the interdisciplinary care team acts as primary care team agent for the coordination of care for a panel of attributed Medicare beneficiaries by ensuring the following: Ensures attributed beneficiaries have timely...