…efficient manner to ensure timely and compliant care coordination, discharge planning, utilization review and social work interventions resulting in quality

…executes on all aspects of the health plan's medical policy, clinical utilization management programs and clinical benefit determinations. This role works closely

…Summary** Molina's Behavioral Health function provides leadership and guidance for utilization management and case management programs for mental health and chemical

…with guidelines and are released in compliance with documented standards. + Review new requests to determine impact on standard workflows, Decision Trees, online

…team, assesses patients for risk of adverse health outcomes, inappropriate utilization , and monitors the impact of care management interventions. Essential

…role: + Oversee the instrument and equipment set-up for your OR, including utilization of preference cards and ability to anticipate your surgeons needs + Coordinate

…planning while supporting a balance of optimal care and appropriate resource utilization . The Care Transitions Navigator will identify potential barriers to patient

…of specialty practice. 5. Participates in APRN interviewing, credentialing, and peer review process as requested. 6. Participates in a minimum of one professional

…development of standards of care and protocols, which may include literature review , development of standards of care/protocols, chart reviews, data analysis, and

…medication provided throughout the hospital. This individual ensures the utilization ofmedication safety principles to assure positive therapeutic outcomes.