- UNC Health Care (Smithfield, NC)
- …through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management staff to ... met and care delivery is coordinated across the continuum. The Utilization Manager completes admission, continued stay, and discharge reviews in accordance… more
- UNC Health Care (Hendersonville, NC)
- …daily with the Care Manager to manage level of care transitions & appropriate utilization of services. Coordinates with the appropriate staff/payers ... the health and well-being of the unique communities we serve. Summary: The Utilization Manager (UM) assesses new admissions, continued stay and discharge review… more
- Intermountain Health (Las Vegas, NV)
- …of staffing, escalations, barrier triage, and coordination with compliance and legal to support care delivery. The Manager Care Management I reports to the ... 5:30 pm Holiday and weekend coverage when needed. The Manager of Care Management I leads and... Care Management I leads and collaborates with care management operations across utilization review, acute… more
- Beth Israel Lahey Health (Plymouth, MA)
- …a job, you're making a difference in people's lives.** Full Time **Job Description:** ** Utilization Review & Denials management manager - Full Time** **Who We ... and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager , you...care determination and the appeal/denial process. + Oversees utilization review workflow processes to ensure timely response to… more
- Helio Health Inc. (Syracuse, NY)
- …to track, review, and analyze data relating to continuous quality improvement. The Utilization Case Manager will work on a Full-Timebasis supporting our ... Assist in developing and administering policies and procedures for utilization . + Negotiating access to care for...also take into account information provided by the hiring manager and program Job LocationsUS-NY-Syracuse Category Case/ Care … more
- Children's Mercy Kansas City (Kansas City, MO)
- …nursing + required within 4 years of hire + 1-2 years experience + Experience in Utilization Review + One of the following: Licensed RN - MO, Registered Nurse ... and training oversight of programs and services. Responsible for effective utilization review and proper resource management of patients, including patient statusing… more
- Magellan Health Services (Shreveport, LA)
- …implement solutions that directly influence quality of care . General Job Information Title Care Manager - Remote/ Licensed in Louisiana Grade 24 Work ... and substance abuse services provided in inpatient and/or outpatient care settings. Collects and analyzes utilization data....Maintains an active work load in accordance with National Care Manager performance standards. + Works with… more
- Prime Healthcare (Lynwood, CA)
- …Of Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred.3. Five years acute care nursing experience preferred. At least one ... Connect With Us! (https://careers-primehealthcare.icims.com/jobs/237903/rn-case- manager utilization… more
- Houston Methodist (Houston, TX)
- …Methodist, the Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse (RN) who comprehensively conducts point of entry and concurrent ... prompt notification of any denials to the appropriate case manager , denials, and pre-bill team members, as well as...hospital. Provides education to physicians, nurses, and other health care providers on utilization management topics. +… more
- Sharp HealthCare (San Diego, CA)
- … care , SNF, home health, or hospice settings. + Experience as a case manager or discharge planner interacting with managed care payers. + Experience with ... 1 **Shift Start Time** **Shift End Time** Other; California Licensed Vocational Nurse (LVN) - CA Board of Vocational...Will Do** To provide discharge planning and coordination of care for members hospitalized in the acute care… more
- Community Health Systems (Longview, TX)
- _Licensed Social Worker- Care Manager - PRN_ _Position Type: PRN Days_ _Benefits:_ + _401(k) with matching contribution_ **Job Summary** The Care Manager - ... LSW is responsible for coordinating and overseeing discharge planning, transitions of care , and case management activities to ensure optimal patient outcomes. This… more
- Veterans Affairs, Veterans Health Administration (Corpus Christi, TX)
- …for consideration is: 11/28/2025. The Mental Health Integrated Services (MHIS) Program Manager is directly responsible to the Associate Chief of Staff for Mental ... planning, establishing, and implementing policies and procedures for the Primary Care Mental Health Integration (PCMHI) Program, Health Behavior Coordination (HBC),… more
- Elevance Health (Asheville, NC)
- …be considered for employment, unless an accommodation is granted as required by law._ The Manager I Care Management ( Manager I GBD Special Programs) is ... include, but are not limited to: + Manages resource utilization to ensure appropriate delivery of care ...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- Select Medical (San Diego, CA)
- **Overview** **Select Specialty Hospital** **Critical Illness Recovery Hospital (LTACH)** **Case Manager (PRN)** Licensed Social Workers Only **Pay: $52/hr** ... doing well by doing what is right. The Case Manager is responsible for utilization reviews and...via focus on resource management within the plan of care . + Demonstrates compliance with facility-wide Utilization … more
- Pearle Vision (Columbus, OH)
- GENERAL FUNCTION: The major responsibility of the Store Manager is to drive profitable sales growth through the delivery of outstanding patient experience. Lead team ... in a positive and productive environment, modeling exemplary patient care . Develop and maintain outstanding associate and doctor satisfaction and retention. MAJOR… more
- WellSpan Health (Lebanon, PA)
- …of patient care between visits. + Assists in the management of patient utilization of health care system and provides patient education relative to health ... Required **Work Experience:** + 1-year Clinical nursing experience (Required) + Wound care experience (Preferred) **Licenses:** + Licensed Practical Nurse Upon… more
- St. Luke's University Health Network (Bethlehem, PA)
- … in the communities we serve, regardless of a patient's ability to pay for health care . The Outpatient Care Manager , Social Worker (OP CM SW) is responsible ... The OP CM SW also collaborates with the Outpatient Care Manager RN, Community Health Worker and...bio-psychosocial needs to ensure efficient and effective continuity of care , utilization of resources and to avoid… more
- WellSpan Health (Chambersburg, PA)
- …of patient care between visits. + Assists in the management of patient utilization of health care system and provides patient education relative to health ... **General Summary** Performs screening to determine appropriate avenue for care of patients. Functions as a member of the...HBO: Evaluates the patient outcome and meets with the manager and the hyperbaric physician to discuss patient treatment… more
- Geisinger (Danville, PA)
- …and Trauma Surgery. We have many resources on our unit including a pharmacist, care manager /social worker, and scheduler to support unit based needs. In ... Geisinger is proud to offer a full time Inpatient Licensed Practical Nurse (LPN) a $10,000 sign on bonus...of evidence based practice. + Provides input to the manager for performance appraisals of care delivery… more
- Geisinger (Wilkes-Barre, PA)
- …the utilization of evidence based practice. + Provides input to the manager for performance appraisals of care delivery team members. + Precepts and ... Job Summary Geisinger is proud to offer an Inpatient Licensed Practical Nurse (LPN) a $10,000 sign on bonus...dependents + Pre-tax savings plans with healthcare and dependent care flexible spending accounts (FSA) and a health savings… more