- Penn State Health (Hershey, PA)
- …PDF for more detailed steps for assistance._ **Union:** Non Bargained **Position** Manager Utilization Management - DAY SHIFT - Utilization ... **SUMMARY OF POSITION:** Position is responsible to thoroughly understand all Utilization Management regulatory requirements for both CMS and DOH,… more
- UNC Health Care (Raleigh, NC)
- …through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management staff to ... Utilization Management Plan. In addition, the Utilization Manager is responsible for revenue protection...and internal equity Work Assignment Type: Onsite Work Schedule: Day Job Location of Job: US:NC:Raleigh Exempt From Overtime:… more
- Sharp HealthCare (San Diego, CA)
- …competency and individual development planning process.Maintain current knowledge of case management , utilization management , and discharge planning, as ... as Allscripts.Identify opportunities for cost reduction and participate in appropriate utilization management venues.Escalate and refers cases for consultation… more
- VNS Health (Manhattan, NY)
- OverviewManages the utilization management team to ensure that standards for service delivery and team/staff performance levels are met or exceeded. This ... includes supporting the VNS Health Plans teams on a day - to- day basis for utilization ...or complaints, and/or approvals requiring next level authorization (eg, utilization management , high cost services, out of… more
- Trinity Health (Silver Spring, MD)
- …Type:** Full time **Shift:** **Description:** The Interim Manager of Care Management & Utilization Review, under the supervision and in collaboration with ... area. + Extensive knowledge of payer mechanisms and clinical utilization management is required. + Knowledge of...trusted provider of health services within our community. A Manager at Holy Cross Hospital is expected to demonstrate… more
- Providence (Mission Hills, CA)
- **Description** The Manager of Utilization Management provides a key role in leading, facilitating and managing the hospital utilization management ... Southern California Region. The Manager assists the Regional Director of Utilization Management , Appeals & Clinical Training through the provision of ongoing… more
- CVS Health (Springfield, IL)
- …**Position Summary:** The Associate Manager is responsible for oversight of Utilization Management /Case Management staff. This position is responsible ... Registered Nurse + 3+ years of Managed Care experience + 1+ years of Utilization Management experience + 1+ year Leadership experience (formal or informal roles)… more
- Sharp HealthCare (San Diego, CA)
- …System Integrated Care Management (ICM) team the Transfer and Admissions Utilization Manager (UM) partners with the Centralized Patient Placement Center ... Guidelines (MCG). + Experience and understanding of federal and state regulations governing utilization management . + Accredited Case Manager (ACM) -… more
- Amazon (Herndon, VA)
- …them to completion. We're seeking an experienced Technical Infrastructure Program Manager to oversee data center electrical infrastructure optimization projects. You ... will lead cross-functional and technical teams identify sub-optimal utilization , determine root causes, design solutions and drive project delivery. Along the way,… more
- Sharp HealthCare (San Diego, CA)
- …it related to the position.Bring to attention of the Supervisor, Utilization Management Care Coordinators, and UM Manager , areas of UM non-compliance and ... The UM Care Coordinator, under the direct supervision of the Supervisor, Utilization Management Care Coordinators, prepares referral requests for outpatient… more
- Sharp HealthCare (San Diego, CA)
- …Guidelines (MCG) + Experience and understanding of federal and state regulations governing utilization management + Accredited Case Manager (ACM) - American ... (RN) - CA Board of Registered Nursing; Accredited Case Manager (ACM) - American Case Management Association...in Healthcare or a related field + 3 Years Utilization Management or case management … more
- UNC Health Care (Hendersonville, NC)
- …the health and well-being of the unique communities we serve. Summary: The Utilization Manager (UM) assesses new admissions, continued stay and discharge review ... management referrals. Initiates appropriate social work referrals. * Performs utilization management assessments and interventions, using collaboration with… more
- LifePoint Health (Danville, VA)
- *Registered Nurse, RN - Utilization Review Case Manager * Job Type:Full Time|Days *$10,000 Sign-on Bonus Eligibility for Full-Time, Bedside RNs* ** Must have ... patient-care innovator. You will shape exceptional patient journeys every day and leverage your skills and our cutting-edge technology...offering safe discharge planning is the use of a Utilization RN and Case Manager RN, in… more
- Covenant Health (Nashua, NH)
- Summary Conducts medical necessity reviews in accordance with the Utilization Management (UM) plan for patients that are housed on a nursing unit, to include ... / services, inappropriate admissions, and unnecessary continued days by utilization of avoidable day tracking in the...of five years broad clinical experience preferred + Case management and/or Utilization Management experience… more
- Hartford HealthCare (Torrington, CT)
- …moment*. **Job:** **Professional Clinical* **Organization:** **Charlotte Hungerford Hospital* **Title:** * Utilization Review Social Work Care Manager (LCSW) - ... Work where *every moment* matters. Every day , over 30,000 Hartford HealthCare colleagues come to...Nurse Director & Social Work Supervisor, the Inpatient Psychiatric Utilization Review Social Worker will work collaboratively with the… more
- LA Care Health Plan (Los Angeles, CA)
- Supervisor, Utilization Management RN Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full ... to achieve that purpose. Job Summary The Supervisor of Utilization Management (UM) RN is responsible for...Management (UM) RN is responsible for executing the day -to- day operations of the UM department, and… more
- Hackensack Meridian Health (Holmdel, NJ)
- …A day in the life of a **Care Coordinator, Utilization Management ** at **Hackensack Meridian** **_Health_** includes: + Follows departmental ... as a leader of positive change. The **Care Coordinator, Utilization Management ** is a member of the...admission review within 24 hours or the first business day . + Refers cases not meeting criteria to the… more
- Hackensack Meridian Health (Neptune, NJ)
- …A day in the life of a **Care Coordinator, Utilization Management ** at **Hackensack Meridian** **_Health_** includes: + Follows departmental ... as a leader of positive change. The **Care Coordinator, Utilization Management ** is a member of the...admission review within 24 hours or the first business day . + Refers cases not meeting criteria to the… more
- Trinity Health (Mason City, IA)
- …Part time **Shift:** Day Shift **Description:** **Position Purpose:** The Utilization Review Case Manager responsibilities include case screening, insurance ... nurse in the state of Iowa. + Bachelor's Degree required. BSN preferred + Utilization management focused certifications that are recognized in the state of Iowa… more
- Henry Ford Health System (Troy, MI)
- …or the equivalent. Additional Information + Organization: Community Care Services + Department: Pharmacy- Utilization Mgmt + Shift: Day Job + Union Code: Not ... Pharmacy Benefits Coordinator facilitates the operations of the Pharmacy Care Management department by organizing, improving, and implementing pharmacy benefit … more