- CHRISTUS Health (Alamo Heights, TX)
- …and operations for assigned areas; at CHRISTUS St. Patrick Hospital. The nurse manager affects departmental outcomes through interpretation, implementation, and ... excellence in patient care, patient experience and patient outcomes. Effectively manages utilization of staff and material resources so that the most therapeutically… more
- CHRISTUS Health (Tenneryville, TX)
- …and operations for assigned areas; at CHRISTUS GSMC - Longview. The nurse manager affects departmental outcomes through interpretation, implementation, and ... excellence in patient care, patient experience and patient outcomes. Effectively manages utilization of staff and material resources so that the most therapeutically… more
- CVS Health (Austin, TX)
- …to make health care more personal, convenient and affordable. **Position Summary:** This Utilization Management (UM) Nurse Consultant role is fully remote and ... requirement (Saturday and Sunday both) per the needs of the team.** The UM Nurse Consultant job duties include (not all encompassing): + Reviews services to assure… more
- University Medicine (Providence, RI)
- …home members to assist the patient to the right level of care and decrease unnecessary utilization . The nurse case manager is an active participant in the ... SUMMARY: Reporting to the Manager of Case Management, the nurse ...from high-risk case management (eg rising risk, frequent ED utilization ). The NCM helps Brown Medicine achieve the triple… more
- Ellis Medicine (Schenectady, NY)
- …Workers (SW). The Discharge Planner's primary function is to work with the Social Worker, Nurse Case Manager , or Utilization Management Nurse to ... beneficiaries per CMS Conditions of Participation at the direction of the Case Manager . + Utilization Management Activities: + Collaborates with Case Managers… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: ... net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates,...implement a successful discharge plan. Works with the UM Manager and Physician Advisor on case reviews for pre-service,… more
- Travelers Insurance Company (Albany, NY)
- …Imagine loving what you do and where you do it. **Job Category** Claim, Nurse - Medical Case Manager **Compensation Overview** The annual base salary range ... Is the Opportunity?** This position is responsible for conducting in-house utilization review with emphasis on determining medical necessity for prospective,… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Utilization Review Manager for the Selikoff Centers for Occupational Health is responsible for the management of program operations ... , and internal and external regulatory and survey requirements. + The Utilization Review Manager collaborates with multiple professionals to support and… more
- ERP International (Nellis AFB, NV)
- **Overview** ERP International is seeking **Registered Nurse (RN) Utilization Managers** for full-time positions in support of theMike O'Callaghan Military ... admissions, including all eligible beneficiaries, to civilian hospitals and notifies Clinical Nurse Case Manager and Patient Administration Element as required.… more
- Stanford Health Care (Palo Alto, CA)
- …delivering evidence-based and patient-centered care. We are seeking a results-driven manager to further develop the framework for clinical, operational, and ... Here, your leadership, coaching, and mentoring would further develop our robust, Utilization Management team. Are you driven by health care innovation, partnerships,… more
- Sharp HealthCare (San Diego, CA)
- …of the System Integrated Care Management (ICM) team the Transfer and Admissions Utilization Manager (UM) partners with the Centralized Patient Placement Center ... preferred.** + Experience and understanding of federal and state regulations governing utilization management. + Accredited Case Manager (ACM) - American Case… more
- Sharp HealthCare (San Diego, CA)
- …Degree in Nursing; Certified Case Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse (RN) - CA Board of Registered ... experience as defined by the CBA. + California Registered Nurse (RN) - CA Board of Registered Nursing -REQUIRED...Experience and understanding of federal and state regulations governing utilization management + Accredited Case Manager (ACM)… more
- Cleveland Clinic (Vero Beach, FL)
- …. May design and initiate special projects as supervised by the Team Manager . Utilization Management Specialist Join our team at Cleveland Clinic Indian ... Under the general supervision of the UM Team Manager , this individual performs UM activities which includes...stay or visit. Some of the responsibilities of a Utilization Management Specialist include medical record review,… more
- Prime Healthcare (National City, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/180750/case- manager -rn utilization ... perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity of service and severity of illness.… more
- Prime Healthcare (Montclair, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/181372/case- manager -%28rn%29 utilization ... perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity of service and severity of illness.… more
- Hackensack Meridian Health (Holmdel, NJ)
- …concurrent managed care denial appeals and retrospective medical record utilization reviews. + Obtains and evaluates medical records for inpatient ... healthcare and serve as a leader of positive change. The **Care Coordinator, Utilization Management** is a member of the healthcare team and is responsible for… more
- Hackensack Meridian Health (Holmdel, NJ)
- …concurrent managed care denial appeals and retrospective medical record utilization reviews. + Obtains and evaluates medical records for inpatient ... healthcare and serve as a leader of positive change. The **Care Coordinator, Utilization Management** is a member of the healthcare team and is responsible for… more
- Prime Healthcare (Reno, NV)
- …preferred. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/183134/case- manager -rn-union 10hr smrmc- utilization ... and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity of service and...last 5 years. + Current licensure as a Registered Nurse in the State of Nevada. + Must be… more
- Munson Healthcare (Traverse City, MI)
- …proficiency in the use of hospital information systems to access information and record data. Continuing Stay + Actively participate in daily huddles, patient care ... patient's clinical status and progression of care. + Consults with case manager and/or physician advisor as necessary to resolve progression-of-care barriers through… more
- Adecco US, Inc. (Minneapolis, MN)
- …of the Utilization Management LPN:** * In collaboration with the Manager of Delegation Oversight, manages delegation oversight and regulatory audits. * Leverages ... Adecco Healthcare & Life Sciences is hiring for a ** Utilization Management** **LPN** to work **remotely** ! This is a work from home position. **Type:** 3-month… more
