- Sutter Health (Burlingame, CA)
- …the acute care patient experience. This position works in collaboration with the Physician , Utilization Manager , Medical Social Worker and bedside RN ... **Organization:** Bay Administration **Position Overview:** Responsible for Utilization Management and accurate bed placement for patients coming in from the ED.… more
- Sutter Health (San Francisco, CA)
- …the acute care patient experience. This position works in collaboration with the Physician , Utilization Manager , Medical Social Worker and bedside RN ... the achievement of optimal health, access to care, and appropriate utilization of resources balanced with the patients' self -determination while coordinating… more
- Sutter Health (Davis, CA)
- …the acute care patient experience. This position works in collaboration with the Physician , Utilization Manager , Medical Social Worker and bedside RN ... the achievement of optimal health, access to care, and appropriate utilization of resources balanced with the patients' self -determination while coordinating… more
- Hackensack Meridian Health (Hackensack, NJ)
- **Overview** The Senior Utilization Review Specialist collaborates with the healthcare team in the management and resolution of activities that assure the integrity ... population and HackensackUMC. These include but are not limited to utilization review, hospital reimbursement, clinical compliance, case management, and transitions… more
- UNC Health Care (Hillsborough, NC)
- **Description** RN Utilization Manager is responsible for clinical reviews for medical necessity for both admission and continuing stay patients during the day ... care episode through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management… more
- AdventHealth (Altamonte Springs, FL)
- **Senior Manager of Utilization ** **-AdventHealth Well65** **All the benefits and perks you need for you and your family:** . Benefits from Day One . Paid Days ... at a practice)** **The role you'll contribute:** The Senior Manager of Utilization will oversee ED, Inpatient,...BLS certification. . 2 years of experience in a physician 's office, clinical or hospital setting. . Knowledge of… more
- Huron Consulting Group (Chicago, IL)
- …clinical outcomes, create a more consumer-centric healthcare experience, and drive physician , patient and employee engagement across the enterprise. Join our team ... improve clinical outcomes, create a consumer-centric healthcare experience, and drive physician , patient and employee engagement across the enterprise. Join our team… more
- The 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 ... records, and internal and external regulatory and survey requirements. + The Utilization Review Manager collaborates with multiple professionals to support and… 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 ... met and care delivery is coordinated. The UM completes utilization reviews in accordance with federal regulations and the...patient data and treatments. Communicates daily with the Care Manager to manage level of care transitions & appropriate… more
- UNC Health Care (Hendersonville, NC)
- **Description** Job Summary The Utilization Manager (UM) assesses new admissions, continued stay and discharge review cases for medical necessity, appropriate ... met and care delivery is coordinated. The UM completes utilization reviews in accordance with federal regulations and the...patient data and treatments. Communicates daily with the Care Manager to manage level of care transitions & appropriate… 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 ... (MCG). + Experience and understanding of federal and state regulations governing utilization management. + Accredited Case Manager (ACM) - American Case… more
- Trinity Health (Silver Spring, MD)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** **Job Title:** Manager Care Mgt & Util Review **Employment Type:** Full Time **Shift:** Day ... to the Director of Care Management + The RN Manager is responsible and accountable for the operational management,...RN Case Managers for in inpatient care coordination and utilization review. Oversees interactions of staff with outside activities… more
- Billings Clinic (Billings, MT)
- …appropriate Priority 5: Escalation Refers cases that require second level review to Physician Advisor, Manager , and Director per department process or procedure ... a difference here. About Us Billings Clinic is a community-owned, not-for-profit, Physician -led health system based in Billings with more than 4,700 employees,… more
- Catholic Health Initiatives (Lexington, KY)
- …inside our hospitals and out in the community. **Responsibilities** The Utilization Management (UM) Director is responsible for the market(s) development, ... implementation, evaluation and direction of the Utilization Management Program and staff in support of the...agencies and internal standards and requirements 7. Collaborates with Physician Advisory Services to identify denial root causes related… more
- LA Care Health Plan (Los Angeles, CA)
- …to develop and implement a successful discharge plan. Works with the UM Manager and Physician Advisor on case reviews for pre-service, concurrent, post-service ... Utilization Management Nurse Specialist LVN II Job Category:...times specific to the case type. Identifies cases needing Physician Advisor (PA) review or input and presents for… more
- Tenet Healthcare (Detroit, MI)
- RN Utilization Review Full Time Days - 2406003414 Description : The Detroit Medical Center (DMC) is a nationally recognized health care system that serves patients ... to help patients achieve optimal health, access to care and appropriate utilization of resources, balanced with the patient’s resources and right to… more
- Hackensack Meridian Health (Holmdel, NJ)
- …and serve as a leader of positive change. The **Care Management, Care Coordinator, Utilization Management** is a member of the healthcare team and is responsible for ... patient's treatment. Accountable for a designated patient caseload; the Care Coordinator, Utilization Management plans effectively in order to manage length of stay,… more
- Hackensack Meridian Health (Hackensack, NJ)
- …and serve as a leader of positive change. The Case Management Care Coordinator, Utilization Management is a member of the healthcare team and is responsible for ... patient's treatment. Accountable for a designated patient caseload; the Care Coordinator, Utilization Management plans effectively in order to manage length of stay,… more
- Hackensack Meridian Health (Belle Mead, NJ)
- …healthcare and serve as a leader of positive change. The Utilization Management Coordinator utilizes clinical knowledge and understanding of behavioral health ... patient caseload. Collaborates with the attending LIP, Clinical Case Manager , nurse, and other members of the treatment team,...ACCESS center staff and PFS department to ensure appropriate utilization of resources and benefits on a case by… more
- LA Care Health Plan (Los Angeles, CA)
- …to develop and implement a successful discharge plan. Works with the UM Manager and Physician Advisor on case reviews for pre-service, concurrent, post-service ... Utilization Management Nurse Specialist RN II Job Category:...cases and reports are maintained and referred to the Physician Advisor/UM Director. Documents in platform/system of record. Utilizes… more