- CHRISTUS Health (Irving, TX)
- …and update educational materials and resources. Demonstrates knowledge of health care professional education and continuing education requirements. Job ... Description Summary: The Program Manager Perinatal Services assists in developing and implementing perinatal nursing initiatives for the CHRISTUS Health System.… more
- CHRISTUS Health (Alamo Heights, TX)
- …patient care , patient experience and patient outcomes. Effectively manages utilization of staff and material resources so that the most therapeutically effective ... care is provided in a safe and cost effective manner. Promotes the professional development of patient care and administrative support staff assigned for… more
- UPMC (Hanover, PA)
- **UPMC is hiring a Professional Care Manager to support the Utilization Review process! This is a full time, day shift position with a rotating weekend ... This position is eligible for a generous Sign on Bonus! _** **Purpose:** The Care Manager (CM) coordinates the clinical and financial plan for patients. Performs… more
- 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
- Hartford HealthCare (Torrington, CT)
- …**Job:** ** Professional Clinical* **Organization:** **Charlotte Hungerford Hospital* **Title:** * Utilization Review Social Work Care Manager (LCSW) ... Worker will work collaboratively with the IP Psychiatry Patient Care Team to assure Utilization Review activities...Review activities on a 17 bed Adult unit. The Care Manager will liaison with insurance companies… more
- Commonwealth Care Alliance (Boston, MA)
- … services,procedures, and facilities under the provisions of CCA's benefits plan.The Manager , Utilization Management is responsible for overseeing and managing ... compliance standards in the area of service decisions and organizational determinations.The Manager , Utilization Management reports to the Director of Clinical… more
- Sharp HealthCare (San Diego, CA)
- …and safe patient handovers to next level of care ; work closely with ambulatory care manager (ACM) at the system level, in clinics, and homecare and sub-acute ... utilization review demands to assure patients are receiving care in the appropriate setting and level of ...Case Manager (CCM) - Commission for Case Manager Certification -PREFERRED **Essential Functions** + Professional … more
- VNS Health (Manhattan, NY)
- … utilization management processes are followed by the service operations staff, utilization staff, and the interdisciplinary care team to ensure cost ... , staff productivity and coverage. * Generates management reports via the care / utilization management systems and demonstrates competency as a super user… more
- AmeriHealth Caritas (Dublin, OH)
- ** Utilization Management Plan Oversight Manager (Ohio Resident)** Location: Dublin, OH Primary Job Function: Medical Management ID**: 37872 **Job Brief** ... Your career starts now. We are looking for the next generation of health care leaders. At AmeriHealth Caritas, we are passionate about helping people get care… more
- Mount Sinai Health System (New York, NY)
- …in Nursing or health-related field preferred. + 5 years minimum of progressive acute care leadership and acute care utilization review experience. + ... **Job Description** The Utilization Review Manager for the Selikoff...area of nursing practice assigned; in this case, acute care utilization review. + Previous experience making… more
- Elevance Health (FL)
- **JR133557 Manager II Behavioral Health Services ( Utilization Management for Behavior Analysis Services)** Responsible for Behavioral Health Utilization ... support staff responsible to ensure medical necessity and appropriateness of care for inpatient/outpatient BH services; ensures appropriate utilization of… more
- Trinity Health (Silver Spring, MD)
- **Employment Type:** Full time **Shift:** **Description:** The Interim Manager of Care Management & Utilization Review, under the supervision and in ... Care Managers. Manages the activities of hospital staff in inpatient care coordination and utilization review. Oversees interactions of staff with outside… more
- Covenant Health (Nashua, NH)
- …+ Maintains/enhances professional development/skills required to function as a Utilization Review Case Manager + Completes all mandatory learning assignments ... Summary Conducts medical necessity reviews in accordance with the Utilization Management (UM) plan for patients that are housed...services and Outpatients in a Bed. Identifies delays in care . Documents and communicates findings with the care… 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 ... to prioritize your well-being so you can provide exceptional care to others. Here, you're not just valued as...offering safe discharge planning is the use of a Utilization RN and Case Manager RN, in… more
- Hackensack Meridian Health (Neptune, NJ)
- …mission to transform healthcare and serve as a leader of positive change. The ** Care Management, Care Coordinator, Utilization Management** is a member of ... of the patient's treatment. Accountable for a designated patient caseload; the Care Coordinator, Utilization Management plans effectively in order to manage… more
- Hackensack Meridian Health (Neptune, NJ)
- …mission to transform healthcare and serve as a leader of positive change. The ** Care Coordinator, Utilization Management** is a member of the healthcare team and ... of the patient's treatment. Accountable for a designated patient caseload; the Care Coordinator, Utilization Management plans effectively in order to manage… more
- UCLA Health (Los Angeles, CA)
- …next level. You can do all this and more at UCLA Health. As a Manager for Medicare Advantage Utilization Management, you'll provide direct management to a team ... care + experience in an HMO environment + Thorough knowledge of health care industry, utilization review, utilization management, and concurrent review… more
- Trinity Health (Mason City, IA)
- …Monday-Friday 0630-1430; no weekends or holidays **About The Job** The Utilization Review Case Manager responsibilities include case screening, insurance ... experience as a registered nurse involving community contact, knowledge of managed care , resource utilization criteria, Medicaid, insurance coverage for acute … 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 ... while ensuring compliance with all local, state and federal regulations governing utilization review activities and/or care management. Expected outcomes include… more
- Sharp HealthCare (San Diego, CA)
- …while ensuring compliance with all local, state and federal regulations governing utilization review activities and/or care management. Expected outcomes include ... Guidelines (MCG) + Experience and understanding of federal and state regulations governing utilization management + Accredited Case Manager (ACM) - American Case… more
