- Christus Health (San Antonio, 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
- SSM Health (St. Charles, MO)
- …Illinois Department of Financial and Professional Regulation (IDFPR) State of Work Location: Missouri Registered Nurse ( RN ) Issued by Compact State Or ... improvement in standard work. May also be responsible for: utilization management process, ED case management...Registered Nurse ( RN ) - Missouri Division of Professional… more
- Fresenius Medical Care (Olmito, TX)
- …Preparedness Plan; ensure maintenance of equipment . Ensure proper medical records management and HIPAA compliance . Oversees the continuous and data driven Quality ... and policies, and then developing and implementing an associated center specific management plan. . Ensure adverse events are reported, documented and necessary… more
- Fresenius Medical Care (San Antonio, TX)
- …all implanted devices are completed accurately, timely and maintained according to records management guidelines. Acts as the Facility Manager in the absence of ... the manager or at the direction of organization management . Appointed Governing Body positions, takes on primary role of certain position or oversees staff… more
- UTMB Health (Galveston, TX)
- …timely and accurate information to payers. The role integrates and coordinates utilization management , care coordination and discharge planning functions. Equal ... Minimum Qualifications: RN with Bachelor's degree in Nursing and two years of inpatient experience in a hospital environment. Current license or valid permit to… more
- Baystate Health (Springfield, MA)
- … Manager / Utilization Management ** The ** RN Hospital Case Manager ** is a registered nurse responsible for the coordination of clinical care, ... of a designated population of patients. The Hospital Case Manager is responsible for overseeing an efficient plan that...for transitions + Leads the team to ensure appropriate utilization of patient resources and directs care to other… more
- Hartford HealthCare (Willimantic, CT)
- …**Title:** * Registered Nurse Case Manager ( RN ) - Utilization Management * **Location:** *Connecticut-Willimantic-Windham Community Memorial ... of the Manager of Continuing Care and Utilization Management and in collaboration with physicians,... experience preferred. *LICENSURE/CERTIFICATION* * Current license as a registered nurse in the State of Connecticut.… more
- Elevance Health (Washington, DC)
- …office 4 days each week. The office is located at 609 H. Street NE.** The ** Manager of Utilization Management ** **ll** is responsible for managing a team of ... acuity. + Provides direct oversight and is responsible for Utilization Management execution/decision making for managed member...as aligned to license which includes 3 years prior management experience + Current active unrestricted RN … more
- CVS Health (Baton Rouge, LA)
- …And we do it all with heart, each and every day. **Position Summary** The Utilization Management Manager of Prior Authorization oversees a team of clinical ... professionals to ensure the efficient, compliant, and high-quality delivery of utilization management processes. This leader supports organizational goals by… more
- UCLA Health (Los Angeles, CA)
- …the 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 ... a self-motivated, detail-oriented, service-driven leader with: + Current unrestricted RN licensure in CA required + Bachelors of Science,...(BSN) degree required + Five or more years of utilization management required + Four or more… 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 ... **Join Our Team of Experts and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager , you will:** + Directs staff… more
- Intermountain Health (Las Vegas, NV)
- …+ Continuous Improvement + Scheduling **Physical Requirements:** **Minimum Qualifications** + Current Registered Nurse ( RN ) license in state of practice ... 5:30 pm Holiday and weekend coverage when needed. The Manager of Care Management I leads and...work and complex care planning, transitions of care, and utilization management . The position ensures compliance with… more
- Highmark Health (Harrisburg, PA)
- …Inc. **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health ... setting **Preferred** + Experience in UM/CM/QA/Managed Care + Medical/Surgical experience + Utilization Management (UM) or (UR) Utilization Review experience… more
- Huron Consulting Group (Chicago, IL)
- …Join our team as the expert you are now and create your future. The Manager of Utilization Management is responsible for planning, organizing, developing, ... Review Plan and the overall operation of the Utilization Management Department in accordance with federal,...Criteria and Milliman Care Guidelines (MCG) preferred. + Current RN license from Maryland Board of Nursing. + CCM… 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 ... Utilization Management Plan. In addition, the Utilization Manager is responsible for revenue protection...date. **Licensure/Certification Requirements:** * Licensed to practice as a Registered Nurse in the state of North… more
- John Muir Health (Walnut Creek, CA)
- …- Case Management Preferred or Equivalent Work Experience **Certifications/Licensures:** + RN Registered Nursing - California Board of NursingRequired + BLS ... this in coordination with the interdisciplinary health team. The RN Case Manager is expected to function...practice with specialized focus on care coordination, compliance, transition management , education, and utilization management .… more
- Cedars-Sinai (Los Angeles, CA)
- …one of America's Best Hospitals. Summary of Essential Duties: + The Utilization Management (UM) Registered Nurse - Medicare Short Stay & Concurrent ... ID** : 14355 **Working Title** : Registered Nurse - Utilization Review Case Manager ... Manager - 8 Hour Days **Department** : Utilization Management **Business Entity** : Cedars-Sinai Medical… more
- Guthrie (Sayre, PA)
- …approaches and make recommendations for alternate levels of care. The Acute Case Manager also performs Utilization Management throughout the continuum of ... degree in addition to a degree in Nursing. A registered nurse with five (5) years relevant...admissions and short procedures by translating clinical information to Utilization Management requirements using pre ‐ determined… more
- Sanford Health (Rapid City, SD)
- …Schedule:** Full time **Weekly Hours:** 40.00 **Department Details** Join our team as a Utilization Review and Case Management Manager and lead a ... supervision of all departmental staff. Maintains a standardization of utilization management process to ensure all policies...in medical necessity review preferred. Currently holds an unencumbered registered nurse ( RN ) license with… more
- Rochester Regional Health (Rochester, NY)
- Job Title: Registered Nurse I Department: Utilization Management Location: Rochester General Hospital Hours Per Week: 40 hours (Full-Time) Schedule: ... Responsibilities include concurrent (as needed) and retrospective reviews. The Utilization Management Nurse will act...Support - American Heart Association (AHA)American Heart Association (AHA), RN - Registered Nurse -… more
