- ERP International (Corpus Christi, TX)
- **Overview** ERP International is seeking a **Registered Nurse (RN)** ** Utilization Manager ** for a full-time position in support of the **Naval Health ... collection. Analyzes data and prepares reports to describe resource utilization patterns. Briefs applicable data/slides to provider staff, executive staff,… more
- Dartmouth Health (Lebanon, NH)
- Overview The Manager of Utilization Management is responsible for day to day operations of the utilization review program at multiple Dartmouth Health system ... These are just a few highlights of being a nurse at Dartmouth Hitchcock Medical Center and Clinics in...country. This all means you can be a happy nurse with more quality time with friends, family, pets… more
- Veterans Affairs, Veterans Health Administration (St. Louis, MO)
- …St. Louis Health Care System (VASTLHCS), St. Louis, Missouri. The Registered Nurse Case Manager ( Utilization Management) demonstrates leadership, experience, ... Nurse Total Rewards The primary purpose of this Registered Nurse Case Manager (RNCM) is to deliver fundamental knowledge-based care to assigned clients while… more
- Crossroads Hospice & Palliative Care (Plymouth Meeting, PA)
- …+ Utilize case management principles to ensure continuity of care and appropriate resource utilization Registered Nurse Case Manager Benefits & Schedule: + ... As a Registered Nurse Case Manager , you will provide direct care to patients in their homes or care facilities. Your role goes beyond offering medical… more
- Lowe's (Charlotte, NC)
- …years of experience in a clinical position. + 3-5 Years of Experience as a Case Manager or Utilization Review Nurse in worker's compensation + Experience in ... license in home State + CCM - Certified Case Manager + CRRN - Certified Rehabilitation Registered Nurse... Manager + CRRN - Certified Rehabilitation Registered Nurse + CDMS - Certified Disability Management Specialist +… more
- Providence (Medford, OR)
- …and geriatric, based on population focus. Duties also include complex discharge planning and utilization review. The Nurse Case Manager must be competent to ... Providence Medford Medical Center, in Medford, OR.** **Full-Time/Day Shift** The RN Case Manager is an expert professional registered nurse who is responsible… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist LVN 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 LVN II will...implement a successful discharge plan. Works with the UM Manager and Physician Advisor on case reviews for pre-service,… 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
- Cedars-Sinai (Los Angeles, CA)
- …us one of America's Best Hospitals! **What You Will Do in This Role:** The Utilization Review Case Manager validates the patient's placement to be at the most ... based on nationally accepted admission criteria. The UR Case Manager uses medical necessity screening tools, such as InterQual...employment. **Req ID** : 5044 **Working Title** : Registered Nurse - Utilization Management 8 Hour Days… more
- Milford Regional Medical Center (Milford, MA)
- …to our community with dignity, compassion, and respect. Statement of Purpose: The Utilization Review Nurse is responsible for utilization management at ... Nursing required Masters in Healthcare preferred Certification/License: Massachusetts Registered Nurse licensure required Certified Case Manager , preferred… more
- Humana (Louisville, KY)
- …a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, ... services and/or benefit administration determinations for Humana's Kentucky Medicaid Plan. The Utilization Management Nurse 2 work assignments are varied and… more
- Travelers Insurance Company (Buffalo, 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
- Pipeline Health System, LLC (Toast, NC)
- Job Title: Utilization Review Registered Nurse - Behavioral Health Unit/FT/Days Job Summary: This Utilization Review (UR) Registered Nurse (RN) position ... and compassionate care to our patients. This position is responsible for utilization review, assessment of discharge planning needs and coordination of effective… more
- Elevance Health (Tampa, FL)
- Senior RN Utilization Review/Management (Acute InPatient) JR116937 **Location:** Must be within 50 miles / 1 hour commute of Tampa or Miami, FL offices. This is ... 5pm, Monday - Friday. **2 Holidays** per year and **occasional** weekends. The ** Nurse Medical Management Sr** serves as **team lead** for nursing staff who… more
- The Cigna Group (Bloomfield, CT)
- …issues, implications and decisions. The Case Management Analyst reports to the Supervisor/ Manager of Appeals and will coordinate and perform all appeal related ... limited to:** + Must have experience in Medicare Appeals, Utilization Case Management or Compliance in Medicare Part C...Additional duties as assigned. **Qualifications** + Education: Licensed Practical Nurse (LPN) or Registered Nurse (RN) +… 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,...in nursing with 4 years of experience. . Registered Nurse with an active and unrestricted license to practice… more
- WellSpan Health (York, PA)
- Utilization Care Manager Location: York Hospital, York, PA Schedule: Part Time Hours: M-F Days Part Time: 20 hours/week General Summary Performs a variety of ... reviews and applies utilization and case management techniques to determine the most... of resources to the attention of the appropriate manager (s). + Prepares and maintains appropriate documentation as required.… more
- Molina Healthcare (NV)
- **JOB TITLE : Manager , Healthcare Services** **This position supports our NEVADA health plan. Nevada residents preferred. Applicants who do not live in Nevada will ... state at this time.** **Prior experience with managed care (Medicaid, Medicare) Utilization Management processes and 3 + years in management / staff oversight… more
- Lucile Packard Children's Hospital Stanford (Palo Alto, CA)
- …include coordinating all facets of a patient's admission/discharge; performing utilization review activities, including review of patient charts for timeliness ... of services as well as appropriate utilization of services; and ensuring optimum use of resources,...activities that lead to optimal patient outcomes. A Case Manager differs from other roles in professional nursing/health care… more