- Stanford Health Care (Palo Alto, CA)
- …leadership, coaching, and mentoring would further develop our robust, Utilization Management team. Are you driven by health care innovation, partnerships, ... while honoring its commitment to delivering evidence-based and patient-centered care . We are seeking a results-driven manager ...+ Knowledge of principles and best practices of case management , utilization review, social work, care… more
- Community Health Systems (Siloam Springs, AR)
- **Job Summary** The Care Manager - LPN supports effective utilization management and discharge planning by coordinating patient care activities under ... + Participates in the development, implementation, and evaluation of utilization management and discharge planning programs to enhance care delivery and… more
- UNC Health Care (Raleigh, NC)
- …through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management ... care delivery is coordinated across the continuum. The Utilization Manager completes admission, continued stay, and...Utilization Management Plan. In addition, the Utilization Manager is responsible for revenue protection… more
- VNS Health (Manhattan, NY)
- …, staff productivity and coverage. + Generates management reports via the care / utilization management systems and demonstrates competency as a super user ... OverviewManages the utilization management team to ensure that...Experience: + Minimum of four years experience in home care , care management or related… more
- McLaren Health Care (Detroit, MI)
- **Position Summary:** Responsible for providing assistance to the Utilization Manager (UM) RN in the coordination of patient admission and continued stay ... observation) based on medical necessity. 2. Performs concurrent and retrospective utilization management -related activities and functions to ensure that… more
- Independent Health (Buffalo, NY)
- …perks, benefits and commitment to diversity and inclusion. **Overview** The Program Manager - Utilization Management (UM) will be accountable for the ... recommendations for improvements to maintain an effective and efficient utilization management process, as well as manage...Coder (CPC) is strongly preferred. + Knowledge of clinical care management processes, member benefit structures and… more
- UNC Health Care (Hendersonville, NC)
- …daily with the Care Manager to manage level of care transitions & appropriate utilization of services. Coordinates with the appropriate staff/payers ... the health and well-being of the unique communities we serve. Summary: The Utilization Manager (UM) assesses new admissions, continued stay and discharge review… more
- Whidbey General Hospital (Coupeville, WA)
- …health, Hospice, skilled nursing, anti-biotic regime, etc. The RN - Care Manager follows the hospital's Case Management / Utilization Plan that integrates ... Utilization Review and Discharge Planning. The RN - Care Manager will lead an assessment to...resource utilization , the discharge planning and appeal/denial management . The RN - Care Manager… more
- VNS Health (Manhattan, NY)
- …and cost-effective health care services. Manages providers, members, team, or care manager generated requests for medical services and renders clinical ... of hospital admissions and emergency department visits through on-going member education, care management and collaboration with IDT members. + Provides input… more
- Community Health Systems (Franklin, TN)
- …clinical expertise to ensure quality, timely, and cost effective utilization management to achieve optimal outcomes. The manager will be responsible for ... overall utilization review process to optimize patient care and manage resources effectively. The manager ...a nurse required + 1-3 years work experience in Care Management or Utilization Review… more
- Beth Israel Lahey Health (Burlington, MA)
- …years of medical/surgical nursing care experience. -Two years of Case Management or Utilization Management experience desirable. - Demonstrated ability ... (RN) Case Manager for Hospital at Home Care Transitions coordinates utilization review, discharge planning...to ensure a timely process. Registered Nurses (RNs) with utilization review experience, case management experience, and… more
- Hackensack Meridian Health (Neptune, NJ)
- …our mission to transform healthcare and serve as a leader of positive change. The ** Care Coordinator, Utilization Management ** is a member of the healthcare ... of the patient's treatment. Accountable for a designated patient caseload; the Care Coordinator, Utilization Management plans effectively in order… more
- Hackensack Meridian Health (Holmdel, NJ)
- …our mission to transform healthcare and serve as a leader of positive change. The ** Care Coordinator, Utilization Management ** is a member of the healthcare ... of the patient's treatment. Accountable for a designated patient caseload; the Care Coordinator, Utilization Management plans effectively in order… more
- UPMC (Hanover, PA)
- **UPMC is hiring a part time Professional Care Manager for our Utilization Review department in Hanover! This is a part time, day shift position with a ... rotating weekend and holiday schedule.** **Purpose:** The Care Manager (CM) coordinates the clinical and...Performs overall utilization management , resource management , discharge planning and post-acute care referrals… more
- LA Care Health Plan (Los Angeles, CA)
- …skills. Preferred: Knowledge of National Committee for Quality Assurance (NCQA) requirements for Utilization Management or Care Management (CM). ... Utilization Management Nurse Specialist RN II...$115,509.00 (Mid.) - $142,166.00 (Max.) Established in 1997, LA Care Health Plan is an independent public agency created… 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
- ERP International (Nellis AFB, NV)
- …direct patient care clinical inpatient and outpatient setting. Must have utilization management experience for 2 years in recent consecutive months including ... Weekends, No Holidays! **Job Specific Position Duties:** * Provides Utilization Management activities and functions by using...case management care and discharge planning for patients… more
- Helio Health Inc. (Syracuse, NY)
- …to track, review, and analyze data relating to continuous quality improvement. The Utilization Case Manager will work on a Full-Timebasis supporting our ... as appropriate. + Assist in developing and administering policies and procedures for utilization . + Negotiating access to care for individuals seeking services… more
- Elevance Health (Tampa, FL)
- …communicates, and monitors program schedule, budget, and resources plan. + Manages resource utilization to ensure appropriate delivery of care to members and ... health plans for people enrolled in Medicaid and/or Medicare programs in Florida. ** Manager II GBD Special Program** **Location:** This position will work a hybrid… more
- Prime Healthcare (Weslaco, TX)
- …#registerednurse #casemanagement Connect With Us! (https://careers-primehealthcare.icims.com/jobs/188814/registered-nurse-case- manager utilization - management ... the point of their admission and across the continuum of the health care management . Works on behalf of the advocate, promoting cost containment and demonstrates… more
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