- Trinity Health (Silver Spring, MD)
- **Employment Type:** Full time **Shift:** **Description:** The Interim Manager of Care Management & Utilization Review, under the supervision and in ... closely related area. + Extensive knowledge of payer mechanisms and clinical utilization management is required. + Knowledge of pertinent regulatory,… more
- 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
- Crouse Hospital (Syracuse, NY)
- …of care . The Care Manager actively participates in the utilization management process using standards of care to determine the most appropriate ... ensure a safe discharge in a timely manner. The Care Manager conducts the initial assessment of...- 5 years' acute hospital experience. Preferred: + Case Management , Utilization Management experience preferred.… more
- UNC Health Care (Chapel Hill, 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
- Sharp HealthCare (San Diego, CA)
- …experience or case management experience + 3 Years recent case management , utilization review, care coordination experience + California Registered ... and individual development planning process.Maintain current knowledge of case management , utilization management , and discharge...level of care ; work closely with ambulatory care manager (ACM) at the system level,… 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...Work 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
- 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
- Penn State Health (Hershey, PA)
- …PDF for more detailed steps for assistance._ **Union:** Non Bargained \#LI-TB1 **Position** Manager Utilization Management - DAY SHIFT - Utilization ... OF POSITION:** Position is responsible to thoroughly understand all Utilization Management regulatory requirements for both CMS...financial health of the organization. This position reports to care management and the department of nursing.… more
- Hackensack Meridian Health (Neptune, NJ)
- …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… 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
- 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 ... + Thorough knowledge of health care industry, utilization review, utilization management , and...off-site meetings and conferences + ACM - Accredited Case Manager preferred + CCM - Certified Case Manager… 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
- 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
- Sharp HealthCare (San Diego, CA)
- …**What You Will Do** As a member of the System Integrated Care Management (ICM) team the Transfer and Admissions Utilization Manager (UM) partners ... while ensuring compliance with all local, state and federal regulations governing utilization review activities and/or care management . Expected outcomes… 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
- 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 ... Guidelines (MCG) + Experience and understanding of federal and state regulations governing utilization management + Accredited Case Manager (ACM) - American… 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
- 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
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