- Stanford Health Care (Palo Alto, CA)
- …and Abilities** + Knowledge of principles and best practices of case management, utilization review , social work, care coordination and discharge planning. ... work-life balance while honoring its commitment to delivering evidence-based and patient-centered care . We are seeking a results-driven manager to further… 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 ... Managers. Manages the activities of hospital staff in inpatient care coordination and utilization review ....trusted provider of health services within our community. A Manager at Holy Cross Hospital is expected to demonstrate… more
- CVS Health (Columbus, OH)
- …for Care Manager call outs, collaborates with Care Manager and Utilization review .- Assists members locate services. Facilitates follow-up ... of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at… more
- CVS Health (Miami, FL)
- …experience + Certified Care Manager (CCM) Certification + Managed care or utilization review experience **Education** + Associates degree or ... care more personal, convenient and affordable. **Position Summary** The Pediatric Care Manager RN will support a population of primarily medically complex… more
- Beth Israel Lahey Health (Burlington, MA)
- …The Inpatient Registered Nurse (RN) Case Manager for Hospital at Home Care Transitions coordinates utilization review , discharge planning and monitors ... a difference in people's lives.** Joint role of Case Manager and Utilization Review Nurse...care experience. -Two years of Case Management or Utilization Management experience desirable. - Demonstrated ability to communicate… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Utilization Review Manager for the Selikoff Centers for Occupational Health is responsible for the management of program operations ... internal and external regulatory and survey requirements. + The Utilization Review Manager collaborates with...of progressive acute care leadership and acute care utilization review experience. +… 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...in employment." **Job:** **Nursing* **Organization:** ** **Title:** *RN - Utilization Review Case Manager * **Location:**… 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 staff to ... met and care delivery is coordinated across the continuum. The Utilization Manager completes admission, continued stay, and discharge reviews in accordance… more
- Trinity Health (Mason City, IA)
- **Employment Type:** Part time **Shift:** Day Shift **Description:** **Position Purpose:** The Utilization Review Case Manager responsibilities include case ... experience as a registered nurse involving community contact, knowledge of managed care , resource utilization criteria, Medicaid, insurance coverage for acute … more
- Hackensack Meridian Health (Hackensack, NJ)
- **Overview** The Senior Utilization Review Specialist collaborates with the healthcare team in the management and resolution of activities that assure the ... population and Hackensack UMC. These include but are not limited to utilization review , hospital reimbursement, clinical compliance, case management, and… more
- Hackensack Meridian Health (Hackensack, NJ)
- **Overview** **The Utilization Review Physician collaborates with the healthcare team in the** **management and resolution of activities that assure the ... population and Hackensack UMC. These include but are not limited to utilization review ,** **hospital reimbursement, clinical compliance, case management, and… more
- Covenant Health (Bangor, ME)
- …of the VP of Accountable Care Operations & Population Health Strategy the Utilization Review Case Manager will work collaboratively with other members of ... the healthcare team. The nurse case manager also acts as an advocate for the patient... conducts medical necessity reviews in accordance with the Utilization Management (UM) plan for patients that are housed… 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 … more
- Hackensack Meridian Health (Belle Mead, NJ)
- …on a case by case basis. Applies case management and utilization review principles in monitoring the delivery of care and promoting optimal communication ... primary therapists and discharge planners regarding transition to alternative levels of care . + Perform concurrent utilization review applying identified… more
- Munson Healthcare (Traverse City, MI)
- …interdisciplinary team members, payers and external case managers Why work as a Utilization Review Specialist at Munson Healthcare? + Our dynamic work ... knowledge about the patient's clinical status and progression of care . + Consults with case manager and/or...+ Minimum of three years clinical experience required. Previous utilization review and/or case management in a… more
- Behavioral Center of Michigan (Warren, MI)
- …skills to help educate the staff and physicians regarding charting. REPORTS TO: Utilization Review Lead/ Manager QUALIFICATIONS: + High School Diploma or ... Under general supervision, the Utilization Review Coordinator provides professional assessment,...those duties include all tasks requested by the UR Manager , CEO or Medical Director to meet the needs… more
- Sharp HealthCare (San Diego, CA)
- …requires the ability to combine clinical/quality considerations with regulatory/financial/ utilization review demands to assure patients are receiving care in ... case management experience + 3 Years recent case management, utilization review , care coordination experience...level of care ; work closely with ambulatory care manager (ACM) at the system level,… more
- BayCare Health System (Clearwater, FL)
- …responsibility and clinical excellence. **BayCare Health System** is currently seeking a ** Utilization Review Specialist Senior** to join our outstanding and ... compassionate team. **The Utilization Review Specialist Senior responsibilities include:** +...all other related parties to ensure appropriate level of care through comprehensive concurrent review for medical… more
- VNS Health (Manhattan, NY)
- …general supervision. Compensation Range:$98,200.00 - $130,800.00 Annual * Reviews specific utilization issues or requests with Clinical Review team, focusing ... utilization management processes are followed by the service operations staff, utilization staff, and the interdisciplinary care team to ensure cost… more
- Elevance Health (Norfolk, VA)
- …PulsePoint locations. **Shift** : 4 weekdays and 1 weekend day as discussed with manager . The **Licensed Utilization Review II** is responsible for working ... **Title:** Licensed Utilization Review II **Location** : This...therapy that is not associated with a continuum of care , radiology review , or other such … more
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