• RN Manager - Care Management…

    Trinity Health (Silver Spring, MD)
    **Employment Type:** Full time **Shift:** Day Shift **Description:** **Job Title:** Manager Care Mgt & Util Review **Employment Type:** Full Time **Shift:** ... 8am - 4:30pm + Reporting to the Director of Care Management + The RN Manager is...the activities of RN Case Managers for in inpatient care coordination and utilization review .… more
    Trinity Health (08/29/24)
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  • Interim Manager - Case Management…

    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
    Trinity Health (10/10/24)
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  • Utilization Review Social Work…

    Hartford HealthCare (Torrington, CT)
    …**Job:** **Professional Clinical* **Organization:** **Charlotte Hungerford Hospital* **Title:** * Utilization Review Social Work Care Manager (LCSW) - ... Worker will work collaboratively with the IP Psychiatry Patient Care Team to assure Utilization Review... activities on a 17 bed Adult unit. The Care Manager will liaison with insurance companies… more
    Hartford HealthCare (08/08/24)
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  • RN Utilization Manager - Care

    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 ... met and care delivery is coordinated across the continuum. The Utilization Manager completes admission, continued stay, and discharge reviews in accordance… more
    UNC Health Care (10/11/24)
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  • Utilization Review Manager

    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
    Mount Sinai Health System (10/31/24)
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  • RN - Utilization Review Case…

    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
    LifePoint Health (09/10/24)
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  • Utilization Review Case…

    Covenant Health (Nashua, NH)
    …and procedures. + Maintains/enhances professional development/skills required to function as a Utilization Review Case Manager + Completes all mandatory ... services and Outpatients in a Bed. Identifies delays in care . Documents and communicates findings with the care...+ Annual goals are achieved. + Attends pertinent case management/ utilization review programs to maintain current knowledge… more
    Covenant Health (10/31/24)
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  • Case Manager - Utilization

    Trinity Health (Mason City, IA)
    …**Hours:** Monday-Friday 0630-1430; no weekends or holidays **About The Job** The Utilization Review Case Manager responsibilities include case screening, ... experience as a registered nurse involving community contact, knowledge of managed care , resource utilization criteria, Medicaid, insurance coverage for acute … more
    Trinity Health (09/06/24)
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  • RN - Lead Care Coordinator…

    Trinity Health (Maywood, IL)
    …quality of care , mitigate cost trends through supporting optimization of utilization review for medical necessity using established care guidelines ... our small but mighty team to guide and manage Utilization Review and Management for the Loyola...and/or outpatient referral authorizations. **Great opportunity for a Lead Care Coordinator to work in an organization that focuses… more
    Trinity Health (09/26/24)
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  • Sr Utilization Review Specialist…

    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 ... patient population and HackensackUMC. These include but are not limited to utilization review , hospital reimbursement, clinical compliance, case management, and… more
    Hackensack Meridian Health (11/02/24)
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  • Physician Utilization Review

    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 (08/19/24)
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  • Utilization Review RN

    Billings Clinic (Billings, MT)
    …, CMS 2 Midnight Rule, or payer authorization for status and level of care Priority 2: Performs Utilization Review (UR) Activities Completes concurrent ... prior to starting. Click here (https://billingsclinic.csod.com/ats/careersite/search.aspx?site=15&c=billingsclinic) to learn more! Utilization Review RN Billings Clinic (Billings Clinic… more
    Billings Clinic (08/06/24)
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  • Utilization Manager (RN)

    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 ... **Description** Job Summary The Utilization Manager (UM) assesses new admissions,...in accordance with federal regulations and the health system's Utilization Review Plan. Responsibilities And Scope +… more
    UNC Health Care (10/31/24)
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  • Utilization Manager (RN)

    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
    UNC Health Care (08/21/24)
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  • Supervisor Care Management RN - Sesh…

    Providence (Anchorage, AK)
    …for Case Managers upon hire + 2 years of Case Management experience including utilization review , care management, care coordination, discharge planning, ... Care Management Services under the direction of the Manager Care Management Services. This work includes...and directly supervising the activities of the case management, utilization review , social services and navigation teams… more
    Providence (11/01/24)
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  • Manager , Utilization Management

    Commonwealth Care Alliance (Boston, MA)
    … services,procedures, and facilities under the provisions of CCA's benefits plan.The Manager , Utilization Management is responsible for overseeing and managing ... the daily operation of the Utilization Management Review Nurse and Specialist staff...in the area of service decisions and organizational determinations.The Manager , Utilization Management reports to the Director… more
    Commonwealth Care Alliance (10/04/24)
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  • UM Coordinator - Utilization Review

    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
    Hackensack Meridian Health (10/28/24)
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  • Utilization Review Coordinator

    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
    Behavioral Center of Michigan (10/22/24)
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  • Manager , Utilization Management…

    Humana (Salem, OR)
    …a part of our caring community and help us put health first** The Manager , Utilization Management Nursing utilizes clinical nursing skills to support the ... and communication of medical services and/or benefit administration determinations. The Manager , Utilization Management Nursing works within specific guidelines… more
    Humana (10/29/24)
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  • SRS-Inpatient Case Manager II…

    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
    Sharp HealthCare (10/30/24)
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