- Trinity Health (Silver Spring, MD)
- … management /supervision/leadership experience in an acute healthcare setting required, preferably with case management , utilization review or closely ... Full time **Shift:** **Description:** The Interim Manager of Care Management & Utilization Review , under...RN with BSN or RN with > 10 years case management experience. Masters Degree preferred. **Minimum… more
- Covenant Health (Nashua, NH)
- …of the health care team. + Annual goals are achieved. + Attends pertinent case management / utilization review programs to maintain current knowledge ... + Maintains/enhances professional development/skills required to function as a Utilization Review Case Manager +...Minimum of five years broad clinical experience preferred + Case management and/or Utilization … more
- Sharp HealthCare (San Diego, CA)
- …nursing experience or case management experience + 3 Years recent case management , utilization review , care coordination experience + California ... performance planning, competency and individual development planning process.Maintain current knowledge of case management , utilization management , and… more
- Stanford Health Care (Palo Alto, CA)
- …of care guidelines and utilization management principles. + Experience in case management , utilization review , or related healthcare roles. + ... hybrid Stanford Health Care job.** **A Brief Overview** The Utilization Management Registered Nurse (UM RN) will...ensure the necessity and appropriateness of care provided. 3. Utilization Review : Conduct thorough utilization … more
- Providence (Anchorage, AK)
- …This work includes planning, coordinating, and directly supervising the activities of the case management , utilization review , social services and ... Managers upon hire + 2 years of Case Management experience including utilization review , care management , care coordination, discharge planning,… more
- Hackensack Meridian Health (Belle Mead, NJ)
- …and benefits on a case by case basis. Applies case management and utilization review principles in monitoring the delivery of care and promoting ... potential or identified concerns to the treatment team, Director of Utilization Management , and the Medical Director. + Review charts at identified review… more
- McLaren Health Care (Detroit, MI)
- …in coding/medical records/billing or healthcare related field + Two years of case management or utilization review , billing, or coding experience + Three ... observation) based on medical necessity. 2. Performs concurrent and retrospective utilization management -related activities and functions to ensure that… more
- UNC Health Care (Raleigh, NC)
- …promote continuity of care and cost effectiveness through the integrating and functions of case management , utilization review and discharge planning. ... **Job Details** Legal Employer: NCHEALTH Entity: UNC REX Healthcare Organization Unit: Rex Case Management Services Work Type: Full Time Standard Hours Per Week:… more
- ChenMed (Colonial Heights, VA)
- …promote continuity of care and cost effectiveness through the integrating and functions of case management , utilization review and discharge planning. ... **ESSENTIAL JOB DUTIES/RESPONSIBILITIES:** + Coordinates the integration of social services/ case management functions into the patient care, discharge… more
- Hackensack Meridian Health (Hackensack, NJ)
- …software to retrieve necessary information, inclusive of free text fields, to support the case management , utilization review process. + Retrieves ... serve as a leader of positive change. The Integrated Case Management Specialist performs selected services and...discharge dates. + Enters LAD into EPIC. + Keeps Utilization Review RN current on updates needed… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Case Manager is responsible for all aspects of case management / utilization review for an assigned group of inpatients, ED ... all new admissions to identify patients where utilization review , discharge planning, and/or case management will be needed using standardized criteria… more
- Alameda Health System (San Leandro, CA)
- …of California. **Additional Information** Note: Must have Hospital Case Management or Utilization Review experience. **Qualifications:** Education: ... The SLH Case Manager RN is responsible for providing comprehensive case management services to clients identified with complex health conditions and… more
- Scripps Health (San Diego, CA)
- …in a lead or supervisory role. * Minimum of 2 years' experience in case management / utilization review , discharge planning, and Millman/InterQual criteria ... Children's Fund (UNICEF). We invite you to join our Scripps Memorial Hospital Encinitas Case Management team as a Supervisor of Case Management . As a… more
- Ellis Medicine (Schenectady, NY)
- …services provided by the Case Manager include, but are not limited to, utilization review , case management , care transition, collaboration with ... years of inpatient experience in a hospital environment preferred. + Previous case management , utilization review , and discharge planning experience… more
- Acacia Network (Bronx, NY)
- …required (Bachelor's Degree preferred) + Minimum of 2 years of case management and/or utilization review experience + Strong problem-solving and advanced ... Acacia Network Inc. Utilization Manager Bronx, : 5/30/2024 Job Description Job...day to day functions of collaborative communication with external case managers at referring provider facilities and/or managed care… more
- Banner Health (Fallon, NV)
- …and regulatory agencies. MINIMUM QUALIFICATIONS Must possess knowledge of case management or utilization review as normally obtained through the ... regulatory requirements. 6. Educates internal members of the health care team on case management and managed care concepts. Facilitates integration of concepts… more
- Brooks-TLC Hospital System, Inc (Dunkirk, NY)
- …years of recent clinical experience in acute care setting. Experience in discharge planning, case management , utilization review , and clinical pathways ... Case Mgmt/Utlization Review Job Description:RN Case Managers apply the Case Management... Case Managers participate in and drive the utilization review process for the hospital by… more
- Banner Health (Page, AZ)
- …and regulatory agencies. MINIMUM QUALIFICATIONS Must possess knowledge of case management or utilization review as normally obtained through the ... regulatory requirements. 6. Educates internal members of the health care team on case management and managed care concepts. Facilitates integration of concepts… more
- Spaulding Rehabilitation (Cambridge, MA)
- …Degree in related field. **Experience** Preferred * 3-5 years of related experience. * Case management , utilization review , or discharge planning ... setting is required. * Health plan experience in utilization review and case management will be considered. **Licensure** Required * Current,… more
- HCA Healthcare (Richmond, VA)
- …work experience in an acute care setting preferred. + Previous case management or utilization review experience preferred. CJW Medical Center ... finances and/or physical disabilities. + As a member of Case Management team you will provides crisis...payers and maintain legible documentation as directed by the Utilization Management Plan. **What qualifications you will… more