- Stanford Health Care (Palo Alto, CA)
- …of care guidelines and utilization management principles. + Experience in case management , utilization review , or related healthcare roles. + ... onsite 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
- 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
- LifePoint Health (Bullhead City, AZ)
- …to promote continuity of care and cost effectiveness through the integrating and functions of case management , utilization review and management of ... ExperienceMinimum of five (5) years management experience, five (5) years of utilization review / case management experience in an acute short term… more
- Sharp HealthCare (Coronado, CA)
- …care nursing experience or case management experience. + 3 Years 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
- Trinity Health (Athens, GA)
- …and health care settings. ** Case Management :** Has overall responsibility of case management , utilization review , and transition planning across ... **Description:** **I.** **Position Summary:** **General:** Responsible and accountable for system-wide case management within St. Mary's Health Care System:… more
- HCA Healthcare (Anchorage, AK)
- …required. + 2+ years of supervisory experience preferred. + Certification in Case Management or Utilization Review preferred. + Ability to establish and ... the opportunity to apply your acute nursing experience and utilization review /discharge planning knowledge to effectively mentor...care facilitation, discharge planning functions and utilization management . + You will lead the Case … more
- Brighton Health Plan Solutions, LLC (New York, NY)
- About The Role BHPS provides Case Management / Utilization Review services to its clients. The Clinical Coordinator facilitates case Management by ... and data collection, entry and clinical screening assessments. The Case Management Department is supervised by the...acuity level and relay status to leadership team. + Review of risk stratification listings for CM candidates and… 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: Per Diem 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
- Sedgwick (Columbia, SC)
- …environment. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Accesses and assigns cases for medical case management , utilization review and clinical ... staff through the completion of components of the case management and utilization review process. + Schedules diagnostic tests and physician appointments… 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
- Banner Health (Sterling, CO)
- …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
- 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 (Greeley, CO)
- …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
- AdventHealth (Land O' Lakes, FL)
- …**The value you'll bring to the team:** . Oversee daily operations of the Case Management utilization review /discharge planning processes, including ... management position directly accountable to the Director of Case Management /Care Management for certain...for the daily operations of the Case Management Department inin accordance with the Utilization … more
- Covenant Health (Nashua, NH)
- …in-services are attended /documented. + Annual goals are achieved. + Attends pertinent case management / utilization review programs to maintain current ... medical necessity (whether based on initial or continuing stay review ) to determine whether a level of care change...Minimum of five years broad clinical experience preferred + Case management and/or Utilization … more
- HCA Healthcare (Davie, FL)
- …or 2 years of critical care experience** + **Certification in case management or utilization review preferred** + **InterQual experience preferred** ... appropriate resource utilization .** **PERFORMANCE EXPECTATIONS:** + **Provides case management services for both inpatient and...growth, we encourage you to apply for our RN Case Manager PRN opening. We promptly review … more
- HCA Healthcare (Denver, CO)
- …School of Nursing. Bachelor of Science Nursing preferred. Certification in case management or utilization review preferred** + **Three years' clinical, ... supporting a balance of optimal care and appropriate resource utilization **What you will do in this role:** +...**What you will do in this role:** + Provides case management services for both inpatient and… more
- McLaren Health Care (Detroit, MI)
- …Bachelor's degree in coding/medical records/billing or UM * Two years of case management or utilization review experience * Three years of recent ... **Department: Case Management ** **Hours per pay period:...patients, colleagues and community. 5. Performs concurrent and retrospective utilization management -related activities and functions to ensure… more
- LifePoint Health (Bullhead City, AZ)
- …based on their professional licensure Minimum Work ExperienceMinimum of 3-5 years in Case Management / Utilization Review X Preferred Required ... care, including admission, length of stay, transfer and discharge. Case Management is a collaborative process of...their comorbid diagnosis. Case Managers will complete the Utilization Review through InterQual or a similar… more