- Dignity Health (Northridge, CA)
- …insurance setting is required. + Certified Case Manager (CCM), Accredited Case Manager (ACM-RN), or UM Certification preferred. + Knowledge of ... care centers. Visit dignityhealth.org/northridgehospital (https://www.dignityhealth.org/socal/locations/northridgehospital) for more information. RN Case Manager (Care Coordinator) Case … more
- Integra Partners (Troy, MI)
- …educator to join our Operations Training & Development team as an Operations UM Training Specialist, specializing in Utilization Management ( UM ) processes. The ... of the Operations training and development program. The Operations UM Training Specialist will work in collaboration with Operations...but are not limited to: + Works with the Manager of Operations Training to develop an end-to-end training… more
- Elevance Health (Norfolk, VA)
- …necessary quality behavioral healthcare in a cost effective setting in accordance with UM Clinical Guidelines and contract. + Refers cases to Peer Reviewers as ... and substance abuse or substance abuse disorder assessment coordination implementation case planning monitoring and evaluating to promote quality member outcomes to… more
- Apex Health Solutions (Houston, TX)
- Summary: The UM Reviewer serves as a contact and resource person to Health Solutions' members for the utilization review (UR) of healthcare services. The UM ... or issues arise. To support care management initiatives, the UM Reviewer should also identify enrollees in need of... Reviewer should also identify enrollees in need of case /disease management services so that proactive interventions can occur.… more
- Sutter Health (Sacramento, CA)
- …clinical, legal, Risk, Ethics and regulatory and reimbursement issues to case managers, physicians, and external entities. * Provides guidance to Utilization ... of recent relevant experience. 2 years experience in Utilization Management ( UM ) and Clinical Denial Management Preferred **SKILLS AND KNOWLEDGE:** Knowledge of… more
- Molina Healthcare (Columbus, OH)
- …medications safety and medication use policies). **KNOWLEDGE/SKILLS/ABILITIES** The Pharmacist, UM will be responsible for reviewing coverage determinations and ... in a timely, compliant, and accurate manner. The Pharmacist, UM will also be responsible for serving as a...changes for the upcoming year. + Works with the Case Management department as part of a member-centered interdisciplinary… more
- Catholic Health Initiatives (Roseburg, OR)
- …within 30 days of hire + Certified Case Manager (CCM), Accredited Case Manager (ACM-RN) or UM Certification preferred Experience: + 2 years acute ... hospital experience. A Master's degree in Nursing or Case Management may be substituted for 1 year of...experience. + 5 years of nursing experience preferred + Case Management experience preferred Education: + Bachelor's degree in… more
- Dignity Health (Phoenix, AZ)
- …state RN License Preferred: + Certified Case Manager (CCM), Accredited Case Manager (ACM-RN), or UM Certification Training: + Knowledge of managed ... acute hospital clinical experience or a Masters degree in Case Management or Nursing field in lieu of 1...with multiple stakeholders + Understand how utilization management and case management programs integrate. + Ability to work as… more
- Dignity Health (Long Beach, CA)
- …(5) years of nursing experience. + Certified Case Manager (CCM) Accredited Case Manager (ACM-RN) or UM Certification preferred + Knowledge of managed ... acute hospital clinical experience or a Masters degree in Case Management or Nursing field in lieu of 1...Professional communication skills. + Understand how utilization management and case management programs integrate. + Ability to work as… more
- Virginia Mason Franciscan Health (Seattle, WA)
- …(5) years of nursing experience. + Certified Case Manager (CCM), Accredited Case Manager (ACM-RN), or UM Certification preferred + Able to apply ... acute hospital clinical experience or a Masters degree in Case Management or Nursing field in lieu of 1...Professional communication skills. + Understand how utilization management and case management programs integrate. + Ability to work as… more
- Dignity Health (Los Angeles, CA)
- …years of nursing experience. + Certified Case Manager (CCM), Accredited Case Manager (ACM-RN), or UM Certification preferred + Knowledge of managed ... acute hospital clinical experience or a Masters degree in Case Management or Nursing field in lieu of 1...Professional communication skills. + Understand how utilization management and case management programs integrate. + Ability to work as… more
- Virginia Mason Franciscan Health (Burien, WA)
- …within hospital Preferred + Certified Case Manager (CCM), Accredited Case Manager (ACM-RN), or UM Certification preferred \#LI-VMFH* **Pay Range** ... two (2) years of acute hospital clinical experience or a Masters degree in Case Management or Nursing field in lieu of 1 year experience. Preferred + Bachelor's… more
- Virginia Mason Franciscan Health (Federal Way, WA)
- …within hospital Preferred + Certified Case Manager (CCM), Accredited Case Manager (ACM-RN), or UM Certification preferred **Pay Range** $48.84 ... two (2) years of acute hospital clinical experience or a Masters degree in Case Management or Nursing field in lieu of 1 year experience. Preferred + Bachelor's… more
- Lakeview NeuroRehabilitation Center (Waterford, WI)
- …a member of the Case Management Team, consisting of the Lead Case Manager , the MD Chair of the UM committee, the Medical Social Worker, and other ... The Scope of Practice for the RN Case Manager includes responsibility for management of the assigned patient population through multidisciplinary team… more
- Houston Methodist (Baytown, TX)
- At Houston Methodist, the Manager Case Mgmt Social Svcs position is responsible for functional and operational aspects of the Case Mgmt./Social Work ... corporate and hospital administrators, medical staff, and defined customers related to the Case Mgmt. system. The Manager Case Mgmt./Social Work position… more
- ERP International (Camp Pendleton, CA)
- **Overview** ERP International, LLC is seeking a **Registered Nurse - Case Manager ** for a full-time position supporting **Branch Health Clinic Port Hueneme, ... for community resources. * Integrate CM and utilization management ( UM ) and integrating nursing case management with...for professional growth and development as related to the case manager position and maintenance of CM… more
- Omaha Children's Hospital (Omaha, NE)
- …team to assess for diagnosis, care needs, and discharge plans. + Introduces Nurse Case Management (NCM) role to family. + Completes NCM assessment and documents in ... policies. + Communicates and collaborates with the Utilization Management ( UM ) Nurse, or other NCMs as necessary to provide...and placement, as applicable. + Monitors system to report case management outcomes and works as a change agent… more
- University of Michigan (Ann Arbor, MI)
- RN CASE MANAGER : University Hospital (Care Management) Apply Now **Job Summary** The RN Case Manager assesses, develops, implements, coordinates and ... effective utilization of resources while promoting quality outcomes. **Organizational Relationships** The RN Case Manager reports directly to the Manager of… more
- LifePoint Health (Hickory, NC)
- Job Summary Manager of Case Management in the departments activities and resources to achieve departmental and organizational objectives and will take the lead ... well in a team environment. **Job:** **Nursing* **Organization:** ** **Title:** * Manager of Case Management* **Location:** *NC-Hickory* **Requisition ID:**… more
- Covenant Health (Nashua, NH)
- …and duplication of care and enhancing quality, cost-effective clinical outcomes. The RN Case Manager works closely with, and delegates care to, the High-Risk ... procedures. + Maintains/enhances professional development/skills required to function as a Case Manager and fulfills organizational requirements (ie, data entry,… more