- Trinity Health (Mason City, IA)
- **Employment Type:** Part time **Shift:** Day Shift **Description:** **Position Purpose:** The Utilization Review Case Manager responsibilities include ... in the state of Iowa. + Bachelor's Degree required. BSN preferred + Utilization management focused certifications that are recognized in the state of Iowa preferred… more
- Providence (Kodiak, AK)
- …standards. The Case Manager /RN Navigator partners with the Utilization Review nurse, patients, physicians, and interdisciplinary team to ensure ... **Description** The Case Manager /RN Navigator is responsible for...needs for discharge planning, admission to swing bed and case management including utilization review … 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 ... in employment." **Job:** **Nursing* **Organization:** ** **Title:** *RN - Utilization Review Case Manager...**Nursing* **Organization:** ** **Title:** *RN - Utilization Review Case Manager * **Location:** *Virginia-Danville*… more
- Covenant Health (Nashua, NH)
- …policies and procedures. + Maintains/enhances professional development/skills required to function as a Utilization Review Case Manager + Completes all ... health care team. + Annual goals are achieved. + Attends pertinent case management/ utilization review programs to maintain current knowledge of UR practices.… more
- Trinity Health (Silver Spring, MD)
- …time **Shift:** **Description:** The Interim Manager of Care Management & Utilization Review , under the supervision and in collaboration with the Director, ... experience in an acute healthcare setting required, preferably with case management, utilization review or...trusted provider of health services within our community. A Manager at Holy Cross Hospital is expected to demonstrate… more
- Actalent (Little Rock, AR)
- …Qualifications/Requirements: 1 to 2 years of experience working as a Case Manager , RN Utilization review and discharge experience required Patient ... $2,200 a week! Day shift! No weekends! Location: Memphis, TN 13 week Case Manager Registered Nurse travel assignment! Paid time off 401K Match Medical, Dental… more
- Sharp HealthCare (San Diego, CA)
- …employer business practices. **What You Will Do** Perform admission and concurrent review of patients, based upon needs regardless of payor sources. Identifies ... health care practitioners involved in Admission & Triage, Discharge planning, and case management of chemical dependency patients. + AHA Basic Life Support for… more
- Ellis Medicine (Schenectady, NY)
- …by the Case Manager include, but are not limited to, utilization review , case management, care transition, collaboration with physicians and social ... SECTION I BASIC FUNCTION: The RN Case Manager has responsibility for ...inpatient experience in a hospital environment preferred. + Previous case management, utilization review , and… more
- Sharp HealthCare (San Diego, CA)
- …care nursing experience or case management experience + 3 Years recent case management, utilization review , care coordination experience + California ... Start Time** **Shift End Time** Master's Degree in Nursing; Bachelor's Degree in Nursing; Certified Case Manager (CCM) - Commission for Case Manager … more
- UNC Health Care (Raleigh, NC)
- **Description** **Full time on-site staff Utilization Manager ** Become part of an inclusive organization with over 40,000 diverse employees, whose mission is to ... through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical...of patient data and treatments. Communicates daily with the Case Manager to manage level of care… more
- Helio Health Inc. (Syracuse, NY)
- …to track, review , and analyze data relating to continuous quality improvement. The Utilization Case Manager will work on a Full-Timebasis supporting our ... issues. To support the mission of Helio Health, theUtilization Case Manager will enhance the program's efforts...Licensed/credentialed applicants preferred. + Two years of experience in utilization review in a hospital, health care,… more
- Prime Healthcare (National City, CA)
- …and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/180750/ case - manager -rn utilization ... to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity,...Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred.3. Five years acute care… more
- Prime Healthcare (Montclair, CA)
- …and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/181372/ case - manager -%28rn%29 utilization ... to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity,...Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred.3. Five years acute care… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Utilization Review Manager for...in the area of nursing practice assigned; in this case , acute care utilization review . ... internal and external regulatory and survey requirements. + The Utilization Review Manager collaborates with...review for medical and pharmacy claims. + Prepares case reports, summaries, or other related documents required to… more
- Prime Healthcare (Reno, NV)
- …Certification (CCM) preferred. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/183134/ case - manager -rn-union 10hr smrmc- utilization ... outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity of service… more
- Stanford Health Care (Palo Alto, CA)
- …Knowledge, Skills and Abilities** + Knowledge of principles and best practices of case management, utilization review , social work, care coordination and ... delivering evidence-based and patient-centered care. We are seeking a results-driven manager to further develop the framework for clinical, operational, and… more
- UCLA Health (Los Angeles, CA)
- …You can do all this and more at UCLA Health. Under the direction of the Utilization Management, Assistant Manager , you will play a key role in processing and ... vital role within a leading health organization. Help ensure smooth and efficient case management processes to support quality care. Take your expertise to the next… more
- BronxCare Health System (Bronx, NY)
- …prepare a response for submission in appeal. - In absence of Director, will review denial correspondence to determine validity of denial reason and course of action ... to be taken. - Maintains a working knowledge of InterQual Acute Level of Care Criteria in order to be able to apply to episode of care and utilize in the formulation of a strong appeal. - Identifies and monitors for patterns and trends in denial activity by… more
- Hackensack Meridian Health (Belle Mead, NJ)
- … of resources and benefits on a case by case basis. Applies case management and utilization review principles in monitoring the delivery of care and ... the care for a designated patient caseload. Collaborates with the attending LIP, Clinical Case Manager , nurse, and other members of the treatment team, ACCESS… more
- Munson Healthcare (Traverse City, MI)
- …team members, payers and external case managers Why work as a Utilization Review Specialist at Munson Healthcare? + Our dynamic work environment includes ... clinical status and progression of care. + Consults with case manager and/or physician advisor as necessary...+ Minimum of three years clinical experience required. Previous utilization review and/or case management… more