• Concurrent Review Nurse-( Auditor)- Metro, East,…

    InnovaCare (San Juan, PR)
    …passion and customer focus to the business. MMM Holdings, Inc.Job Description Inpatient Unit POSITION: Concurrent Review Nurse (CRN) POSITION DESCRIPTION Manages the ... inpatient utilization of healthcare resources and develops, coordinates and...compliance with the Plan's SNP policies and MOC requirements. Clinical staff who do not complete the required annual… more
    InnovaCare (10/16/24)
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  • Case Manager (LVN) - Utilization Mgmt - Sharp…

    Sharp HealthCare (San Diego, CA)
    …and employer business practices. **What You Will Do** The CMI performs clinical /medical necessity reviews and authorizes medical services that meet medical criteria. ... services on pre-certification requests, outpatient procedures, outpatient services, elective inpatient admissions, home health services, genetic testing, orthotics, prosthetics… more
    Sharp HealthCare (11/08/24)
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  • Educational Nurse Coordinator

    University of Michigan (Ann Arbor, MI)
    …evaluate, and modify as necessary nursing care programs in collaboration with the Clinical Nurse Specialist, Clinical Nurse Supervisor and Clinical ... independence, patient self-management and/or family care giving. * Provide clinical expertise in a consultative role to nursing staff....be current and directly related to the care of inpatient Medical and Surgical patient's in an acute care… more
    University of Michigan (11/07/24)
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  • Physician Advisor

    WMCHealth (Valhalla, NY)
    …for Utilization Management and Documentation strategies and processes. Responsibilities: + Reviews inpatient cases when clinical determinations cannot be made by ... aggregate denials/appeals with the Medical Director, peer, or the Clinical Review Supervisor . + Provides continuous education...and accurate manner. .Functions as a resource for initial clinical reviewers. + Serves on UM Committee… more
    WMCHealth (10/08/24)
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  • RN Case Manager: University Hospital (Care…

    University of Michigan (Ann Arbor, MI)
    …nursing management ( supervisor or higher); case management; demonstrated advancement in clinical career ladder (advancement from level C to level D or higher) ... physician, social worker and all members of the interdisciplinary team in the inpatient and emergency department patient care areas. The position is unique in that… more
    University of Michigan (11/08/24)
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  • On-site Phlebotomy Intermediate Manager

    University of Michigan (Ann Arbor, MI)
    …Manager Intermediate Healthcare, this candidate will oversee management of all inpatient phlebotomy teams, and outpatient medical campus phlebotomy blood draw ... with policies and procedures established either by the Laboratory Director or technical supervisor . 4. Keep staff informed of all new policies and modifications. 5.… more
    University of Michigan (10/18/24)
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  • Patient Services Intermediate

    University of Michigan (Ann Arbor, MI)
    …multiple appointment scheduling. + Schedule Pediatric Surgery patients for inpatient and outpatient surgical cases for the following locations/operating rooms: ... help meet patient and surgeon needs with respect to clinical care and productivity. + Advocate for patients and...and work groups as needed. + Develop, along with supervisor and scheduler colleagues, standard work flows and processes… more
    University of Michigan (10/29/24)
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