- Magellan Health Services (Boise, ID)
- …solutions that directly influence quality of care. General Job Information Title Care Manager ( UM /UR) - Remote, Idaho Licensed Grade 24 Work Experience - ... + Maintains an active work load in accordance with National Care Manager performance standards. + Works with community agencies as appropriate. Proposes alternative… more
- LifePoint Health (Las Cruces, NM)
- …local law./ **Job:** **Nursing* **Organization:** **Memorial Medical Center* **Title:** *RN Case Manager - UM - PRN* **Location:** *New Mexico-Las Cruces* ... Memorial Medical Center is a 199-bed hospital offering a spectrum of care, including diagnostic, therapeutic, and rehabilitative services, both on an inpatient and outpatient basis. *Where We Are:* From national parks and monuments to one of the top-rated… more
- Elevance Health (Durham, NC)
- …and depression, and insightful analytics to improve the delivery of care. **BH Care Manager I, UM /Crisis Line - North Carolina** Candidate must live AND be ... to 8 pm (EST) and Rotating Holiday coverage.** The **BH Care Manager I, UM /Crisis Line** is responsible for managing psychiatric and substance abuse health… more
- Elevance Health (FL)
- …necessary quality behavioral healthcare in a cost effective setting in accordance with UM Clinical Guidelines and contract. + Refers cases to Peer Reviewers as ... if all of the following criteria are met: performs UM approvals only, reviews requests for Applied Behavioral Analysis...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- Healthfirst (NY)
- …**Duties and Responsibilities:** + Responsible for developing clinical criteria, medical policies for provider administered medications, review of monthly reports for ... quality assurance, and staying current with literature, evidence-based medicine, and trends in medicine. + Work with prescribing physicians and Medical Directors to discuss clinical rationale for review decisions Supervises, evaluates, and coordinates daily… more
- The Cigna Group (Bloomfield, CT)
- …is a licensed professional with a background in the insurance industry as a care manager in a behavioral healthcare role, or an individual who has worked in a mental ... service as a mental health or chemical dependency counselor. As an Inpatient Care Manager at Evernorth, you will use your clinical knowledge and skills to evaluate… more
- Brighton Health Plan Solutions, LLC (New York, NY)
- …regarding their requests for preservice, prospective, and concurrent reviews. The Senior UM Coordinator reports to the Manager , Utilization Management and/or ... Plan Solutions provides Utilization Management services to its clients. Senior UM Coordinators facilitate utilization review by performing data collection, data… more
- UNC Health Care (Hendersonville, NC)
- …health and well-being of the unique communities we serve. Summary: The Utilization Manager ( UM ) assesses new admissions, continued stay and discharge review ... needs are met and care delivery is coordinated. The UM completes utilization reviews in accordance with federal regulations...patient data and treatments. Communicates daily with the Care Manager to manage level of care transitions & appropriate… more
- UNC Health Care (Raleigh, NC)
- …(EDD). Complete follow-up from CAPP as appropriate. As necessary meet with the Utilization Manager ( UM ) and SW after the meeting to discuss updates and action ... and well-being of the unique communities we serve. **Seeking full-time on-site RN Care Manager to work a variable schedule of 4- 10-hour days (Friday-Monday) or 3-… more
- UNC Health Care (Chapel Hill, NC)
- …(EDD). Complete follow-up from CAPP as appropriate. As necessary meet with the Utilization Manager ( UM ) and SW after the meeting to discuss updates and action ... functions of case management, utilization review and discharge planning. The Care Manager must be highly organized professional with great attention to detail,… more
- Sharp HealthCare (San Diego, CA)
- …System Integrated Care Management (ICM) team the Transfer and Admissions Utilization Manager ( UM ) partners with the Centralized Patient Placement Center (CPPC) ... (RN) - CA Board of Registered Nursing; Accredited Case Manager (ACM) - American Case Management Association (ACMA); Certified...and orientees under the direction of the ICM Centralized UM Leadership team. This position supports the 24/7 System… more
- LA Care Health Plan (Los Angeles, CA)
- …to the needs of LA Care's culturally diverse membership. The position supports the UM Manager /Director. This role also assists UM Educator/ Manager ... required to achieve that purpose. Job Summary The Supervisor of Utilization Management ( UM ) RN is responsible for executing the day-to-day operations of the UM… more
- McLaren Health Care (Detroit, MI)
- **Position Summary:** Responsible for providing assistance to the Utilization Manager ( UM ) RN in the coordination of patient admission and continued stay ... **Essential Functions and Responsibilities as Assigned:** 1. Collaborates with the UM RN to determine the appropriate hospital setting (inpatient vs. observation)… more
- Cleveland Clinic (Vero Beach, FL)
- Under the general supervision of the UM Team Manager , this individual performs UM activities which includes admission review, concurrent review, ... interaction and special projects which are coordinated and directed by the UM Team Manager . May design and initiate special projects as supervised by the Team… more
- LA Care Health Plan (Los Angeles, CA)
- …interaction to develop and implement a successful discharge plan. Works with the UM Manager and Physician Advisor on case reviews for pre-service, concurrent, ... cost cases and reports are maintained and referred to the Physician Advisor/ UM Director. Document in platform/system of record. Utilize designated software system to… more
- Sharp HealthCare (San Diego, CA)
- …to the position.Bring to attention of the Supervisor, Utilization Management Care Coordinators, and UM Manager , areas of UM non-compliance and provide input ... and employer business practices. **What You Will Do** The UM Care Coordinator, under the direct supervision of the...SCMG operation documents as appropriate for approval at the UM Care Coordinator level of review.Appropriately identify claims for… more
- Magellan Health Services (Hodge, LA)
- … UM and CM meetings as needed. + Audits and reviews case manager , Health guide, UM staff, vendor, and provider documentation and telephone interactions ... monitor established quality of care standards in the participating provider network, vendors, UM staff, Health Guides, and for case managers. + Assists in the… more
- Dignity Health (Northridge, CA)
- …insurance setting is required. + Certified Case Manager (CCM), Accredited Case Manager (ACM-RN), or UM Certification preferred. + Knowledge of managed care ... centers. Visit dignityhealth.org/northridgehospital (https://www.dignityhealth.org/socal/locations/northridgehospital) for more information. RN Case Manager (Care Coordinator) Case Manager Northridge Hospital… 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
- Catholic Health Initiatives (Roseburg, OR)
- …State of Oregon required. + BLS within 3 months of hire. + Certified Case Manager , Accredited Case Manager or UM Certification preferred. **Experience:** + ... Two (2) years acute hospital experience. A Master's degree in Case Management or Nursing is accepted in lieu of 1 year of experience. **Education:** + Associates degree in Nursing. BSN or bachelors in related healthcare field preferred. \#carecoordination… more
Related Job Searches:
Care Manager UM,
Case Manager UM,
Case Manager UM Discharge,
Manager,
RN Unit Manager UM,
UM Case Manager RN