- Trinity Health (Silver Spring, MD)
- **Employment Type:** Full time **Shift:** **Description:** The Interim Manager of Care Management & Utilization Review , under the supervision and in ... in an acute healthcare setting required, preferably with case management , utilization review or closely...trusted provider of health services within our community. A Manager at Holy Cross Hospital is expected to demonstrate… more
- Stanford Health Care (Palo Alto, CA)
- …Skills and Abilities** + Knowledge of principles and best practices of case management , utilization review , social work, care coordination and discharge ... practice. Here, your leadership, coaching, and mentoring would further develop our robust, Utilization Management team. Are you driven by health care innovation,… more
- Beth Israel Lahey Health (Burlington, MA)
- …taking a job, you're making a difference in people's lives.** Joint role of Case Manager and Utilization Review Nurse Onsite at Lahey Hospital and Medical ... Manager for Hospital at Home Care Transitions coordinates utilization review , discharge planning and monitors quality...to ensure a timely process. Registered Nurses (RNs) with utilization review experience, case management … more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Utilization Review Manager for the Selikoff Centers for Occupational Health is responsible for the management of program ... medical records, and internal and external regulatory and survey requirements. + The Utilization Review Manager collaborates with multiple professionals to… 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 have ... harassment in employment." **Job:** **Nursing* **Organization:** ** **Title:** *RN - Utilization Review Case Manager * **Location:** *Virginia-Danville*… more
- Sharp HealthCare (San Diego, CA)
- …experience or case management experience + 3 Years recent case management , utilization review , care coordination experience + California Registered ... position requires the ability to combine clinical/quality considerations with regulatory/financial/ utilization review demands to assure patients are receiving… more
- Trinity Health (Mason City, IA)
- **Employment Type:** Part time **Shift:** Day Shift **Description:** **Position Purpose:** The Utilization Review Case Manager responsibilities include case ... nurse in the state of Iowa. + Bachelor's Degree required. BSN preferred + Utilization management focused certifications that are recognized in the state of Iowa… more
- Hackensack Meridian Health (Hackensack, NJ)
- …Hackensack UMC. These include but are not limited to utilization review , hospital reimbursement, clinical compliance, case management , and transitions of ... documentation iv. Target DRGs Reviews v. Use of case manager as a resource 4. Uses guidelines to evaluate...ie MCG, Xsolis) b. Supports & Participates in pre-admission review , utilization management , and concurrent… more
- Hackensack Meridian Health (Hackensack, NJ)
- …Hackensack UMC. These include but are not limited to utilization review ,** **hospital reimbursement, clinical compliance, case management , and transitions of ... documentation** **iv. Target DRGs Reviews** **v. Use of case manager as a resource** **4. Uses guidelines to evaluate...ie MCG,** **Xsolis)** **b. Supports & Participates in pre-admission review , utilization management , and concurrent… more
- Covenant Health (Bangor, ME)
- …supervision of the VP of Accountable Care Operations & Population Health Strategy the Utilization Review Case Manager will work collaboratively with other ... members of the healthcare team. The nurse case manager also acts as an advocate for the patient... conducts medical necessity reviews in accordance with the Utilization Management (UM) plan for patients that… more
- VNS Health (Manhattan, NY)
- …community-based settings. * Manages and evaluates staff in delivery and coordination of utilization management review services in compliance with CMS ... OverviewManages the utilization management team to ensure that...supervision. Compensation Range:$98,200.00 - $130,800.00 Annual * Reviews specific utilization issues or requests with Clinical Review … more
- Behavioral Center of Michigan (Warren, MI)
- …skills to help educate the staff and physicians regarding charting. REPORTS TO: Utilization Review Lead/ Manager QUALIFICATIONS: + High School Diploma or ... Under general supervision, the Utilization Review Coordinator provides professional assessment, planning, coordination, implementation and reporting of complex… more
- Hackensack Meridian Health (Belle Mead, NJ)
- …utilization of resources and benefits on a case by case basis. Applies case management and utilization review principles in monitoring the delivery of ... patient caseload. Collaborates with the attending LIP, Clinical Case Manager , nurse, and other members of the treatment team,...to the treatment team, Director of Utilization Management , and the Medical Director. + Review … more
- Munson Healthcare (Traverse City, MI)
- …the State of Michigan. + Minimum of three years clinical experience required. Previous utilization review and/or case management in a hospital or insurance ... assessment and critical thinking skills necessary to provide utilization review responsibilities. Superior organization and time management skills required;… more
- UNC Health Care (Chapel Hill, NC)
- …through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management staff to ... & the Hospitals? Utilization Management Plan. In addition, the Utilization Manager is responsible for revenue protection by reconciling physician orders,… more
- UCLA Health (Los Angeles, CA)
- …the next level. You can do all this and more at UCLA Health. As a Manager for Medicare Advantage Utilization Management , you'll provide direct management ... HMO environment + Thorough knowledge of health care industry, utilization review , utilization management...off-site meetings and conferences + ACM - Accredited Case Manager preferred + CCM - Certified Case Manager… more
- BayCare Health System (Clearwater, FL)
- …responsibility and clinical excellence. **BayCare Health System** is currently seeking a ** Utilization Review Specialist Senior** to join our outstanding and ... compassionate team. **The Utilization Review Specialist Senior responsibilities include:** +...+ Required RN (Registered Nurse) + Preferred ACM (Case Management ) + Preferred CCM (Case Manager ) **Education:**… 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 ... while ensuring compliance with all local, state and federal regulations governing utilization review activities and/or care management . Expected outcomes… more
- Elevance Health (Norfolk, VA)
- …PulsePoint locations. **Shift** : 4 weekdays and 1 weekend day as discussed with manager . The **Licensed Utilization Review II** is responsible for working ... **Title:** Licensed Utilization Review II **Location** : This...medically appropriate, quality, cost effective care throughout the medical management process. + Educates the member about plan benefits… more
- Sharp HealthCare (San Diego, CA)
- …while ensuring compliance with all local, state and federal regulations governing utilization review activities and/or care management . Expected outcomes ... Experience and understanding of federal and state regulations governing utilization management + Accredited Case Manager...grow individual competency and skillset in the area of utilization review , integrated care management … more
Related Job Searches:
Management,
Manager,
Manager Utilization Management,
Manager Utilization Review,
Review,
Utilization,
Utilization Management,
Utilization Manager,
Utilization Review