- Fresenius Medical Care (Olmito, TX)
- …Preparedness Plan; ensure maintenance of equipment . Ensure proper medical records management and HIPAA compliance . Oversees the continuous and data driven Quality ... and policies, and then developing and implementing an associated center specific management plan. . Ensure adverse events are reported, documented and necessary… more
- Beth Israel Lahey Health (Plymouth, MA)
- …you're making a difference in people's lives.** Full Time **Job Description:** ** Utilization Review & Denials management manager - Full Time** **Who We ... and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager , you will:** + Directs staff performance regarding UR and… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- *_SUMMARY:_* We are currently seeking a* Utilization Review Manager * to join ourTransitional Care Team.This is a full-time role and will be required to work ... utilization of resources, coordination of payer communication, and utilization review and management . Responsible...required or completed within three years of hire **Title:** * Manager - Utilization Review * **Location:**… more
- Huron Consulting Group (Chicago, IL)
- …Join our team as the expert you are now and create your future. The Manager of Utilization Management is responsible for planning, organizing, developing, ... Review Plan and the overall operation of the Utilization Management Department in accordance with federal,...and may be implemented in the future._ **Position Level** Manager **Country** United States of America At Huron, we're… more
- UNC Health Care (Raleigh, 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
- Logan Health (Kalispell, MT)
- …lead the way as our Manager of Clinical Documentation Integrity (CDI) & Utilization Review ! This role is ideal for a collaborative RN leader who understands ... workflows with clarity. What You'll Be Doing: As the Manager of CDI & Utilization Review...with the Chief Medical Officer on utilization review initiatives, length of stay management , and… more
- Cedars-Sinai (Los Angeles, CA)
- …more about you and your skills! **What will you be doing in this role?** The Utilization Review Case Manager validates the patient's placement to be at the ... ID** : 14141 **Working Title** : Registered Nurse - Utilization Review Case Manager -...- PER DIEM - 8 Hour Days **Department** : Utilization Management **Business Entity** : Cedars-Sinai Medical… more
- Children's Mercy Kansas City (Kansas City, MO)
- …development of, and training oversight of programs and services. Responsible for effective utilization review and proper resource management of patients, ... quality, and Lean process improvements, and facilitating the quarterly Utilization Review Committee meetings. Provides evidence based...of hire + One of the following: American Case Management , Certified Case Manager required upon hire… more
- Intermountain Health (Las Vegas, NV)
- … Manager of Care Management I leads and collaborates with care management operations across utilization review , acute and emergency department care, ... with compliance and legal to support care delivery. The Manager Care Management I reports to the...+ Previous management experience in hospital care management , utilization review , ambulatory care… more
- Houston Methodist (Houston, TX)
- …+ Five years of hospital clinical nursing experience, which includes three years in utilization review and/or case management **LICENSES AND CERTIFICATIONS - ... At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position...to physicians, nurses, and other health care providers on utilization management topics. + Initiates improvement of… more
- CVS Health (Baton Rouge, LA)
- …And we do it all with heart, each and every day. **Position Summary** The Utilization Management Manager of Prior Authorization oversees a team of clinical ... Lead, coach, and develop a multidisciplinary team responsible for utilization review , prior authorization, and case management functions. + Monitor team… more
- Highmark Health (Harrisburg, PA)
- …Highmark Inc. **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of ... + Experience in UM/CM/QA/Managed Care + Medical/Surgical experience + Utilization Management (UM) or (UR) Utilization Review experience **LICENSES AND… 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
- Hartford HealthCare (Willimantic, CT)
- …Works under the direction of the Manager of Continuing Care and Utilization Management and in collaboration with physicians, social services, and other ... * Three years clinical nursing required. * Two years experience with case management , discharge planning, utilization review and/or home care required.… more
- Tenet Healthcare (Detroit, MI)
- RN Utilization Review - Case Management - 2506004107 Description : Join our dedicated healthcare team where compassion meets innovation! As a Registered ... for case management scope of services including: Utilization Management services supporting medical necessity and...level of care Mentor and monitor work delegated to Utilization Review LVN/LPN and/or Authorization Coordinator as… more
- Dallas Behavioral Healthcare Hospital (Desoto, TX)
- The Utilization Review Case Manager is responsible for working with insurance companies and managed care systems for the authorization, concurrent and ... access the full range of their benefits through the utilization review process. + Conducts admission reviews....degree such as nursing, social work, psychology, health information management or other related healthcare field is preferred or… more
- Cedars-Sinai (Los Angeles, CA)
- …Motions, Eye/Hand/Foot Coordination **Req ID** : 14355 **Working Title** : Registered Nurse - Utilization Review Case Manager - 8 Hour Days **Department** ... one of America's Best Hospitals. Summary of Essential Duties: + The Utilization Management (UM) Registered Nurse - Medicare Short Stay & Concurrent Denials… more
- Sanford Health (Rapid City, SD)
- …time **Weekly Hours:** 40.00 **Department Details** Join our team as a Utilization Review and Case Management Manager and lead a high-impact, data-driven ... experience as a case manager preferred. One year of leadership/ management experience preferred. Experience in medical necessity review preferred. Currently… more
- Baystate Health (Springfield, MA)
- …Minimum - Midpoint - Maximum $46.22 - $53.13 - $62.85 **Per Diem Hospital Case Manager / Utilization Management ** The **RN Hospital Case Manager ** ... of a designated population of patients. The Hospital Case Manager is responsible for overseeing an efficient plan that...+ Requires a working knowledge of community resources and Utilization /Quality Review standards and activities conducted by… more
- LifeCenter Northwest (Bellevue, WA)
- …- $159,600.00 Salary Position Type Full Time Description and Qualifications The Manager , Organ Utilization (OUM) provides strategic leadership and operational ... results and identify areas for improvement. + Partner with the Organ Utilization Program Manager (OUPM) on OUCT staffing, onboarding, competency development,… more
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