• CHRISTUS Health (Alamo Heights, TX)
    …and operations for assigned areas; at CHRISTUS St. Patrick Hospital. The nurse manager affects departmental outcomes through interpretation, implementation, and ... excellence in patient care, patient experience and patient outcomes. Effectively manages utilization of staff and material resources so that the most therapeutically… more
    JobGet (11/05/24)
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  • Prisma Health (Columbia, SC)
    …Degree in Nursing. BSN preferred.One year experience as a registered nurse .Required Licensure/Registrations/CertificationsLicensed to practice as a ... and/or all the nursing units within the scope of RN practice. This scope includes medical-surgical, telemetry, progressive and...Registered Nurse in South CarolinaIn Lieu Of The Above Minimum… more
    JobGet (11/01/24)
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  • Prisma Health (Greenville, SC)
    …and utilization of unit resources. Shares accountability with Nurse Manager for unit/department/organizational goal achievement.Assists in planning, ... health. Serve with compassion. Be the difference.Job SummaryIn collaboration with the nurse manager , supervises staff and unit operations and provides direct… more
    JobGet (11/01/24)
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  • Manager , Utilization

    Humana (Salem, OR)
    …a part of our caring community and help us put health first** The Manager , Utilization Management Nursing utilizes clinical nursing skills to support ... communication of medical services and/or benefit administration determinations. The Manager , Utilization Management Nursing works...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) in the… more
    Humana (10/29/24)
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  • Manager , Utilization

    Commonwealth Care Alliance (Boston, MA)
    …care services,procedures, and facilities under the provisions of CCA's benefits plan.The Manager , Utilization Management is responsible for overseeing and ... managing the daily operation of the Utilization Management Review Nurse and...in the area of service decisions and organizational determinations.The Manager , Utilization Management reports to… more
    Commonwealth Care Alliance (10/04/24)
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  • Manager , Utilization

    Providence (Mission Hills, CA)
    **Description** The Manager of Utilization Management provides a key role in leading, facilitating and managing the hospital utilization management ... The Manager assists the Regional Director of Utilization Management , Appeals & Clinical Training through...related area + Upon hire: California Registered Nurse License + 5 years Healthcare management more
    Providence (11/04/24)
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  • Associate Manager - Duals…

    CVS Health (Springfield, IL)
    …**Position Summary:** The Associate Manager is responsible for oversight of Utilization Management /Case Management staff. This position is responsible ... department + 3+ years inpatient clinical experience as a Registered Nurse + 3+ years of Managed...years of Managed Care experience + 1+ years of Utilization Management experience + 1+ year Leadership… more
    CVS Health (10/26/24)
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  • Interim Manager - Case Management

    Trinity Health (Silver Spring, MD)
    …travel paid._** **Minimum Licensure/Certification Required (if applicable):** + State of Maryland license as a Registered Nurse + RN with BSN or RN with ... time **Shift:** **Description:** The Interim Manager of Care Management & Utilization Review, under the supervision and in collaboration with the Director,… more
    Trinity Health (10/10/24)
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  • Utilization Management

    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 ... a self-motivated, detail-oriented, service-driven leader with: + Current unrestricted RN licensure in CA required + Bachelors of Science,...(BSN) degree required + Five or more years of utilization management required + Four or more… more
    UCLA Health (08/23/24)
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  • Manager Utilization

    Corewell Health (Grand Rapids, MI)
    …+ 5 years of relevant clinical experience in acute care or office setting + LIC - Registered Nurse ( RN ) from the State of Michigan upon hire Preferred + 5 ... Job Summary Effectively leads and motivates the Utilization Management team to ensure the goals and standards of the department are being met. This position is… more
    Corewell Health (11/01/24)
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  • Manager , Utilization Licensed…

    Humana (Columbus, OH)
    …a part of our caring community and help us put health first** The Manager , Utilization Management Behavioral Health utilizes behavioral health knowledge and ... and communication of medical services and/or benefit administration determinations. The Manager , Utilization Management Behavioral Health works within… more
    Humana (10/29/24)
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  • SRS-Inpatient Case Manager II…

    Sharp HealthCare (San Diego, CA)
    …Certified Case Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse ( RN ) - CA Board of Registered Nursing ... experience + 3 Years recent case management , utilization review, care coordination experience + California Registered Nurse ( RN ) - CA Board of… more
    Sharp HealthCare (10/30/24)
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  • Utilization Management Specialist NE

    Cleveland Clinic (Vero Beach, FL)
    Manager . May design and initiate special projects as supervised by the Team Manager . Utilization Management Specialist Join our team at Cleveland Clinic ... of the most respected healthcare organizations in the world. Utilization Management (UM) Specialists perform UM activities,...of professional nursing. + Current state licensure as a Registered Nurse ( RN ). + Basic… more
    Cleveland Clinic (10/31/24)
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  • Manager II Behavioral Health Services…

    Elevance Health (FL)
    **JR133557 Manager II Behavioral Health Services ( Utilization Management for Behavior Analysis Services)** Responsible for Behavioral Health Utilization ... Candidate will be responsible for the oversight of the utilization management team. + Responsible for a...ALL FUNCTIONS: Requires current, active, unrestricted license such as RN , LCSW (as applicable by state law and scope… more
    Elevance Health (11/02/24)
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  • RN Utilization Manager - Care…

    UNC Health Care (Smithfield, NC)
    …through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management staff to ... Utilization Management Plan. In addition, the Utilization Manager is responsible for revenue protection...date. **Licensure/Certification Requirements:** * Licensed to practice as a Registered Nurse in the state of North… more
    UNC Health Care (10/11/24)
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  • RN Manager - Care Management

    Trinity Health (Silver Spring, MD)
    …MD **Description:** + Full-Time 8am - 4:30pm + Reporting to the Director of Care Management + The RN Manager is responsible and accountable for the ... will need:** + State of Maryland license as a Registered Nurse + BSN required; MSN Degree...required. + Extensive knowledge of payer mechanisms and clinical utilization management is required **Preferred:** + At… more
    Trinity Health (08/29/24)
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  • Appeals Manager , Department…

    BronxCare Health System (Bronx, NY)
    …special projects and committees as determined by Director. Qualifications CERTIFICATION/LICENSURE : Registered Nurse or physician or a foreign medical graduate ... and implementation of educational programs for Denial Prevention and Management . Responsibilities - Establish and maintain positive relationships with patients,… more
    BronxCare Health System (09/18/24)
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  • Utilization Management Plan…

    AmeriHealth Caritas (Dublin, OH)
    ** Utilization Management Plan Oversight Manager (Ohio Resident)** Location: Dublin, OH Primary Job Function: Medical Management ID**: 37872 **Job Brief** ... Officer for the Ohio Market, this position is representing Utilization Management (UM) in state interactions/audits, validation...RN license in OH. + 3+ years of utilization /case management experience in relevant scope preferred,… more
    AmeriHealth Caritas (09/21/24)
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  • Per Diem RN - Utilization

    Sharp HealthCare (San Diego, CA)
    …Certified Case Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse ( RN ) - CA Board of Registered Nursing; ... clinical experience as defined by the CBA. + California Registered Nurse ( RN ) - CA...Experience and understanding of federal and state regulations governing utilization management + Accredited Case Manager more
    Sharp HealthCare (11/02/24)
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  • Registered Nurse RN Case…

    HCA Healthcare (Richmond, VA)
    …at Chippenham Hospital have the opportunity to make a real impact. As a Registered Nurse RN Case Manager you can be a part of change. **Benefits** ... by location._ We are seeking a Registered Nurse RN Case Manager for...experience in a hospital setting preferred.** + **Previous case management or utilization review experience preferred.** CJW… more
    HCA Healthcare (08/22/24)
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