- CHRISTUS Health (Wake Village, TX)
- …two (2) years' experience in Case Management and/or Utilization Management is required. Licenses, Registrations, or Certifications RN License in the ... Description Summary: The Registered Nurse Clinical Care Coordinator is...errors are identified to maximize hospital reimbursement and resource utilization . * Responsible for 24/7 ongoing management … more
- CHRISTUS Health (Tenneryville, TX)
- …and operations for assigned areas; at CHRISTUS GSMC - Longview. 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
- CHRISTUS Health (Hollywood Park, 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
- 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
- Penn State Health (Hershey, PA)
- …Manager Utilization Management - DAY SHIFT - Utilization Management **Location** US:PA: Hershey | Registered Nurse | Full Time **Req ID** null ... OF POSITION:** Position is responsible to thoroughly understand all Utilization Management regulatory requirements for both CMS...nursing required + Currently licensed to practice as a registered nurse by Pennsylvania Board of … more
- 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
- 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
- Elevance Health (Tampa, FL)
- …with health plans for people enrolled in Medicaid and/or Medicare programs in Florida. ** Manager I Utilization Management ** **Location:** 11430 NW 20th ST, ... workplace model with PulsePoint sites used for collaboration, community, and connection. The ** Manager I Utilization Management ** is responsible for the… more
- 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
- 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
- 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
- Prime Healthcare (Weslaco, TX)
- …#rnheros #rnweekendstaff #casemanagement Connect With Us! (https://careers-primehealthcare.icims.com/jobs/183021/ registered - nurse -case- manager utilization ... Overview KNAPP MEDICAL CENTER IS LOOKING FOR A PRN REGISTERED NURSE CASE MANAGER TO WORK WEEKENDS. WE OFFER: + Competitive PRN Compensation + Medical… more
- 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
- 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
- Prime Healthcare (Montclair, CA)
- …and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/181372/case- manager -%28rn%29 utilization - management ... an accredited school of nursing and a current state Registered Nurse license.2. Grandfathered prior to April...Of Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred.3. Five years acute… more
- 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
- 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
- Guthrie (Cortland, NY)
- …safe discharge, based on assessed needs and available resources. The Acute Case Manager also performs Utilization Management throughout the continuum of ... This is an integrated Case Management and Utilization Review position. The Acute Care Case Manager...degree in addition to a degree in Nursing. A registered nurse with five (5) years relevant… more
- 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
- Trinity Health (Ann Arbor, MI)
- …clinical, age specific, developmental, cultural and spiritual needs. Facilitates utilization management documentation and appropriate communication with external ... knowledge of rules, regulations, policies, and procedures related to utilization management work processes and criteria. +...completion of home care planning as requested by Case Manager . + Supports Social Work & Case Management… more
