- 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 operations ... internal and external regulatory and survey requirements. + The Utilization Review Manager collaborates with...at Mount Sinai is ranked No. 14 nationwide in National Institutes of Health funding and in the 99th… more
- Trinity Health (Silver Spring, MD)
- …time **Shift:** **Description:** The Interim Manager of Care Management & Utilization Review , under the supervision and in collaboration with the Director, ... activities of hospital staff in inpatient care coordination and utilization review . Oversees interactions of staff with...trusted provider of health services within our community. A Manager at Holy Cross Hospital is expected to demonstrate… 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 ... in our community. Our hospital has a lower than national average patient ratio. Our team's approach to offering...in employment." **Job:** **Nursing* **Organization:** ** **Title:** *RN - Utilization Review Case Manager * **Location:**… more
- Stanford Health Care (Palo Alto, CA)
- …and Abilities** + Knowledge of principles and best practices of case management, utilization review , social work, care coordination and discharge planning. + ... delivering evidence-based and patient-centered care. We are seeking a results-driven manager to further develop the framework for clinical, operational, and… more
- Trinity Health (Mason City, IA)
- **Employment Type:** Part time **Shift:** Day Shift **Description:** **Position Purpose:** The Utilization Review Case Manager responsibilities include case ... in the state of Iowa. + Bachelor's Degree required. BSN preferred + Utilization management focused certifications that are recognized in the state of Iowa preferred… 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 are housed… more
- UNC Health Care (Chapel Hill, NC)
- **Description** Surgery, Women's, & Children's Utilization Manager **(part-time: 20 hrs/week)** + Weekends only (Saturday & Sunday) + 8:30a-6:30p + **No Nights** ... care episode through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management… more
- Sharp HealthCare (San Diego, CA)
- …position requires the ability to combine clinical/quality considerations with regulatory/financial/ utilization review demands to assure patients are receiving ... Degree in Nursing; Bachelor's Degree in Nursing; Certified Case Manager (CCM) - Commission for Case Manager ...case management experience + 3 Years recent case management, utilization review , care coordination experience + California… 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...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- Providence (Mission Hills, CA)
- **Description** Provide prospective, retrospective, and concurrent utilization reviews for our LA ministries. Conduct clinical reviews and review medical records ... strong clinical background combined with well-developed knowledge and skills in Utilization Management, medical necessity, and patient status determination. The … more
- Sharp HealthCare (San Diego, CA)
- …employer business practices. **What You Will Do** Perform admission and concurrent review of patients, based upon needs regardless of payor sources. Identifies ... will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a… more
- UNC Health Care (Hendersonville, NC)
- …the health and well-being of the unique communities we serve. Summary: The Utilization Manager (UM) assesses new admissions, continued stay and discharge ... in accordance with federal regulations and the health system's Utilization Review Plan. Responsibilities: * Uses approved...patient data and treatments. Communicates daily with the Care Manager to manage level of care transitions & appropriate… more
- Helio Health Inc. (Syracuse, NY)
- …degree preferred. + Licensed/credentialed applicants preferred. + Two years of experience in utilization review in a hospital, health care, or managed care ... of federal and state regulations applicable to treatment and reimbursement. + Utilization review procedures and techniques. Our Comprehensive Employee Benefits… more
- UCLA Health (Los Angeles, CA)
- …+ experience in an HMO environment + Thorough knowledge of health care industry, utilization review , utilization management, and concurrent review ... all this and more at UCLA Health. As a Manager for Medicare Advantage Utilization Management, you'll...following major functions: + Pre-service Authorizations/Denial Letters + Concurrent Review + Continuity of Care + Retro Claims +… more
- US Tech Solutions (Columbia, SC)
- …mental health/chemical dependency, orthopedic, general medicine/surgery. OR, 4 years utilization review /case management/clinical/or combination; 2 of 4 years ... promote quality, cost effective outcomes. Performs medical or behavioral review /authorization process. Ensures coverage for appropriate services within benefit and… more
- Mount Sinai Health System (New York, NY)
- **Job Description** ** Utilization Review Admission Specialist (OR Scheduler), Operating Room Surgical Scheduling, Mount Sinai West - Full Time, Days** The ... Utilization Review Specialist coordinates scheduling of all...operating room procedures. Seeks the assistance of the Nurse Manager in identifying cases, which require pre admission screening… more
- Prime Healthcare (Garden City, MI)
- …With Us! (https://careers-primehealthcare.icims.com/jobs/182009/discharge-planner utilization - review /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) ... based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic… more
- Sharp HealthCare (San Diego, CA)
- …of the System Integrated Care Management (ICM) team the Transfer and Admissions Utilization Manager (UM) partners with the Centralized Patient Placement Center ... and internal transfer requests and direct admission requests. This position supports utilization review functions to ensure appropriate patient status and… more
- Holcim US (Houston, TX)
- Carbon Capture Utilization Storage Integration Manager Requisition ID: 9456 Location: Houston, TX, US, 77547 Pay Type: Salary Travel Requirement: 31-40% **ARE ... Aggregates and Solutions & Products. Description: **ABOUT THE ROLE** The Carbon Capture Utilization and Storage Integration Manager will report to the Senior… more
- Sharp HealthCare (San Diego, CA)
- …Management (ICM) team the Per Diem RN (Adv CN)-Unit A4 position supports utilization review functions to ensure appropriate patient status before the patient ... while ensuring compliance with all local, state and federal regulations governing utilization review activities and/or care management. Expected outcomes include… more
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