- Commonwealth Care Alliance (Boston, MA)
- 013650 CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management (UM) ... review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key...accurate documentation of clinical decisions and works with UM Manager to ensure consistency in applying policy + Works… more
- University Health (Pleasanton, TX)
- …Staff nurse II or above). Work experience in case management, utilization review or hospital quality is preferred. LICENSURE/ CERTIFICATIONS Current ... POSITION SUMMARY/RESPONSIBILITIES The nurse case manager coordinates, in collaboration with the patient and interdisciplinary team, the treatment/ plan of care… more
- Heart Hospital of Austin (Pflugerville, TX)
- …to you, we encourage you to apply for our Registered Nurse Case Manager opening. Our team will promptly review your application. Highly qualified candidates ... in their positions. Join our Team as a(an) Registered Nurse Case Manager and access programs to...supporting a balance of optimal care and appropriate resource utilization . You will provide case management services for both… more
- Christus Health (Euless, TX)
- …in CHRISTUS RN Care Manager I position. Case management and Utilization Review experience preferred. Licenses, Registrations, or Certifications RN License in ... the information that follows below. Summary: The RN Care Manager (CM) II works with physicians and multidisciplinary team...patient need, manage length of stay and promote efficient utilization of resources to include the facilitation of patient… more
- Battelle Memorial Institute (Colorado Springs, CO)
- …within legal and professional parameters + Knowledge and skill in using pre-established utilization review criteria to recognize and report actual or potential ... (HRA) business line is seeking a highly motivated, full-time ** Nurse Case Manager ** to join our team...programs for equal treatment of all staff and full utilization of all qualified employees at all levels within… more
- Christus Health (San Antonio, TX)
- …Medicare GMLOS by managing per Milliman/Interqual Care Guidelines. Resource/ Utilization Management/appropriateness: Assess assigned patient population for medical ... Proactively refers cases to physician adviser for P2P, medical necessity review , and denail avoidance. Demonstrates and maintains current knowledge of regulatory… more
- HCA HealthONE Rose (Denver, CO)
- …satisfaction and personal growth, we encourage you to apply for our Clinical Nurse Coordinator Inpatient Surgery opening. We promptly review all applications. ... Nurses! Introduction Do you have the career opportunities as a(an) Clinical Nurse Coordinator Inpatient Surgery you want with your current employer? We have… more
- Greenspring Village by Erickson Senior Living (Springfield, VA)
- Location: Greenspring Village by Erickson Senior Living Join our team as the Nurse Manager , RN also known as the Clinical Manager ! The Clinical Manager ... leadership meetings such as Wound Rounds, Clinical Operations Meeting, Utilization Review , and Performance Improvement/Risk Management/Safety (PI/RM/S) Committee… more
- ChristianaCare (Newark, DE)
- RN Case Manager - Weekender - Day Shift Saturday & Sunday (Plus one rotating Friday shift). Newark, DE ChristianaCare - Wilmington Hospital is currently recruiting ... an RN Case Manager - Weekender with experience in Transitional Care or...Worker - Resolves psycho-social barriers and supports discharge needs. Utilization Management - Reviews patient status for appropriateness and… more
- Katmai (Fort Carson, CO)
- … as needed to provide direction in care management. + Plan and prioritize utilization review (UR) activities to ensure identified patient needs are addressed ... record data. + Facilitate the development and integration of utilization management (UM) review policies and procedures...last two (2) years as a practical or vocational nurse . + Current, full, active, and unrestricted license as… more
- ERP International (Luke AFB, AZ)
- …Case Management Society of America (CMSA); American Accreditation Healthcare Commission/ Utilization Review Accreditation Commission (URAC); CAMH; (AAAHC); Health ... Current, full, active, and unrestricted license to practice as a Registered Nurse , any state. Clinical Certification:** Certified Case Manager by Commission… more
- Stanford Health Care (Palo Alto, CA)
- …responsibilities include coordinating all facets of a patient's admission/discharge; performing utilization review activities, including review of patient ... Health Care (SHC)? Are you a seasoned RN Case Manager ? Here is your opportunity to work with the...interdisciplinary team members; arranges followup care as appropriate. + Utilization Review -- Reviews prospectively, concurrently and… more
- Valley Health System Consolidated Services (Las Vegas, NV)
- …minimum three years experience in varied clinical settings. Two years experience in Utilization Review , Utilization Management or Case Management preferred. ... establishing a safe, individualized discharge and providing proficient timely utilization management services to ensure that maximum reimbursement is...Has a current license to practice as a Registered Nurse in the State of Nevada. Other: Must be… more
- University of New Mexico - Hospitals (Willard, NM)
- …patient responses to interventions in collaboration with quality assurance and utilization review , maintaining interdependent follow-up as necessary * VARIANCE ... Case Manager RN Sign-on Bonus and Relocation Reimbursement available!...are achieved within established time frames and with efficient utilization of resources. Conduct initial and ongoing assessments, initiate… more
- Valley Health System Consolidated Services (Las Vegas, NV)
- …minimum three years experience in varied clinical settings. Two years experience in Utilization Review , Utilization Management or Case Management preferred. ... establishing a safe, individualized discharge and providing proficient timely utilization management services to ensure that maximum reimbursement is...Has a current license to practice as a Registered Nurse in the State of Nevada. Other: Must be… more
- Stanford Health Care (Palo Alto, CA)
- …responsibilities include coordinating all facets of a patient's admission/discharge; performing utilization review activities, including review of patient ... provide requested clinical and psychosocial information to assurereimbursement. + Utilization Review -- Reviews prospectively, concurrently and retrospectively… more
- University of New Mexico - Hospitals (Albuquerque, NM)
- …patient responses to interventions in collaboration with quality assurance and utilization review , maintaining interdependent follow-up as necessary * VARIANCE ... limited to experience, education, and other business and organizational considerations. Department: Utilization Management - UH Read on to fully understand what this… more
- Life Care Center of Post Falls (Post Falls, ID)
- …of clinical experience in post-acute care setting preferred Prior case management, utilization review , and discharge planning experience preferred Specific Job ... Position Summary The Care Manager Assistant - LPN assists with the coordination...Currently licensed/registered in applicable State. Must maintain an active nurse (LPN) license in good standing throughout employment. One… more
- UNIVERSITY HEALTH (San Antonio, TX)
- …that promotes Healthcare Effectiveness Data and Information Set (HEDIS) metrics, Utilization Review Accreditation Commission (URAC), and the Joint Commission ... SUMMARY/RESPONSIBILITIES Works under the direct supervision of the Coding Education & Audit Manager . Will perform any or a combination of the following types of… more
- Stony Brook University (Stony Brook, NY)
- …Department may include the following but are not limited to:** + Completes Utilization review screen for inpatient and observation cases. Activity includes UR ... RN Case Manager **Position Summary** At Stony Brook Medicine, a...cases for authorization for in patient stay. + Staff review short stay, long stay and complex cases to… more
