- Dartmouth Health (White River Junction, VT)
- …Case Manager - Home Health Full Time, Days Why work as a Utilization Review Case Manager at Visiting Nurse and Hospice for Vermont and New Hampshire? ... CT, MA, MD, NJ, NY, OH, RI, WY. Visiting Nurse and Hospice for VT & NHcovers more than...that enrich the lives of the people we serve. Utilization Review Case Managersat VNH manage home… more
- UCLA Health (Los Angeles, CA)
- …for assessing and coordinating care for a diverse group of patients. This in-patient utilization review case manager position will work on-site at our ... coordination of care. In this role you will perform utilization review while assuring the delivery of...accepted for current UCLA Health Nursing staff) + CA RN License and BLS certification + Recent experience in… more
- Baptist Memorial (Memphis, TN)
- …federal and other payer requirements. RN , Nurse , Registered Nurse Responsibilities * Monitors and completes utilization review processes * ... of clinical experience at least 2 of which involve Utilization Review or Case Management Preferred- RN...Employee referral program Job Summary: Position: 18373 - System Manager - Utilization Review Facility: BMHCC Corporate… more
- Beth Israel Lahey Health (Plymouth, MA)
- …you're not just taking a job, you're making a difference in people's lives.** MANAGER , UTILIZATION REVIEW & DENIALS MGMT **Job Description:** Beth Israel ... pertain to level of care determination and the appeal/denial process. + Oversees utilization review workflow processes to ensure timely response to denials. +… more
- Beth Israel Lahey Health (Burlington, MA)
- …people's lives.** Joint role of Case Manager and Utilization Review Nurse **Job Description:** The Inpatient Registered Nurse ( RN ) Case ... Manager for Hospital at Home Care Transitions coordinates utilization review , discharge planning and monitors quality assurance for Lahey Clinic inpatient… more
- Ascension Health (Baltimore, MD)
- …education, experience, location, qualifications and comparison with associates in similar roles_ ** Registered Nurse , Certified Case Manager (CCM, ACM, URAC) ... salary range at the time of the offer._ **Responsibilities** Manage effective utilization review processes, including management of patient statusing processes… more
- UPMC (Hanover, PA)
- **UPMC is hiring a part time Professional Care Manager for our Utilization Review department in Hanover! This is a part time, day shift position with a ... rotating weekend and holiday schedule.** **Purpose:** The Care Manager (CM) coordinates the clinical and financial plan for...of hire. UPMC approved Care Management certification preferred. + Registered Nurse ( RN ) + Act… more
- Fairview Health Services (St. Paul, MN)
- …Work on a variety of special projects and assume other duties as assigned by the Utilization Review Manager or Supervisor. + Understand and focus on key ... M Health Fairview has an immediate opening for a Utilization Management Specialist RN . This is a...**Required** Education: Bachelor's degree in Nursing Experience: 3-5 years Utilization Review or Case Management experience in… more
- Community Health Systems (Naples, FL)
- …direction of the Utilization Review (UR) Director/ Manager the Utilization Review (UR) Nurse reviews all admissions for medical necessity, correct ... required + 2-4 years clinical practice experience required + Utilization Review experince preferred + Experience in...written and verbal communication skills. **Licenses and Certifications** + RN - Registered Nurse -… more
- Trinity Health (Athens, GA)
- …Full time **Shift:** Day Shift **Description:** Will work some weekends The Utilization Review (UR) Coordinator works, in collaboration with a multidisciplinary ... intensity of service for patients to ensure appropriate and timely utilization of hospital services. **Licensure/Certification/Registration:** Current GA RN … more
- MD Anderson Cancer Center (Houston, TX)
- …in coordinating care for high risk and complex patients. Preferred experience: Utilization review experience Licensure / Certification Required: Current State of ... care * Ensure appropriate payment of services that includes review of the appropriate patient class, providing clinical reviews...Texas Professional Nursing License ( RN ). Basic Life Support (BLS) or Cardiopulmonary Resuscitation (CPR)… more
- Ochsner Health (Lafayette, LA)
- …medical management, or other related MCO departments/functions. **Certifications** Required - Current registered nurse ( RN ) license in state of practice. ... *MSW accepted in lieu of registered nurse ( RN ) licensure. Preferred...Determines appropriate staffing levels and the interviewing, hiring, performance review , and termination of employees within practice unit(s); maintains… more
- Avera (Sioux Falls, SD)
- …transfers from Avera facilities as Swing Bed transfers. + Supports compliance with Utilization Review Process. Case Manager will have ongoing conversation ... with Utilization Review staff on patients status and ongoing coverage +...the employer. **Required Education, License/Certification, or Work Experience:** + Registered Nurse ( RN ) - Board… more
- Prime Healthcare (Lynwood, CA)
- …education, credentials and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/189319/case- manager %2c- rn utilization - review ... 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 (Hendersonville, NC)
- …effectiveness through the integrating and functions of care management, utilization review and discharge planning. The Care Manager must be highly organized ... complex patients and identify trends. Formulates potential solutions with Utilization Manager and Social Worker and continuously...Required * Must be licensed to practice as a Registered Nurse in the state of North… more
- Stanford Health Care (Palo Alto, CA)
- …to create an effective plan to address them. **Licenses and Certifications** + Nursing / RN - Registered Nurse - State Licensure and/or Compact State ... and Abilities** + Knowledge of principles and best practices of case management, utilization review , social work, care coordination and discharge planning. +… more
- HCA Healthcare (Richmond, VA)
- …you to apply for our Registered Nurse RN Case Manager PRN opening. We review all applications. Qualified candidates will be contacted for interviews. ... the PRN career opportunities as a Registered Nurse RN Case Manager PRN...a hospital setting preferred.** + **Previous case management or utilization review experience preferred.** CJW Medical Center… more
- AdventHealth (La Grange, IL)
- …skills **.** Teamwork principles **EDUCATION AND EXPERIENCE REQUIRED:** . Associates Degree Nursing or RN Diploma degree . Registered Nurse ( RN ) . ... **LICENSURE, CERTIFICATION OR REGISTRATION REQUIRED:** **.** State of Illinois registered nurse license **LICENSURE, CERTIFICATION OR REGISTRATION PREFERRED:**… more
- HCA Healthcare (Derry, NH)
- …set us apart from any other healthcare provider. We are seeking a Registered Nurse Case Manager RN to join our healthcare family. **Benefits** Parkland ... patient care. Apply today for our Registered Nurse Case Manager RN opportunity....Case Manager 's primary duties are to provide Utilization Review and Case Management functions for… more
- HCA Healthcare (Richmond, VA)
- …career path, we encourage you to apply for our Case Manager Registered Nurse RN PRN opening. We review all applications. Qualified candidates will be ... Do you have the career opportunities as a(an) Case Manager Registered Nurse RN...in this role is to Performs admission and concurrent review for all payers and maintains legible documentation as… more