- Spectraforce Technologies (Columbia, SC)
- …determinations. Identifies and makes referrals to appropriate staff (Medical Director, Case Manager , Preventive Services, Subrogation, Quality of care Referrals, ... Role Name: Managed Care Coordinator UM II Location: Columbia, SC 29203 Work Environment:...Experience: 7 years-healthcare program management. Preferred Licenses and Certificates: Case Manager certification, clinical certification in specialty… more
- ERP International (Hurlburt Field, FL)
- **Overview** ERP International is seeking a full time **Registered Nurse (RN) Case Manager ** in support of the 1st Special Operations Medical Group at Hurlburt ... Education (CCNE). Certification(s):** Possess one of the following certifications: Commission for Case Manager Certification Certified Case Manager … more
- ERP International (Twentynine Palms, CA)
- …of the following certifications: (Must obtain within 18 months of employment.) o Commission for Case Manager Certification Certified Case Manager (CCM) o ... for community resources. - Integrate CM and utilization management ( UM ) and integrating nursing case management with...Rehabilitation Counselor (CRC) o American Nurses Credentialing Center Nurse Case Manager (RN-NCM) o National Academy of… more
- Katmai (Usaf Academy, CO)
- **SUMMARY:** Performs healthcare coordination and case management activities IAW Medical Treatment Facility (MTF) instructions. **ESSENTIAL DUTIES & ... on Accreditation of Healthcare Organizations(JCAHO), Ambulatory Health Care (AAAHC) & Case Management Society of America (CMSA)). + Collaborates with military and… more
- ERP International (Tinker AFB, OK)
- **Overview** ERP International, LLC is seeking a **Registered Nurse - Case Manager ** for a full-time position supporting **SHG Clinic** in support of **Tinker ... Medical Evaluation Unit (THMEU) in San Antonio, Tx. The Case Manager will be required to attend...for community resources. - Integrate CM and utilization management ( UM ) and integrating nursing case management with… more
- Stony Brook University (Stony Brook, NY)
- RN Case Manager **Position Summary** At Stony Brook Medicine, a **RN Case Manager ** is a valuable member of our team, who provides clinical services to ... our high standard of excellence. **Duties of a RN Case Manager in the Care Management Department...their work and follow up with cases. **Preferred:** CM, UM , Quality, Coding, Risk or MCG Certification Working knowledge… more
- ERP International (Luke AFB, AZ)
- …license to practice as a Registered Nurse, any state. Clinical Certification:** Certified Case Manager by Commission for Case Management (CCM) **or** ... databases for community resources. - Integrate CM and utilization management ( UM ) and integrating nursing case management with social work case management. -… more
- San Francisco Health Plan (San Francisco, CA)
- Reporting to the Director of Clinical Operations, the Nurse Manager , Prior Authorizations, provides clinical and operational leadership to the Prior Authorizations ... (PA) team within the Utilization Management ( UM ) function. You will manage a team of registered...in a healthcare setting required; experience in managed care, case management, resource management, or utilization review, preferred. 2… more
- Commonwealth Care Alliance (Boston, MA)
- …Operating Procedures + Ensures accurate documentation of clinical decisions and works with UM Manager to ensure consistency in applying policy + Works with ... UM Manager and other clinical leadership to... UM Manager and other clinical leadership to ensure that departmental...RN **Desired Licensing (nice to have):** + CCM (Certified Case Manager ) **Required Experience (must have):** +… more
- Santa Clara Family Health Plan (San Jose, CA)
- …to change. FLSA Status: Exempt Department: Health Services Reports To: Manager , Utilization Management GENERAL DESCRIPTION OF POSITION The Supervisor of Utilization ... Management ( UM ) is responsible for the direct oversight of daily...each essential duty listed below satisfactorily. 1.Collaborate with the Manager of Utilization Management to implement and supervise all… more
- Prisma Health (Greenville, SC)
- …compassion. Be the difference. Job Summary The RN-Patient Progression Leader provides case management services for hospital patients, including, but not limited to, ... Verify transportation prior to day of discharge. Utilization Management: 1. Completes UM (Complete concurrent/continuous stay reviews) to assure that all payor and… more
- Astronics (Waukegan, IL)
- ODA Program Manager Astronics Subsidiary Astronics CSC Location Waukegan, IL Description Astronics Connectivity Systems and Certification serves as the experienced, ... Best and Brightest Employers to Work For award. **Summary** The ODA Program Manager is a technical position responsible for ensuring all requirements are met in… more
- Universal Health Services, Inc. (Franklin, TN)
- …Rolling Hills Hospital is seeking a dedicated and detail-oriented Utilization Management Manager to join our dynamic UM team. In this role, ... with third-party payers to secure necessary authorizations for patient services. Case Review: Evaluate the appropriateness of admissions, continued stays, and… more
- Universal Health Services, Inc. (Phoenix, AZ)
- Responsibilities The UM Coordinator contacts external case managers/managed care organizations for certification and recertification of insurance benefits ... the insurance companys requirements for continued stay and discharge planning. The UM Coordinator is responsible for having a thorough understanding of the patients… more
- Universal Health Services, Inc. (Phoenix, AZ)
- …Coordinator to join our team of compassionate, dedicated professionals. The UM Coordinator contacts external case managers/managed care organizations for ... the insurance company's requirements for continued stay and discharge planning. The UM Coordinator is responsible for having a thorough understanding of the… more
- Katmai (Fort Carson, CO)
- …+ Identify cases that may benefit from alternative levels of care and involve the case manager as needed to provide direction in care management. + Plan and ... + Facilitate the development and integration of utilization management ( UM ) review policies and procedures into operations. + Perform...Cross. + Must understand the principles of UR and UM and be able to apply knowledge in processing… more
- Katmai (Fort Carson, CO)
- …+ Identify cases that may benefit from alternative levels of care and involve the case manager as needed to provide direction in care management. + Plan and ... workers. + Apply principles of utilization review (UR) and utilization management ( UM ) in processing specialty referrals. + Plan and perform specialty referral… more
- Santa Clara Family Health Plan (San Jose, CA)
- …No. 521 GENERAL DESCRIPTION OF POSITION Under the guidance and direction of the UM department RN Manager or Director, the Utilization Management Review Nurse ... or programs for member identified continuity of care needs, such as Case Management, Behavioral Health, Managed Long Term Services and Supports (MLTSS), community… more
- Providence (Santa Rosa, CA)
- …degree for Case Management/ UM Review: Nursing or related field. + Certified Case Manager (CCM) or Accredited Case Manager (ACM) upon hire + ... **Description** RN Manager - Case Management unit at...related field - Nursing Preferred. + Bachelor's degree for Case Management/ UM Review: Nursing or related… more
- Healthfirst (NY)
- …such as Medicare, Medicaid and//or Managed Long-Term Care Plan (MLTCP) Experience working as a case manager for a long-term care programs such as PACE, MAP or ... authorization, concurrent review, and service requests Lead, coach, and develop UM managers overseeing interdisciplinary teams of registered nurses, social workers,… more
