- Apex Health Solutions (Houston, TX)
- Summary: The UM Reviewer serves as a contact and resource person to Health Solutions' members for the utilization review (UR) of healthcare services. The UM ... or issues arise. To support care management initiatives, the UM Reviewer should also identify enrollees in need of... Reviewer should also identify enrollees in need of case /disease management services so that proactive interventions can occur.… more
- Sharp HealthCare (San Diego, CA)
- …patient care, SNF, home health, or hospice settings. + Experience as a case manager or discharge planner interacting with managed care payers. + Experience with ... hospital stay beginning with the admission review of the case manager and reviews with the Case ...to acute or visit to the Emergency Department.Informs Director, QI/ UM of any quality issues.Attends hospitalists rounds, as required,… more
- YesCare Corp (Bartow, FL)
- …to sites and providers for authorization numbers + Forwards daily inpatient case management abstracts to Corporate UM + Reviews requests for outpatient ... forwards to Corporate UM Medical Director + Performs monthly audit of Inpatient , ER and Outpatient Events + Performs hospital review of complicated and extended… more
- Access Dubuque (Dubuque, IA)
- RN-Care Coordinator **UnityPoint Health Finley Hospital** 1 Positions ID: 36229590 Posted On 07/10/2024 **Job Overview** **Overview** The Care Coordinator ... and evaluation of patient-focused care for prioritized patients. + Documents the case management plan to include clinical needs, barriers to quality care, effective… more
- Catholic Health Initiatives (Omaha, NE)
- …(5) years of nursing experience. + Certified Case Manager (CCM), Accredited Case Manager (ACM-RN), or UM Certification preferred + Able to apply clinical ... **Overview** The RN Care Coordinator is responsible for overseeing the progression of...to ensure progression of care and appropriate utilization of inpatient resources using established evidence based guidelines/criteria. 5. Collaborates… more
- Virginia Mason Franciscan Health (Seattle, WA)
- …(5) years of nursing experience. + Certified Case Manager (CCM), Accredited Case Manager (ACM-RN), or UM Certification preferred + Able to apply clinical ... adoption assistance, annual bonus eligibility, and more! **Responsibilities** The Care Coordinator RN is responsible for overseeing the progression of care and… more
- Virginia Mason Franciscan Health (Federal Way, WA)
- …if located within hospital Preferred + Certified Case Manager (CCM), Accredited Case Manager (ACM-RN), or UM Certification preferred **Pay Range** $46.96 - ... + Sign on Bonus available **Responsibilities** **JOB SUMMARY / PURPOSE** The Care Coordinator RN is responsible for overseeing the progression of care and discharge… more
- Virginia Mason Franciscan Health (Silverdale, WA)
- …if located within hospital Preferred + Certified Case Manager (CCM), Accredited Case Manager (ACM-RN), or UM Certification preferred **Pay Range** $46.96 - ... + Sign on Bonus available **Responsibilities** **JOB SUMMARY / PURPOSE** The Care Coordinator RN is responsible for overseeing the progression of care and discharge… more
- Catholic Health Initiatives (Omaha, NE)
- …five (5) years of nursing experience. + Certified Case Manager (CCM) Accredited Case Manager (ACM-RN) or UM Certification preferred + Able to apply clinical ... team to ensure progression of care and appropriate utilization of inpatient resources using established evidence based guidelines/criteria. 5. Collaborates with the… more
- Corewell Health (Royal Oak, MI)
- …coordination; and/or discharge/transition planning). 2. Responsible for managing a case load of patients that includes facilitating utilization management, and/or ... provide effective transition for patients utilizing hospital outpatient, observation or inpatient services. 4. May review cases for medical necessity, uses InterQual… more
- Corewell Health (Farmington Hills, MI)
- …coordination; and/or discharge/transition planning). + Responsible for managing a case load of patients that includes facilitating utilization management, and/or ... provide effective transition for patients utilizing hospital outpatient, observation or inpatient services. + May review cases for medical necessity, uses InterQual… more
- Catholic Health Initiatives (Roseburg, OR)
- …+ BLS within 3 months of hire. + Certified Case Manager, Accredited Case Manager or UM Certification preferred. **Experience:** + Two (2) years acute ... **Responsibilities** **Shift:** Casual Part-Time, Weekdays **Job Summary:** The Nurse Care Coordinator is responsible for overseeing the progression of care and… more