- CHRISTUS Health (Wake Village, TX)
- … utilization . * Educates hospital and ED providers on levels of care , resource utilization , payor practices, and documentation. Escalates to Physician Advisor ... Description Summary: The Registered Nurse Clinical Care Coordinator is responsible for evaluating, coordinating, processing, screening, and documentation of patient… more
- CHRISTUS Health (Irving, TX)
- Description Summary: The Program Manager Perinatal Services assists in developing and implementing perinatal nursing initiatives for the CHRISTUS Health System. ... nursing standardization, evidence-based practices, operational excellence, and optimal patient care performance. Assists in establishing effective strategies for service… more
- CHRISTUS Health (Alamo Heights, TX)
- …patient care , patient experience and patient outcomes. Effectively manages utilization of staff and material resources so that the most therapeutically effective ... assigned areas; at CHRISTUS St. Patrick Hospital. The nurse manager affects departmental outcomes through interpretation, implementation, and evaluation...patient care is provided in a safe and cost effective… more
- Hartford HealthCare (Torrington, CT)
- …*your moment*. **Job:** **Professional Clinical* **Organization:** **Charlotte Hungerford Hospital* **Title:** * Utilization Review Social Work Care Manager ... Worker will work collaboratively with the IP Psychiatry Patient Care Team to assure Utilization Review activities...Review activities on a 17 bed Adult unit. The Care Manager will liaison with insurance companies… more
- Magellan Health Services (Boise, ID)
- …solutions that directly influence quality of care . General Job Information Title Care Manager (SUD utilization review preferred) - REMOTE USA Grade ... and substance abuse services provided in inpatient and/or outpatient care settings. Collects and analyzes utilization data....Maintains an active work load in accordance with National Care Manager performance standards. + Works with… more
- UNC Health Care (Smithfield, NC)
- …through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management staff to ... care delivery is coordinated across the continuum. The Utilization Manager completes admission, continued stay, and...the Case Manager to manage level of care transitions & appropriate utilization of services.… more
- UPMC (Hanover, PA)
- **UPMC is hiring a Professional Care Manager to support the Utilization Review process! This is a full time, day shift position with a rotating weekend and ... This position is eligible for a generous Sign on Bonus! _** **Purpose:** The Care Manager (CM) coordinates the clinical and financial plan for patients. Performs… more
- CenterWell (Las Vegas, NV)
- …for managing populations and coordinating care to reduce acute and post-acute care utilization . The Manager role is hybrid with travel requirements ... and help us put health first** **The Role** The Care Integration Team Manager is responsible for...create action plans that will reduce acute and post-acute care utilization . + Solicits/shares feedback with market… more
- Sharp HealthCare (San Diego, CA)
- …to the position.Bring to attention of the Supervisor, Utilization Management Care Coordinators, and UM Manager , areas of UM non-compliance and provide ... Care Coordinator, under the direct supervision of the Supervisor, Utilization Management Care Coordinators, prepares referral requests for outpatient… more
- Humana (Salem, OR)
- …a part of our caring community and help us put health first** The Manager , Utilization Management Nursing utilizes clinical nursing skills to support the ... and communication of medical services and/or benefit administration determinations. The Manager , Utilization Management Nursing works within specific guidelines… more
- UNC Health Care (Hendersonville, NC)
- …daily with the Care Manager to manage level of care transitions & appropriate utilization of services. Coordinates with the appropriate staff/payers ... **Description** Job Summary The Utilization Manager (UM) assesses new admissions,...complex patients and identify trends. Formulates potential solutions with Care Manager and Social Worker and continuously… more
- UNC Health Care (Hendersonville, NC)
- …daily with the Care Manager to manage level of care transitions & appropriate utilization of services. Coordinates with the appropriate staff/payers ... the health and well-being of the unique communities we serve. Summary: The Utilization Manager (UM) assesses new admissions, continued stay and discharge review… more
- Commonwealth Care Alliance (Boston, MA)
- … services,procedures, and facilities under the provisions of CCA's benefits plan.The Manager , Utilization Management is responsible for overseeing and managing ... compliance standards in the area of service decisions and organizational determinations.The Manager , Utilization Management reports to the Director of Clinical… more
- UNC Health Care (Raleigh, NC)
- …and functions of case management, utilization review and discharge planning. The Care Manager must be highly organized professional with great attention to ... the unique communities we serve. **Seeking full-time on-site RN Care Manager to work a variable schedule... Care Management Assistant. Consult Social Worker and/or Utilization Manager per established departmental protocol. Maintain… more
- UNC Health Care (Chapel Hill, NC)
- …and functions of case management, utilization review and discharge planning. The Care Manager must be highly organized professional with great attention to ... from CAPP as appropriate. As necessary meet with the Utilization Manager (UM) and SW after the... Care Management Assistant. Consult Social Worker and/or Utilization Manager per established departmental protocol. Maintain… more
- Sharp HealthCare (San Diego, CA)
- …and safe patient handovers to next level of care ; work closely with ambulatory care manager (ACM) at the system level, in clinics, and homecare and sub-acute ... Degree in Nursing; Bachelor's Degree in Nursing; Certified Case Manager (CCM) - Commission for Case Manager ...utilization review demands to assure patients are receiving care in the appropriate setting and level of … more
- VNS Health (Manhattan, NY)
- … utilization management processes are followed by the service operations staff, utilization staff, and the interdisciplinary care team to ensure cost ... , staff productivity and coverage. * Generates management reports via the care / utilization management systems and demonstrates competency as a super user… more
- McLaren Health Care (Detroit, MI)
- **Position Summary:** Responsible for providing assistance to the Utilization Manager (UM) RN in the coordination of patient admission and continued stay ... based on medical necessity. 2. Performs concurrent and retrospective utilization management-related activities and functions to ensure that appropriate data… more
- AmeriHealth Caritas (Dublin, OH)
- ** Utilization Management Plan Oversight Manager (Ohio Resident)** Location: Dublin, OH Primary Job Function: Medical Management ID**: 37872 **Job Brief** ... Your career starts now. We are looking for the next generation of health care leaders. At AmeriHealth Caritas, we are passionate about helping people get care… more
- UNC Health Care (Hendersonville, NC)
- …of care management, utilization review and discharge planning. The Care Manager must be highly organized professional with great attention to detail, ... well-being of the unique communities we serve. Summary: The Care Manager - RN provides ongoing support...complex patients and identify trends. Formulates potential solutions with Utilization Manager and Social Worker and continuously… more
