- University of New Mexico - Hospitals (Albuquerque, NM)
- …limited to experience, education, and other business and organizational considerations. Department: Utilization Management - UH Read on to fully understand what ... - Identify appropriate patients within designated specialty area requiring patient case management interventions by utilizing established procedures including… more
- University of New Mexico - Hospitals (Albuquerque, NM)
- …to experience, education, and other business and organizational considerations.Department: Utilization Management - UHFTE: 1.00Full TimeShift: DaysPosition ... - Identify appropriate patients within designated specialty area requiring patient case management interventions by utilizing established procedures including… more
- Swedish Health Services (Renton, WA)
- …Acts as resource and provides oversight for the Case Management Associate for discharge planning and utilization activities *Coordination: Integrates ... on what really matters - our patients. The nurse case manager coordinates the care and service...Department leadership, the Medical Director, or Physician Advisor. *Resource Management ; Assures prudent utilization of all resources… more
- Reed Smith LLP (Pittsburgh, PA)
- …Plans to improve profitability (Client Value Team engagement/matter management , additional staffing/resource levers, client/matter selection, timekeeper ... for ourselves and for our communities. Position Summary The Global Practice Senior Manager for Life Sciences and Health Industry Group (LSHI) will support the… more
- Molina Healthcare (Houston, TX)
- …(CPHM), Certified Professional in Health Care Quality (CPHQ), Commission for Case Manager Certification (CCMC), Case Management Society of America (CMSA) ... oversight and clinical leadership for health plan and/or market specific utilization management and care management behavioral health programs and chemical… more
- University Health (San Antonio, TX)
- …preferred. Three years recent, full time hospital experience preferred. Work experience in case management , utilization review, or hospital quality assurance ... a registered nurse is required. National certification in related field is desirable. Case Manager Certification (CCM, CPHQ, or ANCC) or Certified Diabetes Nurse… more
- University Health (San Antonio, TX)
- …preferred. Three years recent, full-time hospital experience preferred. Work experience in case management , utilization review or hospital quality assurance ... practice as a registered nurse is required. National certification in related field is preferred. Case Manager Certification (CCM or ANCC) is highly desirable. more
- Actalent (Duluth, GA)
- …nurse opportunity! Description Nurse will be working on site. Responsibilities will include: Case Manager / Utilization Management (90%) and Discharge ... Case management & Utilization ... Case management & Utilization management ...and Oregon. Required Skills At least 1 year of case management /care management Must be… more
- Arnot Health (Elmira, NY)
- …improvement and evaluation processes related to the management of patient care . The Case Manager will review all patients for utilization management ... to the guidelines. . Identifies the appropriate patients for Case Management services. . Maintains a working...and participates in them. . The Case Manager tracks and trends LOS , resource utilization… more
- Tenet Healthcare (Detroit, MI)
- RN Utilization Review - Case Management - 2506004107 Description : Join our dedicated healthcare team where compassion meets innovation! As a Registered ... This position integrates national standards for case management scope of services including: Utilization ...experience preferred. Active and valid RN license required. Accredited Case Manager (ACM) preferred. Skills Required Analytical… more
- Houston Methodist (Houston, TX)
- …+ Five years of hospital clinical nursing experience, which includes three years in utilization review and/or case management **LICENSES AND CERTIFICATIONS - ... ensures prompt notification of any denials to the appropriate case manager , denials, and pre-bill team members,...state, local, and federal programs + Comprehensive knowledge of utilization management , case management… more
- Helio Health Inc. (Syracuse, NY)
- …efforts to track, review, and analyze data relating to continuous quality improvement. The Utilization Case Manager will work on a Full-Timebasis supporting ... by the hiring manager and program Job LocationsUS-NY-Syracuse Category Case /Care Management Position Type Full-Time Work Arrangement Onsite ID 2025-6210 more
- Dallas Behavioral Healthcare Hospital (Desoto, TX)
- The Utilization Review Case Manager is responsible for working with insurance companies and managed care systems for the authorization, concurrent and ... to help patients access the full range of their benefits through the utilization review process. + Conducts admission reviews. + Conducts concurrent and extended… more
- Prime Healthcare (Lynwood, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/236088/rn- case - manager ... Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred.3. Five years acute care...nursing experience preferred. At least one year experience in case management , discharge planning or nursing … more
- Beth Israel Lahey Health (Plymouth, MA)
- …a job, you're making a difference in people's lives.** Full Time **Job Description:** ** Utilization Review & Denials management manager - Full Time** **Who ... and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager...administration or related field preferred or commensurate experience and Case Management Certification required + Minimum of… more
- LifeCenter Northwest (Bellevue, WA)
- …- $159,600.00 Salary Position Type Full Time Description and Qualifications The Manager , Organ Utilization (OUM) provides strategic leadership and operational ... Responsibilities + Lead and engage daily with the Organ Utilization Coordinator (OUC) team in donor case ...identify areas for improvement. + Partner with the Organ Utilization Program Manager (OUPM) on OUCT staffing,… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …National certification of any of the following: CPHM (Certified Professional in Healthcare Management ), CCM (Certified Case Manager ), ACM (Accredited Case ... *_SUMMARY:_* We are currently seeking a* Utilization Review Manager * to join ourTransitional...functions. Oversees daily operations, which include supervising staff performing utilization management activities. The goal is to… more
- Elevance Health (Washington, DC)
- …office 4 days each week. The office is located at 609 H. Street NE.** The ** Manager of Utilization Management ** **ll** is responsible for managing a team of ... acuity. + Provides direct oversight and is responsible for Utilization Management execution/decision making for managed member...UM + Assists and provides back up coverage to Case Management team **Minimum Requirements:** + BA/BS… more
- Elevance Health (Tampa, FL)
- …is granted as required by law. *Must reside in the state of Florida* The ** Manager of Utilization Management ** is responsible for managing a team of ... MSN, MPH, MPA, MSW or MBA with Health Care Concentration preferred. + Certified Case Manager Certification preferred. Please be advised that Elevance Health only… more
- Children's Mercy Kansas City (Kansas City, MO)
- …Compact within 60 days of hire + One of the following: American Case Management , Certified Case Manager required upon hire + Employees must obtain ... American Case Management or equivalent within 730 days + Employees must obtain Certified Case Manager or equivalent within 730 days + Refer to Nursing… more
