- Christus Health (San Antonio, TX)
- …for assigned areas; at CHRISTUS St. Patrick Hospital. The nurse manager affects departmental outcomes through interpretation, implementation, and evaluation ... excellence in patient care, patient experience and patient outcomes. Effectively manages utilization of staff and material resources so that the most therapeutically… more
- Christus Health (Irving, TX)
- Description Summary: The Registered Nurse Navigator Population Health Senior is accountable for coordinating and managing a designated patient caseload patient ... preventive care, and ensuring patients receive appropriate and timely interventions. Registered Nurse Navigator Population Health Senior will work… more
- Rochester Regional Health (Rochester, NY)
- …Schedule: Straight Shift- Days. Every other weekend/holidays. Sign-On Bonus: $15,000 SUMMARY : As a Registered Nurse ( RN ), you're the engine and the heart of ... on 3800 provide direct bedside care, patient education, pain management , post-op recovery support, and discharge planning. The unit...Support - American Heart Association (AHA)American Heart Association (AHA), RN - Registered Nurse -… more
- Christus Health (San Antonio, TX)
- …Medicare GMLOS by managing per Milliman/Interqual Care Guidelines. Resource/ Utilization Management /appropriateness: Assess assigned patient population for ... This position provides expertise and leadership to insure effective resource management for patient care delivery (Conditions of Participation COP 482.30). Case… more
- Fresenius Medical Care (Albany, OR)
- …Assists with implementing appropriate training according to policy; ensure ongoing compliance with all risk management initiatives. Responsible for aggressively ... staff training, equipment, physician and patient relations, cost containment, supply management , medical records, patient billing, OSHA and all company, state and… more
- Fresenius Medical Care (Ponca City, OK)
- …Classification of Disease (ICD) coding. Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review. ... payroll. PHYSICIANS: Facilitates the application process for physician privileges and compliance with Fresenius Medical Care Medical Staff By-Laws. Responsible for… more
- Fresenius Medical Care (Fayetteville, NC)
- …appropriate training according to FMS policy, including training to ensure ongoing compliance with all FMS risk management initiatives. Provides opportunities ... vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements. Ensure… more
- Alameda Health System (Oakland, CA)
- …plans Role Overview: Alameda Health System is hiring! The Director of Utilization Management holds a critical role encompassing operational oversight, strategic ... hoc duties as needed. In essence, they orchestrate efficient utilization management to deliver high-quality patient care....Required Licenses/Certifications : Valid license to practice as a Registered Nurse in the State of California.… more
- CenterWell Home Health (Pittsfield, MA)
- …driver's license, auto insurance and reliable transportation. Two years as a Registered Nurse with at least one-year of management experience in a home care, ... sit on-site at our Pittsfield, MA branch location. The RN Clinical Manager coordinates and oversees all direct care...accredited School of Nursing. Current state license as a Registered Nurse . Proof of current CPR. Valid… more
- University of New Mexico - Hospitals (Corrales, NM)
- …Essential: * Sig Hazard: Chemicals, Bio Hazardous Materials req PPE * Subject to an annual contract and performance appraisal Department: Registered Nurse ... and facilitate communication, problem solving, decision-making, crisis intervention, resource utilization , and conflict management * SUPERVISION - Develop… more
- Christus Health (Somerset, TX)
- …on for more details, and make sure to apply today. The nurse manager affects departmental outcomes through interpretation, implementation, and evaluation of hospital ... excellence in patient care, patient experience and patient outcomes. Effectively manages utilization of staff and material resources so that the most therapeutically… more
- Tufts Medicine Care at Home (Haverhill, MA)
- …our High Pointe House Facility in Haverhill, MA, and Skilled Nursing Facility management and oversight. Hours: Full Time 40 Hours Location: Lowell MA and Haverhill ... Description Minimum Qualifications: 1. Bachelor's degree in Nursing (BSN). 2. Massachusetts RN Licensure. 3. Five (5) years of palliative, hospice, complex care… more
- Harbor Health Services, Inc. (Mattapan, MA)
- …and quality, financial, and compliance goals are met. Responsibilities: Utilization Management Partners across the organization and in particular, with ... 580 participants. We are currently seeking a Director of Utilization Management & Quality Programs. Harbor Health... treatment guidelines. Ensures controls are established to maintain compliance with all contract requirements, as well as state… more
- University Health (San Antonio, TX)
- …of Nurse Examiners of the State of Texas to practice as a registered nurse is required. National certification in related field is desirable. Case Manager ... years recent, full time hospital experience preferred. Work experience in case management , utilization review, or hospital quality assurance experience is… more
- AnMed Health (Anderson, SC)
- …continued stay/concurrent review, retrospective review, bed status management , resource utilization management , regulatory compliance , and related denial ... is responsible for performing the daily operations of the Utilization Management program at AnMed within the...of severity of illness and intensity of services, regulatory compliance with documentation and physician orders. + Reviews all… more
- UNC Health Care (Kinston, NC)
- …clinical experience as a Registered Nurse required. + 2 years utilization review, care management , or compliance experience preferred. + Minimum 1 ... management preferred. + **LICENSURE/REGISTRATION/CERTIFICATION** + Licensed to practice as a Registered Nurse in the state of North Carolina. **Job Details**… more
- Community Health Systems (Franklin, TN)
- …evaluating the necessity, appropriateness, and efficiency of hospital services to ensure compliance with utilization management policies. This role conducts ... extended stays, identifying opportunities for process improvements to enhance utilization management . + Serves as a key...regulations and patient confidentiality standards. **Licenses and Certifications** + RN - Registered Nurse -… more
- Commonwealth Care Alliance (Boston, MA)
- …**Position Summary:** Reporting to the Manager Utilization Management , the Nurse Utilization Management (UM) Reviewer is responsible for day-to-day ... service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has...has a key role in ensuring CCA meets CMS compliance standards in the area of service decisions and… more
- Ascension Health (St. Charles, IL)
- …coordinate compliance to federally mandated and third party payer utilization management rules and regulations. **Requirements** Licensure / Certification / ... offer._ **Responsibilities** Provide health care services regarding admissions, case management , discharge planning, and utilization review. +...Registration: + Registered Nurse credentialed from the Illinois Board… more
- Katmai (Fort Carson, CO)
- …Red Cross. + Three (3) years within the last four (4) years as a registered nurse in utilization management . + One (1) year of experience in UR/UM and ... Provide a comprehensive utilization review (UR) and utilization management (UM) program for all TRICARE...full, active, and unrestricted license to practice as a registered nurse . + Must be a graduate… more
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