- UNC Health Care (Chapel Hill, NC)
- **Description** Surgery, Women's, & Children's Utilization Manager **(part-time: 20 hrs/week)** + Weekends only (Saturday & Sunday) + 8:30a-6:30p + **No Nights** ... care episode through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management… more
- UNC Health Care (Hendersonville, NC)
- …the health and well-being of the unique communities we serve. Summary: The Utilization Manager (UM) assesses new admissions, continued stay and discharge review ... met and care delivery is coordinated. The UM completes utilization reviews in accordance with federal regulations and the...patient data and treatments. Communicates daily with the Care Manager to manage level of care transitions & appropriate… more
- Acacia Network (Bronx, NY)
- Acacia Network Inc. Utilization Manager Bronx, : 5/30/2024 Job Description Job ID#: 3904 Job Category: Acacia Network Inc. Position Type: Full Time Details: ... residential services requiring MCO approval. The salary for the Utilization Manageris $65,000/annually based on relevant experience. KEY ESSENTIAL FUNCTIONS:… more
- Samaritan Daytop Village (Rhinebeck, NY)
- …and goal of sustaining high quality care/service delivery to persons served, the Utilization Manager works to assist CASAC Counselors and supervisory staff as ... needed with assuring compliance with external and internal utilization review/quality and appropriateness requirements. What qualifications do you need: + Bachelor… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Utilization Review Manager for the Selikoff Centers for Occupational Health is responsible for the management of program operations ... records, and internal and external regulatory and survey requirements. + The Utilization Review Manager collaborates with multiple professionals to support and… more
- Helio Health Inc. (Syracuse, NY)
- …to track, review, and analyze data relating to continuous quality improvement. The Utilization Case Manager will work on a Full-Timebasis supporting our ... appropriate. + Assist in developing and administering policies and procedures for utilization . + Negotiating access to care for individuals seeking services at Helio… more
- Penn State Health (Hershey, PA)
- …PDF for more detailed steps for assistance._ **Union:** Non Bargained \#LI-TB1 **Position** Manager Utilization Management - DAY SHIFT - Utilization ... **SUMMARY OF POSITION:** Position is responsible to thoroughly understand all Utilization Management regulatory requirements for both CMS and DOH, developing and… more
- LifePoint Health (Danville, VA)
- *Registered Nurse, RN - Utilization Review Case Manager * Job Type:Full Time|Days *$10,000 Sign-on Bonus Eligibility for Full-Time, Bedside RNs* ** Must have ... approach to offering safe discharge planning is the use of a Utilization RN and Case Manager RN, in conjunction with a Social Worker. *About our Health System*… more
- Trinity Health (Mason City, IA)
- …Type:** Part time **Shift:** Day Shift **Description:** **Position Purpose:** The Utilization Review Case Manager responsibilities include case screening, ... in the state of Iowa. + Bachelor's Degree required. BSN preferred + Utilization management focused certifications that are recognized in the state of Iowa preferred… more
- Holcim US (Houston, TX)
- Carbon Capture Utilization Storage Integration Manager Requisition ID: 9456 Location: Houston, TX, US, 77547 Pay Type: Salary Travel Requirement: 31-40% **ARE ... & Products. Description: **ABOUT THE ROLE** The Carbon Capture Utilization and Storage Integration Manager will report to the Senior Project Manager … more
- Covenant Health (Bangor, ME)
- …of the VP of Accountable Care Operations & Population Health Strategy the Utilization Review Case Manager will work collaboratively with other members of ... the healthcare team. The nurse case manager also acts as an advocate for the patient... conducts medical necessity reviews in accordance with the Utilization Management (UM) plan for patients that are housed… more
- Beth Israel Lahey Health (Burlington, MA)
- …taking a job, you're making a difference in people's lives.** Joint role of Case Manager and Utilization Review Nurse Onsite at Lahey Hospital and Medical Center ... Case Manager for Hospital at Home Care Transitions coordinates utilization review, discharge planning and monitors quality assurance for Lahey Clinic inpatient… more
- UCLA Health (Los Angeles, CA)
- …next level. You can do all this and more at UCLA Health. As a Manager for Medicare Advantage Utilization Management, you'll provide direct management to a team ... (BSN) degree required + Five or more years of utilization management required + Four or more years of...off-site meetings and conferences + ACM - Accredited Case Manager preferred + CCM - Certified Case Manager… more
- CVS Health (Austin, TX)
- …make health care more personal, convenient and affordable. **Position Summary:** This Utilization Management (UM) Nurse Consultant role is fully remote and employee ... assure medical necessity, applies clinical expertise to assure appropriate benefit utilization , facilitates safe and efficient discharge planning and works closely… more
- Sharp HealthCare (San Diego, CA)
- …of the System Integrated Care Management (ICM) team the Transfer and Admissions Utilization Manager (UM) partners with the Centralized Patient Placement Center ... preferred.** + Experience and understanding of federal and state regulations governing utilization management. + Accredited Case Manager (ACM) - American Case… 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
- ERP International (Macdill AFB, FL)
- …Nursing Education (CCNE). **Experience:** Minimum 1 year experience as a RN Utilization Manager within the past 24 months. Licensure:** Active, unrestricted ... **Overview** ERP International is seeking a ** Utilization Management** **Registered** **Nurses (RN)** for a Full-Time position at MacDill AFB, FL. Apply online today… more
- Healthfirst (NY)
- …Negotiates rates with non-partner providers, where applicable. Ensures appropriate access and utilization of a full continuum of network and community resources to ... LPN, LMSW, LMHC,LMFT, LCSW, PT, OT, and/or ST license + For Episodic Utilization /Case Management: NYS RN or Licensed Social Worker (LCSW/LMSW any state) **Preferred… more
- VNS Health (Manhattan, NY)
- OverviewManages the utilization management team to ensure that standards for service delivery and team/staff performance levels are met or exceeded. This includes ... the VNS Health Plans teams on a day- to-day basis for utilization issues, problem resolution, complaint resolution and other service related issues. Manages… more
- Behavioral Center of Michigan (Warren, MI)
- …to help educate the staff and physicians regarding charting. REPORTS TO: Utilization Review Lead/ Manager QUALIFICATIONS: + High School Diploma or equivalent. ... Under general supervision, the Utilization Review Coordinator provides professional assessment, planning, coordination,...those duties include all tasks requested by the UR Manager , CEO or Medical Director to meet the needs… more
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