• Utilization Manager II - UM System…

    Sharp HealthCare (San Diego, CA)
    …Will Do** As a member of the System Integrated Care Management (ICM) team the Utilization Manager (UM) II position supports utilization review functions to ... Guidelines (MCG) + Experience and understanding of federal and state regulations governing utilization management + Accredited Case Manager (ACM) - American Case… more
    Sharp HealthCare (12/15/24)
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  • RN Utilization Manager - Surgery,…

    UNC Health Care (Chapel Hill, NC)
    …care episode through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management ... needs are met and care delivery is coordinated across the continuum. The Utilization Manager completes admission, continued stay, and discharge reviews in… more
    UNC Health Care (01/08/25)
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  • Utilization Manager (RN)

    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
    UNC Health Care (11/20/24)
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  • Utilization Manager -OASAS Program

    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
    Samaritan Daytop Village (12/22/24)
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  • Utilization Review Manager -Selikoff…

    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
    Mount Sinai Health System (10/31/24)
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  • Utilization Case Manager

    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
    Helio Health Inc. (01/04/25)
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  • Program Manager - Utilization

    Independent Health (Buffalo, NY)
    …perks, benefits and commitment to diversity and inclusion. **Overview** The Program Manager - Utilization Management (UM) will be accountable for the management, ... containment activities, and services on automated UM review. The Program Manager will ensure accurate implementation, system configuration and appropriate benefit… more
    Independent Health (12/14/24)
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  • Registered Nurse (RN) Case Manager

    Community Health Network (Indianapolis, IN)
    Registered Nurse (RN) Case Manager / Utilization Review - North Emergency Job Ref 2408203 Category Nursing Job Family Case Manager Department Case Management ... **Make a Difference** Community North has a part-time RN Case Manager / Utilization Review position available in the Emergency Department. The Registered Nurse… more
    Community Health Network (12/12/24)
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  • RN Case Manager - Utilization Review

    UCLA Health (Los Angeles, CA)
    …for assessing and coordinating care for a diverse group of patients. This in-patient utilization review case manager position will work on-site at our UCLA ... coordination of care. In this role you will perform utilization review while assuring the delivery of concurrent and...and BLS certification + Recent experience in case management, utilization management and discharge planning + Minimum of three… more
    UCLA Health (01/04/25)
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  • CHS Utilization and Appeals Manager

    Catholic Health Services (Melville, NY)
    …Health was named Long Island's Top Workplace! Job Details Position Summary: The Utilization and Appeals Manager (UAM) proactively conducts clinical reviews and ... payors for additional clinical documentation. | Acts as liaison between the Utilization and Appeals Management Department and the physician of record, as required.… more
    Catholic Health Services (12/19/24)
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  • Utilization Review Case Manager

    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
    Covenant Health (11/27/24)
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  • Utilization Review Care Manager

    Hartford HealthCare (Mansfield Center, CT)
    …empowering individuals to participate in their own care and recovery. _*Job Summary*_ Utilization Review Care Manager coordinates the care of clients in ... your moment.* **Job:** **Behavioral Health* **Organization:** **Natchaug Hospital* **Title:** * Utilization Review Care Manager - Behavioral Health* **Location:**… more
    Hartford HealthCare (12/04/24)
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  • Utilization Review RN Case Manager

    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
    LifePoint Health (12/09/24)
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  • Case Manager with Utilization Review…

    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
    Beth Israel Lahey Health (12/10/24)
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  • Utilization Management Manager

    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
    UCLA Health (11/22/24)
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  • UMII Transfer and Admission - Utilization

    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 ... (MCG). + Experience and understanding of federal and state regulations governing utilization management. + Accredited Case Manager (ACM) - American Case… more
    Sharp HealthCare (12/06/24)
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  • Integrated Care Management Assistant…

    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
    McLaren Health Care (10/14/24)
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  • Site Utilization and Proposal Management…

    Lockheed Martin (Greenville, SC)
    **Description:** **Site Utilization and Proposal Management Asc Manager ** **Location: Greenville SC** **What You Will Be Doing** Lockheed Martin Aeronautics is ... hiring a Site Utilization and Business Development Proposal Manager in Greenville, South Carolina\. In this leadership role, you will manage the end\-to\-end… more
    Lockheed Martin (12/07/24)
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  • Episodic Utilization Case Manager

    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
    Healthfirst (11/24/24)
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  • Utilization Management Specialist

    UCLA Health (Los Angeles, CA)
    Description Under the direction and supervision of the Utilization Management Manager , the Utilization Management Specialist is responsible for overseeing ... standards, promoting quality care access for members while optimizing network utilization and reducing unnecessary out-of-network expenses + Collaborate closely with… more
    UCLA Health (12/04/24)
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