- Arnot Health (Elmira, NY)
- …areas suitable for nursing research. + Promotes research-based practice. Standard VIII. Resource Utilization The Nurse Manager evaluates and administers the ... DUTIES AND RESPONSIBILITIES: Standards of Care Standard I. Assessment The Nurse Manager develops, maintains, and evaluates patient/client and staff… more
- 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 ... a Difference** Community North has a part-time RN Case Manager / Utilization Review position available in the Emergency...Review position available in the Emergency Department. The Registered Nurse Case Manager is responsible for the… more
- Arnot Health (Elmira, NY)
- …the organization. + Recognizes importance of positive relationship between Nurse Manager and staff. Standard VII. Resource Utilization The Assistant Nurse ... Job Description MAIN FUNCTION: The Assistant Nurse Manager provides administrative duties and direct patient care as needed based on patient acuity and staffing… more
- Prime Healthcare (Weslaco, TX)
- …#registerednurse #casemanagement Connect With Us! (https://careers-primehealthcare.icims.com/jobs/188814/registered- nurse -case- manager utilization ... -management/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilityKnapp Medical Center LocationUS-TX-Weslaco ID2025-188814 CategoryClinical Professional Position TypeFull Time ShiftDays Job TypeNon-Exempt 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 ... as an employee, but as a person. As a*registered nurse (RN)*joining our team, you're embracing a vital mission...offering safe discharge planning is the use of a Utilization RN and Case Manager RN, in… 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 ... 8:00am-4:30pm Weekend and holiday rotations required **Job Description:** The Inpatient Registered Nurse (RN) Case Manager for Hospital at Home Care Transitions… more
- Lowe's (Charlotte, NC)
- …years of experience in a clinical position. + 3-5 Years of Experience as a Case Manager or Utilization Review Nurse in worker's compensation + Experience in ... license in home State + CCM - Certified Case Manager + CRRN - Certified Rehabilitation Registered Nurse... Manager + CRRN - Certified Rehabilitation Registered Nurse + CDMS - Certified Disability Management Specialist +… more
- Humana (Lexington, KY)
- …help us put health first** Humana Healthy Horizons in Kentucky is seeking a Utilization Management Nurse 2 who will utilize clinical nursing skills to support ... services and/or benefit administration determinations for Humana's Kentucky Medicaid Plan. The Utilization Management Nurse 2 work assignments are varied and… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: ... net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates,...implement a successful discharge plan. Works with the UM Manager and Physician Advisor on case reviews for pre-service,… more
- VNS Health (Manhattan, NY)
- … or an Occupational Therapist in New York State required + Certified Case Manager preferred + For SelectHealth ETE Only: Nurse Practitioner (NP) certification ... cost-effective health care services. Manages providers, members, team, or care manager generated requests for medical services and renders clinical determinations in… more
- McLaren Health Care (Indianapolis, IN)
- We are looking for a Utilization Management RN to join us in leading our organization forward. McLaren Integrated HMO Group (MIG), a division of McLaren Health Care ... Inc. at https://www.mdwise.org/ **Position** **Summary:** This position is responsible for utilization management functions. This includes but is not limited to… more
- Glens Falls Hospital (Glens Falls, NY)
- …can be foundhere. **Job:** **Nursing - Case Management* **Title:** *RN - Utilization Review Nurse * **Location:** *NY-Glens Falls* **Requisition ID:** *2410V* ... timely and accurate information to payers. The role integrates and coordinates utilization management and denial prevention by focusing on identifying and removing… more
- US Tech Solutions (Columbia, SC)
- …Identifies and makes referrals to appropriate staff (Medical Director, Case Manager , Preventive Services, Subrogation, Quality of care Referrals, etc.). Participates ... education with members and providers regarding health care delivery system, utilization on networks and benefit plans. May identify, initiate, and participate… more
- 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
- 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
- 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 ... Health Plans teams on a day- to-day basis for utilization issues, problem resolution, complaint resolution and other service...and current registration to practice as a registered professional nurse in New York State Required + Valid driver's… more
- 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
- 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
- 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
- Ascension Health (Baltimore, MD)
- …experience, location, qualifications and comparison with associates in similar roles_ **Registered Nurse , Certified Case Manager (CCM, ACM, URAC) preferred or ... **Details** + **Department:** Utilization Management + **Schedule:** On-site, Monday-Friday, 8:00AM-4:30PM. Must...staff **Requirements** Licensure / Certification / Registration: + Registered Nurse obtained prior to hire date or job transfer… more
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