• Utilization Review Case

    Covenant Health (Bangor, ME)
    …the supervision 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... 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 RN Case

    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 ... employment." **Job:** **Nursing* **Organization:** ** **Title:** * Utilization Review RN Case Manager *...** **Title:** * Utilization Review RN Case Manager * **Location:** *Virginia-Danville* **Requisition ID:**… more
    LifePoint Health (12/09/24)
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  • RN Case Manager - Utilization

    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 ... coordination of care. In this role you will perform utilization review while assuring the delivery of...RN License and BLS certification + Recent experience in case management, utilization management and discharge planning… more
    UCLA Health (01/04/25)
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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 ... it without you. **Make a Difference** Community North has a part-time RN Case Manager / Utilization Review position available in the Emergency Department.… more
    Community Health Network (12/12/24)
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  • Oncology Prior Authorization Case

    University of Miami (Miami, FL)
    …System Department of UMHC SCCC Business Operations has an exciting opportunity for a full time Utilization Review Case Manager to work to work remote. ... and retrospective chart reviews for clinical utilization and authorization. The Utilization Review Case Manager coordinates with the healthcare team… more
    University of Miami (12/06/24)
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  • Case Manager with Utilization

    Beth Israel Lahey Health (Burlington, MA)
    …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 ... Manager for Hospital at Home Care Transitions coordinates utilization review , discharge planning and monitors quality...Case Manager experience as well as Utilization Review experience ( review medical… more
    Beth Israel Lahey Health (12/10/24)
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  • Registered Nurse (RN) - Case Manager

    Avera (Sioux Falls, SD)
    …from Avera facilities as Swing Bed transfers. + Supports compliance with Utilization Review Process. Case Manager will have ongoing conversation with ... Transfer Center RN and accepting physician. The Transfer Center Case Manager reviews patients for medical necessity,...Utilization Review staff on patients status and ongoing coverage +… more
    Avera (12/23/24)
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  • Case Manager RN - Southern Region

    CVS Health (Lewisburg, WV)
    …+ Foster care experience + Crisis intervention skills + Managed care/ utilization review experience + Certified Case Manager (CCM) certification + ... care more personal, convenient and affordable. **Position Summary** The Case Manager RN (CM RN) is responsible...face member visits + Using clinical tools and information/data review , conducts an evaluation of member's needs and benefit… more
    CVS Health (01/01/25)
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  • RN Case Manager - Utilization

    Mayo Clinic (Jacksonville, FL)
    …care coordination, resource utilization , and clinical documentation. The RN Case Manager will function within the Mayo Clinical Nursing Professional ... Case Manager provides leadership through education on case management/ utilization management concepts, committee work, research, and community… more
    Mayo Clinic (01/09/25)
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  • Case Manager - Utilization

    Prime Healthcare (Lynwood, CA)
    …education, credentials and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/185693/ case - manager utilization - review ... to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity,...Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred.3. Five years acute care… more
    Prime Healthcare (12/31/24)
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  • RN/ Case Manager -MSH- Case

    Mount Sinai Health System (New York, NY)
    …Requirements** + Previous experience as in homecare, long term care or utilization review preferred. + Discharge Planner or Case Manager preferred. + ... **Job Description** **RN/ Case Manager MSH Case ...a. Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case more
    Mount Sinai Health System (01/01/25)
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  • Case Manager RN-Mount Sinai West-…

    Mount Sinai Health System (New York, NY)
    …preferred. + Previous experience as in homecare, long term care or utilization review preferred. + Discharge Planner or Case Manager preferred. + ... **Job Description** The Case Manager (CM) will be responsible...1. Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case more
    Mount Sinai Health System (12/25/24)
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  • Case Manager I - Utilization

    Dignity Health (Stockton, CA)
    …atmosphere that fosters communication trust and personal growth. **Responsibilities** **Position Summary:** Case Manager 1 assists Case Managers in ... to patients and their families acting as liaison between the case manager treatment team and physicians referral sources outside therapists community agencies… more
    Dignity Health (01/08/25)
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  • RN Acute Case Manager - Case

    Guthrie (Cortland, NY)
    … Management and Utilization Review position. The Acute Care Case Manager utilizes industry accepted processes for achieving timely, optimal patient ... based on assessed needs and available resources. The Acute Case Manager also performs Utilization ...of experience in an acute care setting with strong case management, utilization review and… more
    Guthrie (11/13/24)
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  • Lowe's Care Nurse - Case Manager

    Lowe's (Charlotte, NC)
    …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 a ... for medically managing a minimum caseload of 65 including review of claims identified for Medicare Set-Aside. **What you...RN license in home State + CCM - Certified Case Manager + CRRN - Certified Rehabilitation… more
    Lowe's (12/04/24)
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  • Enhanced Care Management Clinical Specialist II

    LA Care Health Plan (Los Angeles, CA)
    …California License. Licenses/Certifications Preferred Certified Professional in Utilization Review (CPUR) Certified Case Manager (CCM) Required ... Information Preferred: Certification in Certified Professional in Utilization Review (CPUR), Certified Case Manager (CCM), Utilization Management or… more
    LA Care Health Plan (12/30/24)
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  • Director of Case Management…

    Ascension Health (Kalamazoo, MI)
    …or management experience preferred. **Additional Preferences** There will be a dual focus on case management and utilization review in this position + ... + One or more of the following required: + Case Manager credentialed from the Commission for...Case Management experience - Strongly preferred + Utilization Review experience - Strongly preferred **Why… more
    Ascension Health (11/26/24)
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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 ... issues. To support the mission of Helio Health, theUtilization Case Manager will enhance the program's efforts...Licensed/credentialed applicants preferred. + Two years of experience in utilization review in a hospital, health care,… more
    Helio Health Inc. (01/04/25)
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  • Clinical Case Manager /RN-Virtual

    Alight (NJ)
    …+ 5+ years medical advisory experience in occupational health, worker compensation, disability, health case management, or utilization review . + 2+ years as ... Additionally, demonstrate excellent problem-solving skills when questioned on your case management plans. + Consulting on medical, behavioral health,...a Clinical Case Manager + Demonstrate a dedication to providing high quality… more
    Alight (01/02/25)
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  • ** Case Manager - SRMC…

    Prime Healthcare (Redding, CA)
    …and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/189120/** case - manager srmc- utilization ... to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity,...Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred.3. Five years acute care… more
    Prime Healthcare (01/09/25)
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