- University of New Mexico - Hospitals (Corrales, NM)
- …patient responses to interventions in collaboration with quality assurance and utilization review , maintaining interdependent follow-up as necessary * TREATMENT ... outcomes are achieved within established time frames and with efficient utilization of resources. Conduct initial and ongoing assessments, initiate disease… more
- Interim HealthCare (Greenwood, IN)
- …as a Registered Nurse (RN) in home health or similar setting; previous case management/ utilization review experience preferred. OASIS experience preferred. ... your community, you'll change lives every day. As a Registered Nurse Case Manager (RNCM), you will: Conduct In Person patient interviews and comprehensive… more
- CenterWell Home Health (Pittsfield, MA)
- …of action through the utilization of Performance Improvement principles. Responsible for review of the appropriate number of Case Managers and clinical staff ... at our Pittsfield, MA branch location. The RN Clinical Manager coordinates and oversees all direct care patient services...clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the… more
- Christus Health (San Antonio, TX)
- …resource management for patient care delivery (Conditions of Participation COP 482.30). Case Managers enhance the continuity of care and cost effectiveness by ... integrating the functions of case management, resource management, clinical documentation management, and discharge planning (Conditions of Participation COP… more
- Molina Healthcare (San Antonio, TX)
- …Management (CPHM), Certified Professional in Health Care Quality (CPHQ), Commission for Case Manager Certification (CCMC), Case Management Society of ... oversight and clinical leadership for health plan and/or market specific utilization management and care management behavioral health programs and chemical… more
- University Health (San Antonio, TX)
- …preferred. Three years recent, full time hospital experience preferred. Work experience in case management, utilization review , or hospital quality assurance ... a registered nurse is required. National certification in related field is desirable. Case Manager Certification (CCM, CPHQ, or ANCC) or Certified Diabetes Nurse… more
- University Health (San Antonio, TX)
- …preferred. Three years recent, full-time hospital experience preferred. Work experience in case management, utilization review or hospital quality assurance ... practice as a registered nurse is required. National certification in related field is preferred. Case Manager Certification (CCM or ANCC) is highly desirable. more
- Dallas Behavioral Healthcare Hospital (Desoto, TX)
- The Utilization Review Case Manager is responsible for working with insurance companies and managed care systems for the authorization, concurrent and ... help patients access the full range of their benefits through the utilization review process. + Conducts admission reviews. + Conducts concurrent and extended… more
- Eastern Connecticut Health Network (Manchester, CT)
- POSITION SUMMARY: The Utilization Review Case Manager (UR CM) works in collaboration with the physician and interdisciplinary team to support the ... in the acute-care setting. + Minimum of 1 year Utilization Review experience preferred via industry clinical...Care and status on all patients through collaboration with Case Manager . + Demonstrates thorough knowledge in… more
- Mount Sinai Health System (New York, NY)
- …homecare, long term care or utilization review preferred. Discharge Planner or Case Manager preferred. Manager or a minimum of 3-5 years experience ... **Job Description** **RN/ Case Manager MSH Case ...a. Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case… more
- Prime Healthcare (Lynwood, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/236088/rn- case - manager ... 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
- 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** **RN/ Case Manager (Inpatient) Mount Sinai Morningside...1. Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case… more
- UNC Health Care (Kinston, NC)
- … case management, utilization review and discharge planning. The Case Manager must be highly organized professional with great attention to detail ... adaptable to frequent change, and compliant with regulatory and departmental guidelines and policies. Responsibilities: + Patients/Families, Hospital staff, Medical staff, Community agencies, and Insurance Companies are served by conducting interpersonal… more
- Dignity Health (Long Beach, CA)
- …conferences when appropriate, discharge planning activities, and coordination with the multidisciplinary team/ Utilization Review Case Manager for ... general guidance of the Director of Rehabilitation Services and Therapy Manager ; the Physical Therapist administers patient evaluations, plans and implements patient… more
- Mayo Clinic (Rochester, MN)
- …physicians and multi-disciplinary teams. Major Functions of the RN Case Manager include: Utilization Review , including concurrent admission status and ... Retirement: Competitive retirement package to secure your future. **Responsibilities** The RN Case Manager provides ongoing support to Mayo Clinic Rochester and… more
- Houston Methodist (Houston, TX)
- …+ Five years of hospital clinical nursing experience, which includes three years in utilization review and/or case management **LICENSES AND CERTIFICATIONS - ... At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position...ensures prompt notification of any denials to the appropriate case manager , denials, and pre-bill team members,… more
- Tenet Healthcare (Detroit, MI)
- RN Utilization Review - Case Management - 2506004107 Description : Join our dedicated healthcare team where compassion meets innovation! As a Registered ... care and appropriate level of care Mentor and monitor work delegated to Utilization Review LVN/LPN and/or Authorization Coordinator as needed. (5% daily,… 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 ... 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
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- *_SUMMARY:_* We are currently seeking a* Utilization Review Manager * to join ourTransitional Care Team.This is a full-time role and will be required to work ... following: CPHM (Certified Professional in Healthcare Management), CCM (Certified Case Manager ), ACM (Accredited Case ...required or completed within three years of hire **Title:** * Manager - Utilization Review * **Location:**… more
- Children's Mercy Kansas City (Kansas City, MO)
- …of, and training oversight of programs and services. Responsible for effective utilization review and proper resource management of patients, including patient ... quality, and Lean process improvements, and facilitating the quarterly Utilization Review Committee meetings. Provides evidence based...days of hire + One of the following: American Case Management, Certified Case Manager … more
