- 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. + ... not limited to: a. Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case management will be needed using… more
- Centene Corporation (Carson City, NV)
- …preferred** + **Time Zone Alignment: Team is based in Pacific Time** + ** Utilization Review experience within a managed care organization** + **Coordinate with ... appropriate level of care + Interacts with providers, community agencies, and other utilization review staff to coordinate and ensure a safe, effective, and… more
- Logan Health (Kalispell, MT)
- …all applicable Logan Health, State, and Federal requirements as they relate to Utilization Review , Discharge Planning, and Care Coordination processes as ... settings, ensuring seamless coordination of services for optimal patient outcomes. Inpatient Utilization Management + Manage and review inpatient services to… more
- SUNY Upstate Medical University (Syracuse, NY)
- …attendance and therapy records. Interfaces with nursing, medical staff, utilization review social services, discharge planner , therapy team to assist ... in successful treatment plan and patient discharge . Assess and recommends and requisitions purchases for equipment and supplies that pertain to therapeutic… more
- National Health Care Associates (Bethel, CT)
- …both + Experience in skilled nursing facilities, clinical reimbursement, concurrent review and/or utilization management is desirable + Experience/knowledge of ... ensure our short-term, skilled nursing patients are medically stable with a safe discharge plan to promote success in the community and limit readmissions. **Key… more
- Vanderbilt University Medical Center (Nashville, TN)
- …continuum of care. Conducts initial and/or concurrent utilization review medical necessity criteria. ... http://www.vanderbilt.edu/work-at-vanderbilt/requirements/nursing4.pdf . Position Shift: PRN (minimum 3 shifts per six-week schedule) 8 am - 4:30 pm KEY RESPONSIBILITIES + Assesses and identifies patients with complex clinical needs that require a coordinated… more
- Sharp HealthCare (San Diego, CA)
- …position requires the ability to combine clinical/quality considerations with regulatory/financial/ utilization review demands to assure patients are receiving ... medical record and provides information to the department head as indicated. + Utilization review and utilization managementThe RN CM I will:Conduct… more
- University of Utah Health (Salt Lake City, UT)
- …or third-party payer. + Alerts and discusses with physician/provider and case manager/ discharge planner when patient no longer meets medical necessity criteria ... and as a team member. **Qualifications** **Qualifications** **Required** + One year Utilization Review or Case Management experience. **Licenses Required** +… more
- Humana (Jackson, MS)
- …critical care, emergency room, trauma units, etc. + Experience as an MDS Coordinator or discharge planner in an acute care setting + Previous experience in ... utilization management/ utilization review for a health plan or acute care setting + Compact license PLUS a single state RN Licensure in any of the following… more
- Sharp HealthCare (San Diego, CA)
- …SNF, home health, or hospice settings. + Experience as a case manager or discharge planner interacting with managed care payers. + Experience with InterQual or ... and Chula Vista.** **What You Will Do** To provide discharge planning and coordination of care for members hospitalized...patient under assigned workload initially and reviews based on review of care plan.Makes rounds and sees every patient… more
- Cedars-Sinai (CA)
- …the established/communicated timeframe + Documents appropriate reviews for assigned patients using utilization review tool. + Provides telephonic review for ... and provides information related to disease progression. + Collaborates with discharge planner to make orders and arranges for home care equipment, healthcare… more
- Cedars-Sinai (Marina Del Rey, CA)
- …the established/communicated timeframe + Documents appropriate reviews for assigned patients using utilization review tool. + Provides telephonic review for ... and provides information related to disease progression. + Collaborates with discharge planner to make orders and arranges for home care equipment, healthcare… more
- Hawaiian Electric (Honolulu, HI)
- …planning process to input projects and programs into the company portfolio for review and approval at an executive level. Ensures that budgeted goals and performance ... and potential risks. + Drives Efficiency: Drives efficiency through the utilization of standardized T&D engineering design and materials. Works with Conceptual… more
- HCA Healthcare (Houston, TX)
- …of the Case management Staff functioning as communicator, leader, assessor, planner , implementor, and evaluator. Actively participates in the collaborative program ... which requires review of patient activities related to medical necessity of...hospitalization, appropriateness of length of stay, timely and appropriate utilization of services rendered and identification of patient needs… more
- Post Holdings Inc. (New Albany, OH)
- …centers, balancing customer demand with cost-effective production and capacity utilization . The planner partners closely with cross-functional teams-including ... most cost-effective manner. + Address quality issues with co-manufacturers. + Review and address any invoice discrepancies. + Collaborate closely with… more
- Insight Global (Eden Prairie, MN)
- …Places material into storage locations in a manner that will achieve best utilization of available space. 4. Receives, issues and delivers material in suitable ... requested on unplanned basis and determines whether items may be issued or planner /buyer approval must be obtained. 7. Operates a variety of powered industrial… more
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