- 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 ... in employment." **Job:** **Nursing* **Organization:** ** **Title:** *RN - Utilization Review Case Manager...**Nursing* **Organization:** ** **Title:** *RN - Utilization Review Case Manager * **Location:** *Virginia-Danville*… more
- Covenant Health (Nashua, NH)
- …policies and procedures. + Maintains/enhances professional development/skills required to function as a Utilization Review Case Manager + Completes all ... health care team. + Annual goals are achieved. + Attends pertinent case management/ utilization review programs to maintain current knowledge of UR practices.… more
- Trinity Health (Mason City, IA)
- …its goals **Hours:** Monday-Friday 0630-1430; no weekends or holidays **About The Job** The Utilization Review Case Manager responsibilities include ... in the state of Iowa. + Bachelor's Degree required. BSN preferred + Utilization management focused certifications that are recognized in the state of Iowa preferred… more
- University of Miami (Miami, FL)
- …and the Department Sylvester Business Operations have an exciting opportunity for a Full Time Utilization Review Case Manager to work at Sylvester ... and retrospective chart reviews for clinical utilization and authorization. The Utilization Review Case Manager coordinates with the healthcare team… more
- 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 ...+ Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case… 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** The Case Manager (CM) will be responsible...1. Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case… more
- Trinity Health (Columbus, OH)
- …enrollment opportunities at the Mount Carmel College of Nursing **About the job:** The **RN Case Manager , Utilization Review ** ensures that services are ... **Employment Type:** Part time **Shift:** **Description:** ** Utilization Review RN, Case Management** **Why Mount Carmel?** With five hospitals… more
- Trinity Health (Silver Spring, MD)
- …time **Shift:** **Description:** The Interim Manager of Care Management & Utilization Review , under the supervision and in collaboration with the Director, ... experience in an acute healthcare setting required, preferably with case management, utilization review or...trusted provider of health services within our community. A Manager at Holy Cross Hospital is expected to demonstrate… more
- Sharp HealthCare (San Diego, CA)
- …care nursing experience or case management experience + 3 Years recent case management, utilization review , care coordination experience + California ... Start Time** **Shift End Time** Master's Degree in Nursing; Bachelor's Degree in Nursing; Certified Case Manager (CCM) - Commission for Case Manager … more
- UNC Health Care (Raleigh, NC)
- **Description** **Full time exempt, 40 hours per week Utilization Manager - Medical necessity review for Surgical admissions** Become part of an inclusive ... through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical...of patient data and treatments. Communicates daily with the Case Manager to manage level of care… more
- 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
- 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
- Sharp HealthCare (San Diego, CA)
- …members to case management or quality management as appropriate for utilization or quality issues while maintaining department processes in compliance with the ... necessity reviews and authorizes medical services that meet medical criteria. The review of care is region specific and consists of outpatient healthcare services… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Utilization Review Manager for...in the area of nursing practice assigned; in this case , acute care utilization review . ... internal and external regulatory and survey requirements. + The Utilization Review Manager collaborates with...review for medical and pharmacy claims. + Prepares case reports, summaries, or other related documents required to… more
- Trinity Health (Silver Spring, MD)
- …activities of RN Case Managers for in inpatient care coordination and utilization review . Oversees interactions of staff with outside activities and agencies ... Type:** Full time **Shift:** Day Shift **Description:** **Job Title:** Manager Care Mgt & Util Review **Employment...in an acute healthcare setting. + Designation Changes and Utilization Review + Knowledge of pertinent regulatory,… more
- UCLA Health (Los Angeles, CA)
- …You can do all this and more at UCLA Health. Under the direction of the Utilization Management, Assistant Manager , you will play a key role in processing and ... vital role within a leading health organization. Help ensure smooth and efficient case management processes to support quality care. Take your expertise to the next… more
- Hartford HealthCare (Torrington, CT)
- …*your moment*. **Job:** **Professional Clinical* **Organization:** **Charlotte Hungerford Hospital* **Title:** * Utilization Review Social Work Care Manager ... Nurse Director & Social Work Supervisor, the Inpatient Psychiatric Utilization Review Social Worker will work collaboratively...activities on a 17 bed Adult unit. The Care Manager will liaison with insurance companies and other referral… more
- BronxCare Health System (Bronx, NY)
- …prepare a response for submission in appeal. - In absence of Director, will review denial correspondence to determine validity of denial reason and course of action ... to be taken. - Maintains a working knowledge of InterQual Acute Level of Care Criteria in order to be able to apply to episode of care and utilize in the formulation of a strong appeal. - Identifies and monitors for patterns and trends in denial activity by… more
- Hackensack Meridian Health (Belle Mead, NJ)
- … of resources and benefits on a case by case basis. Applies case management and utilization review principles in monitoring the delivery of care and ... the care for a designated patient caseload. Collaborates with the attending LIP, Clinical Case Manager , nurse, and other members of the treatment team, ACCESS… more
- Hackensack Meridian Health (Hackensack, NJ)
- …and HackensackUMC. These include but are not limited to utilization review , hospital reimbursement, clinical compliance, case management, and transitions of ... **Overview** **The Senior Utilization Review Specialist collaborates with the...conflicting documentation iv. Target DRGs Reviews v. Use of case manager as a resource 4. Uses… more