- Hackensack Meridian Health (Neptune, NJ)
- …includes: + Follows departmental workflows for utilization review activities including admission reviews, admission denials , continued stay reviews, ... unwarranted admissions . + Performs chart reviews for appropriateness of admission and continued hospital stay applying appropriate clinical criteria. Performs … more
- Hackensack Meridian Health (Holmdel, NJ)
- …_Health_ includes: + Follows departmental workflows for utilization review activities including admission reviews, admission denials , continued stay reviews, ... unwarranted admissions . + Performs chart reviews for appropriateness of admission and continued hospital stay applying appropriate clinical criteria. Performs … more
- Hackensack Meridian Health (Hackensack, NJ)
- …Health includes: + Follows departmental workflows for utilization review activities including admission reviews, admission denials , continued stay reviews, ... unwarranted admissions . + Performs chart reviews for appropriateness of admission and continued hospital stay applying appropriate clinical criteria. Performs … more
- Hackensack Meridian Health (Hackensack, NJ)
- …may include: + Follows departmental workflows for utilization review activities including admission reviews, admission denials , continued stay reviews, ... unwarranted admissions + Performs chart reviews for appropriateness of admission and continued hospital stay applying appropriate clinical criteria, performs … more
- Hackensack Meridian Health (Hackensack, NJ)
- …**Responsibilities** + Follows departmental workflows for utilization review activities including admission reviews, admission denials , continued stay ... unwarranted admissions . + Performs chart reviews for appropriateness of admission and continued hospital stay applying appropriate clinical criteria. Performs … more
- HCA Healthcare (El Paso, TX)
- **Description** **Introduction** Want to join a team of daring managers who care without reservations or limits? Our Las Palmas Medical Center team is looking for ... auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more. + Free counseling… more
- UNC Health Care (Hendersonville, NC)
- …with patient/patient representative, multidisciplinary team, third party payers and care managers/social workers. Provides information regarding denials and ... communities we serve. Summary: The Utilization Manager (UM) assesses new admissions , continued stay and discharge review cases for medical necessity, appropriate… more
- UNC Health Care (Hendersonville, NC)
- …with patient/patient representative, multidisciplinary team, third party payers and care managers/social workers. Provides information regarding denials and ... **Description** Job Summary The Utilization Manager (UM) assesses new admissions , continued stay and discharge review cases for medical necessity, appropriate class… more
- UNC Health Care (Rocky Mount, NC)
- …health care team to ensure efficient throughput from hospital admission through discharge and to the appropriate post-acute setting. **Responsibilities:** 1. ... of medical necessity reviews (ie - observation/outpatient, inpatient) within 24 hours of patient's admission to the acute care setting and for continued stay in… more
- Penn Medicine (Plainsboro, NJ)
- …is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field ... + The Case Manager supports the interdisciplinary team in facilitating patient care , with the underlying objective of enhancing the quality of clinical outcomes… more
- Intermountain Health (Salt Lake City, UT)
- …as assigned. Communicates any necessary information to payers to help appeal existing denials . Uses level of care criteria to justify the patient's severity ... expertise and critical thinking skills to develop and implement a plan of care that provides cost effective, extraordinary care . This position works… more
- Virginia Mason Franciscan Health (Bremerton, WA)
- …as required within the market. **Essential Key Job Responsibilities** 1. Conducts admission and continued stay reviews per the Care Coordination Utilization ... In 2020, united in a fierce commitment to deliver the highest quality care and exceptional patient experience, Virginia Mason and CHI Franciscan Health came together… more
- Catholic Health Services (Bethpage, NY)
- …we treat and serve our communities. We work collaboratively to provide compassionate care and utilize evidence based practice to improve outcomes - to every patient, ... was named Long Island's Top Workplace. Job Details Our Care Managers will: Educate staff, physicians, patients, and families...and families in the case management process. Review new admissions and continued stay patients to determine whether MCG… more
- WMCHealth (Poughkeepsie, NY)
- …of admissions , transfers, continued stays, and discharges. a-Addresses potential denials proactively to prevent or avert unnecessary admissions . a-Identifies ... their psychosocial and cultural framework. Across the continuum of care , the Case Manager coordinates the planning of post-discharge...insurance reviews in a timely manner, resulting in no denials that are attributable to a delay in review.… more
- WMCHealth (Poughkeepsie, NY)
- …of admissions , transfers, continued stays, and discharges. + Addresses potential denials proactively to prevent or avert unnecessary admissions . + Identifies ... their psychosocial and cultural framework. Across the continuum of care , the Case Manager coordinates the planning of post-discharge...insurance reviews in a timely manner, resulting in no denials that are attributable to a delay in review.… more
- Granville Health System (Oxford, NC)
- …complete and accurate patient records, including the use of Present on Admission indicators. #Obtains documentation relevant to denials avoidance related to ... CDI Specialist is responsible for interacting with physicians and other patient care providers and coders in establishing the principal and secondary diagnoses,… more
- Dartmouth Health (Lebanon, NH)
- …Access Hospitals. This role involves collaborating with program medical directors, care teams and health plans to ensure regulatory compliance and appropriate ... have strong communication and analytical skills. Experience with Epic and medical necessity denials is preferred. This position has the option to be Fully Remote!… more
- AdventHealth (La Grange, IL)
- … denials , documents avoidable days, and facilitates progression of care . **.** Collaborates with Utilization Management staff for collaboration on patient ... Road, La Grange, IL 60525 **The role you'll contribute:** The RN Care Manager in collaboration with the patient/family, social workers, nurses, physicians and… more
- AdventHealth (Winter Garden, FL)
- …potential denials , documents avoidable days, and facilitates progression of care . + Collaborates with Utilization Management staff for collaboration on patient ... license as an RN **Preferred qualifications:** + Bachelor of Science in Nursing ( BSN ) + ACM/CCM Certification + Experience in Care Management/ Utilization… more
- Mount Sinai Health System (New York, NY)
- …the forward planning of successful strategies to assure timely and efficient care to patients. This involves the delivery of comprehensive front-line Case Management ... services, including utilization management, care facilitation and discharge planning. The Director works with senior leadership to achieve performance targets and… more