- LifePoint Health (Las Cruces, NM)
- …state or local law./ **Job:** **Nursing* **Organization:** **Memorial Medical Center* **Title:** *RN Case Manager - UM - PRN* **Location:** *New Mexico-Las ... Memorial Medical Center is a 199-bed hospital offering a spectrum of care, including diagnostic, therapeutic, and rehabilitative services, both on an inpatient and outpatient basis. *Where We Are:* From national parks and monuments to one of the top-rated… more
- Apex Health Solutions (Houston, TX)
- Summary: The UM Reviewer serves as a contact and resource person to Health Solutions' members for the utilization review (UR) of healthcare services. The UM ... or issues arise. To support care management initiatives, the UM Reviewer should also identify enrollees in need of... Reviewer should also identify enrollees in need of case /disease management services so that proactive interventions can occur.… more
- Elevance Health (Topeka, KS)
- …HEDIS reporting experience preferred. + MS/MA degree in a health care field or MBA with Health Care concentration preferred. + Certified Case Manager preferred. ... **Director I HCMS - UM /CM - Kansas** **Location:** This position will work...+ Oversees the development and execution of medical and case management policies, procedures, and guidelines; assists in developing… more
- Molina Healthcare (Nacogdoches, TX)
- …auditing of registered nurse and other clinical functions in Utilization Management ( UM ), Case Management (CM), Member Assessment Team (MAT), Health Management ... + May conduct staff trainings as needed. + Communicates with QA supervisor/ manager about issues identified and works collaboratively to resolve/correct them. **JOB… more
- Hackensack Meridian Health (Belle Mead, NJ)
- …the care for a designated patient caseload. Collaborates with the attending LIP, Clinical Case Manager , nurse, and other members of the treatment team, ACCESS ... department to ensure appropriate utilization of resources and benefits on a case by case basis. Applies case management and utilization review principles in… more
- Elevance Health (Nashville, TN)
- …with providers and external physicians. + May conduct peer-to-peer clinical appeal case reviews with attending physicians or other ordering providers to discuss ... to Medical Director Associates. + Works independently with oversight from immediate manager . + May be responsible for an entire clinical program and/or independently… more
- Elevance Health (Atlanta, GA)
- …with providers and external physicians. + May conduct peer-to-peer clinical appeal case reviews with attending physicians or other ordering providers to discuss ... to Medical Director Associates. + Works independently with oversight from immediate manager . + May be responsible for an entire clinical program and/or independently… more
- Catholic Health Initiatives (Roseburg, OR)
- …+ BLS within 3 months of hire. + Certified Case Manager , Accredited Case Manager or UM Certification preferred. **Experience:** + Two (2) years acute ... hospital experience. A Master's degree in Case Management or Nursing is accepted in lieu of 1 year of experience. **Education:** + Associates degree in Nursing. BSN… more
- Sharp HealthCare (San Diego, CA)
- …with direct reports.Ensure staff understanding and support the achievement of UM Department goals, effective case management while maintaining compliance ... **What You Will Do** Provide leadership and direct supervision for Utilization Management ( UM ) department staff. Accountable for results of the UM department as… more
- Fairfax County Sheriff's Office (Fairfax, VA)
- BHN Clinician/ Case Manager Print (https://www.governmentjobs.com/careers/fairfaxcounty/jobs/newprint/4579415) Apply BHN Clinician/ Case Manager Salary ... well-developed knowledge and skills in areas of utilization management ( UM ), behavioral health, medical necessity and overall patient care....intake and to clients on an ongoing basis as case manager ; + Monitors and assesses clients… more
- Stanford Health Care (Palo Alto, CA)
- …| Stanford Health Care (SHC)? Here is your opportunity to mentor and support the UM professionals. Here is your opportunity to put your UM experience and ... an onsite Stanford Health Care job.** **A Brief Overview** The Dir-Utilization Management ( UM ) leads and shapes the UM Strategy, while providing management… more
- ERP International (Yuma, AZ)
- **Overview** ERP International, LLC is seeking a **Registered Nurse - Case Manager ** for a full-time position at theCamp Pendleton **Branch Health Clinic** in ... for community resources. * Integrate CM and utilization management ( UM ) and integrating nursing case management with...for professional growth and development as related to the case manager position and maintenance of CM… more
- Omaha Children's Hospital (Omaha, NE)
- …team to assess for diagnosis, care needs, and discharge plans. * Introduces Nurse Case Management (NCM) role to family. * Completes NCM assessment and documents in ... processes. + Communicates and collaborates with the Utilization Management ( UM ) Nurse, or other NCMs as necessary to provide...and placement, as applicable. + Monitors system to report case management outcomes and works as a change agent… more
- Omaha Children's Hospital (Omaha, NE)
- …team to assess for diagnosis, care needs, and discharge plans. + Introduces Nurse Case Management (NCM) role to family. + Completes NCM assessment and documents in ... policies. + Communicates and collaborates with the Utilization Management ( UM ) Nurse, or other NCMs as necessary to provide...and placement, as applicable. + Monitors system to report case management outcomes and works as a change agent… more
- The Arora Group (Mayport, FL)
- Registered Nurse Case Manager Nurse Currently recruiting a Registered Nurse Case Manager in Mayport, Florida to provide care to active duty American ... Port at Naval Branch Health Clinic Mayport. Registered Nurse Case Manager is full-time position, 80 hrs/2...community resources, etc. + Integrate CM and utilization management ( UM ) and integrate nursing case management with… more
- The Arora Group (Twentynine Palms, CA)
- Registered Nurse Case Manager Nurse Currently recruiting a Registered Nurse (RN) Case Manager near Palm Springs, California, to provide care to family ... per two week period. DUTIES OF THE REGISTERED NURSE CASE MANAGER (RN): + P articipate in...including assessment, planning, implementation, coordination, and monitoring. + Integrate case management (CM) with utilization management ( UM )… more
- The Arora Group (Coronado, CA)
- Registered Nurse Case Manager Nurse Currently recruiting a Registered Nurse (RN) Case Manager in Coronado, California, to work at Coronado Naval Base, ... between 7:30AM - 8:00PM. DUTIES OF THE REGISTERED NURSE CASE MANAGER (RN): + Perform a full...for community resources. + Integrate CM and utilization management ( UM ) and integrating nursing case management with… more
- Matrix Providers (Glendale, AZ)
- Registered Nurse - Case Manager - Luke AFB, AZ Location: Glendale, AZ, United States Healthcare Provider Type : Nursing START YOUR APPLICATION ... Matrix. Matrix Providers is hiring a Registered Nurse - Case Manager to join our team of...for community resources. + Integrate CM and utilization management ( UM ) and integrate nursing case management with… more
- Albany Medical Center (Albany, NY)
- …Care Management/Social Work Work Shift: Day (United States of America) The Case Manager is accountable to facilitate the interdisciplinary team to ... assigned service line across the continuum of care. The Case Manager works proactively with the Quality...of non-coverage reinstatement and continued stay. g. Follows department UM guidelines. 3. Quality Improvement a. Collaborates with the… more
- ERP International (Hill AFB, UT)
- **Overview** ERP International is seeking a **Registered Nurse - Case Manager (RN)** for a full-time position supportingHill AFB, UT ... for community resources. + Integrate CM and utilization management ( UM ) and integrating nursing case management with...: Possess one of the following: + Commission for Case Manager Certification Certified Case … more