- Children's Mercy Kansas City (Kansas City, MO)
- …of children beyond the walls of our hospital. Overview The BSN , Admission and Denials Care Manager utilizes clinical expertise, insurance knowledge, ... Care Management Department. The goal of the Admission and Denials Care Manager...be safely rendered at home to prevent non-medically necessary admissions . + To accomplish the goals of utilization management,… more
- Billings Clinic (Billings, MT)
- …what we need from the team to get the patient to the next level of care , and expected discharge plan *Ensure that admission review is completed on assigned ... You'll want to join Billings Clinic for our outstanding quality of care , exciting environment, interesting cases from a vast geography, advanced technology and… more
- 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 (Edison, 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 (Edison, NJ)
- …**Responsibilities** 1. Follows departmental workflows for utilization review activities including admission reviews, admission denials , continued stay ... **Overview** The Care Management, Care Coordinator, Utilization Management...admissions . 4. Performs chart reviews for appropriateness of admission and continued hospital stay applying appropriate clinical criteria.… more
- Hackensack Meridian Health (Brick, 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
- AdventHealth (Tampa, FL)
- …use clinical expertise by analyzing patient records to determine legitimacy of hospital admission , treatment, and appropriate level of care . The UM RN leverages ... for observation and inpatient stay visits to avoid unnecessary denials . . Working in collaboration with facility Care...license to practice as a Registered Nurse (ADN or BSN ) required. . Minimum three years acute care… 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
- 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
- Nuvance Health (Danbury, CT)
- …and improvement of clinical initiatives focused on reducing LOS, Denials , Re- admissions and ensuring appropriate levels of care . Actively involved in all ... as assessment and intervention in cases involving complex family/patient dynamics. 8. Care Coordinators in utilization review audits all admissions and continued… more
- AdventHealth (Orlando, FL)
- …use clinical expertise by analyzing patient records to determine legitimacy of hospital admission , treatment, and appropriate level of care . The UM RN leverages ... **The value you'll bring to the team:** + Monitors admissions and performs initial patient reviews within 24 hours...practice in Florida as a Registered Nurse (ADN or BSN ) required. + Minimum three years acute care… more
- Virginia Mason Franciscan Health (Bremerton, WA)
- …stay authorizations as required within the market. Essential Job Duties: + 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
- Children's Mercy Kansas City (Kansas City, MO)
- …utilization of inpatient services and outpatient observation services including appropriateness of admission and continuation of current level of care to ensure ... bed status must be correct from the time of admission , leading proper resource utilization, care , and...demonstrated by decreased lengths of stay, decreased readmissions, decreased denials , and increased patient satisfaction. + Function as a… 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
- Intermountain Health (Ogden, 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
- UPMC (Harrisburg, PA)
- …insurance companies, utilizing insurance portals to submit and process approvals and denials ._ **Purpose:** The Care Manager (CM) coordinates the clinical and ... OBS, etc.) Obtains all necessary authorizations for level of care including admission and continued stay. Follows...+ Two (2) years of nursing experience required. + BSN or related Bachelor's degree preferred. + Previous case… more
- HCA Healthcare (Nashville, TN)
- …nurses to work more efficiently. **Are you passionate about delivering patient-centered care ?** Submit your application for Coordinator Hospice Care RN position ... and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more. +.... + Assists medical staff to improve DNR on admission documentation, and direct admission to Hospice… 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 (Kingston, NY)
- …input for reviews on a daily basis in cases of potential utilization denials . Convenes and chairs multidisciplinary care conferences for patients readmitted ... link (https://pm.healthcaresource.com/cs/wmc1/#/preApply/26663) Internal Applicant link Job Details: Summary: Provides care management and care coordination for patients… 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