- VHC Health (Arlington, VA)
- Case Manager / Utilization Review Registered Nurse Job Description Purpose & Scope: The Case Manager is responsible for the collaborative process ... and available resources to promote quality cost-effective outcomes. Additionally, the Case Manager ensures that identified and referred patients have… more
- Actalent (Oklahoma City, OK)
- Hiring for Case Manager - Utilization Review Job Description Care Managers perform integrated case management (CM) and disease management (UM) ... practice guidelines, community resources, contracting and community care standards to each case . Responsibilities: * Determine, develop, and implement a plan of care… 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
- Providence (Kodiak, AK)
- …standards. The Case Manager /RN Navigator partners with the Utilization Review nurse, patients, physicians, and interdisciplinary team to ensure ... **Description** The Case Manager /RN Navigator is responsible for...needs for discharge planning, admission to swing bed and case management including utilization review … more
- Mayo Clinic (Jacksonville, FL)
- …care coordination, resource utilization , and clinical documentation. The RN Case Manager will function within the Mayo Clinical Nursing Professional ... Case Manager provides leadership through education on case management/ utilization management concepts, committee work, research, and community… more
- 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
- Prime Healthcare (Lynwood, CA)
- …education, credentials and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/175183/ case - manager %2c-rn utilization - review ... to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity,...Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred.3. Five years acute care… 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
- Trinity Health (Fresno, CA)
- …to the Manager Social Services*, Social Services, this position coordinates utilization review service for defined patient populations across the acute care ... continuum. This includes discharge planning, utilization management, care coordination collaboration, and...accredited baccalaureate nursing program (BSN) is preferred. 4. Certified Case Manager (CCM) national certification is preferred.… more
- University of Miami (Miami, FL)
- …UHealth System, Department of Utilization Management, has an exciting opportunity for an Utilization Review Case Manager to work remote. The ... and retrospective chart reviews for clinical utilization and authorization. The Utilization Review Case Manager coordinates with the healthcare team… more
- Ellis Medicine (Schenectady, NY)
- …by the Case Manager include, but are not limited to, utilization review , case management, care transition, collaboration with physicians and social ... SECTION I BASIC FUNCTION: The RN Case Manager has responsibility for ...inpatient experience in a hospital environment preferred. + Previous case management, utilization review , and… 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
- 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
- Prime Healthcare (Reno, NV)
- …Certification (CCM) preferred. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/175874/ case - manager -rn-union 10hr smrmc- utilization ... outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity of service… 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
- Prime Healthcare (Aurora, IL)
- … Utilization Review Committee wherever applicable. Participate in regular Utilization committee and Case management meetings with stakeholders from all ... staff and hospital management staff. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/177335/regional- utilization - review - manager /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilityMercy Medical Center… 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
- Billings Clinic (Billings, MT)
- …starting. Click here (https://billingsclinic.csod.com/ats/careersite/search.aspx?site=15&c=billingsclinic) to learn more! Utilization Review RN Billings Clinic ... - 44.18 Under the direction of department leadership, the Utilization Review / Management RN. This position is...and outside agency requirements. The responsibilities of the UR case manager are listed below, in order… 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