• Merck & Co. (North Wales, PA)
    …key priorities for our Company is a significant focus-on Data and its utilization as a Strategic asset to drive insights-driven decisions. The opportunity to ... Services team's mission is to focus on driving these capabilities to increase utilization of data within the organization.How will you invent the future?-We have an… more
    HireLifeScience (09/06/24)
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  • Trusted Resource Associates (TRA) (Palm Springs, CA)
    Trusted Resource Associates (TRA) is seeking a local contract nurse RN Utilization Review for a local contract nursing job in Palm Springs, California.Job ... Description & RequirementsSpecialty: Utilization ReviewDiscipline: RNStart Date: 09/25/2024Duration: 13 weeks40 hours per...security compared to with an outside agency. The RN Case Manager is responsible to facilitating care… more
    JobGet (08/26/24)
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  • Pacer Staffing (Atlanta, GA)
    Shift - Standard | Mon to Fri Location - Remote ( Case Manager - serious diagnoses. Children/Pediatric with down syndrome, serious disabilities, physical ... complex case management services from a non-ECHO case manager . Maintains knowledge of and compliance...and build group engagement. Technical Skills: Thorough knowledge of Case Management, Utilization Management, TRICARE policies and… more
    JobGet (09/15/24)
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  • Northeast Georgia Health System, Inc (Gainesville, GA)
    …of individual patient needs; Works collaborate with the Physicians, patient/family, nursing, utilization review and other members of the healthcare team to ... case management experience supervised by a certified case manager , or 24 months full-time ...to ensure services will be covered.Coordinate and communicate with Utilization Review Nurse on a daily, consistent… more
    JobGet (09/15/24)
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  • Northeast Georgia Health System, Inc (Gainesville, GA)
    …at all campuses operated by NGHS. Collaborates with the physicians, patients, families, nursing, utilization review and other members of the health care team to ... Guidelines. This position will provide cross coverage for all Case Managers as required across all settings in the...rotation (as needed). The Complex Transitions of Care Team Manager will follow identified patients for a period of… more
    JobGet (09/15/24)
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  • Pacer Staffing (Atlanta, GA)
    …regulatory requirements, and HIPAA privacy regulations. . Thorough knowledge of Case Management, Utilization Management, HIPAA Privacy and Security regulations. ... NCL state . Minimum of three years clinical experience . Experience in case management, care coordination or discharge planning in an acute, ambulatory or specialty… more
    JobGet (09/15/24)
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  • Neil & Laura Clark Women & Children's Center (Findlay, OH)
    PURPOSE OF THIS POSITION The purpose of the BVMP Behavioral Health Therapist/ Case Manager is to provide a range of psychological assessment, diagnostic, ... therapeutic, and/or case management services for individuals, couples, groups, and/or families,...in various committees and meetings to contribute information regarding utilization of services and quality of healthcare for the… more
    JobGet (09/15/24)
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  • ICONMA (Kentfield, CA)
    Requirements: Must have strong Utilization Review and InterQual experience required! Conducting patient initial assessments Acute Care hospital experience EPIC ... experience Active CA RN License Certifications/Requirements: BLS/BCLS Must have strong Utilization Review and InterQual experience required! Minimum Years of… more
    JobGet (09/15/24)
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  • ICONMA (Kentfield, CA)
    Requirements: Must have strong Utilization Review and InterQual experience required! Conducting patient initial assessments Acute Care hospital experience EPIC ... EMR documentation experience Active CA RN License Shift Information: Day shift (0800-1630), Monday thru Friday Minimum Years of Experience: 2 Certifications/Requirements: BLS/BCLS more
    JobGet (09/15/24)
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  • Equiliem (Orange, CA)
    …position such as those listed above may also be qualifying.Preferred Prior authorization/ utilization review experience. Managed care experience. Post degree ABA ... motivated and experienced Care Manager , with Behavioral Health experience. The Care Manager is responsible for the oversight and review of Behavioral Health… more
    JobGet (09/15/24)
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  • Blanchard Valley Health System (Findlay, OH)
    …to the Acute Care Transitions Team, including the disciplines of Social Work, Case Management, Utilization Review , and Emergency Department Care Navigation ... of appropriate services during acute care stay. Duty 9: Maintains position as Utilization Review committee chair. Works in collaboration with ambulatory care… more
    JobGet (09/15/24)
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  • Accounting Now (Carson City, NV)
    …(ABA) services only, and there is licensed staff supervisionPrevious experience in case management/ utilization management with a broad range of experience with ... and outpatient professional treatment health benefits through telephonic or written review Will use appropriate screening criteria knowledge and clinical judgment to… more
    JobGet (09/15/24)
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  • Staffing Now (Carson City, NV)
    …(ABA) services only, and there is licensed staff supervision. Previous experience in case management/ utilization management with a broad range of experience with ... and outpatient professional treatment health benefits through telephonic or written review . Will use appropriate screening criteria knowledge and clinical judgment… more
    JobGet (09/15/24)
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  • Northeast Georgia Health System, Inc (Oakwood, GA)
    …to ensure appropriate feedback is received before product decisions are made. Utilization Review of necessity, quality, effectiveness and efficiency of medical ... of system-wide opportunities as they relate to Value Analysis standardization, utilization and implementation. Facilitate Value Analysis Teams (VAT) to most… more
    JobGet (09/15/24)
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  • Northeast Georgia Health System, Inc (Oakwood, GA)
    …the health of our communities. About the Role:Job SummaryUnder the supervision of the Utilization Review Manager , this position is responsible for ensuring ... of the pre-certification process.Works in conjunction with Physician offices, Case Management, Utilization Review , and patients to obtain supporting clinical… more
    JobGet (09/15/24)
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  • ChristianaCare (Wilmington, DE)
    …MODEL:Our Care Management Triad Team Model is a collaboration between the following:RN Case Manager - manage patient care and drive patient progression and ... discharge plan.Social Worker - resolve psycho-social barriers and supports discharge needs. Utilization Management - review patient status for appropriateness and… more
    JobGet (09/15/24)
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  • Case Manager - Utilization

    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
    Trinity Health (09/06/24)
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  • Case Manager , RN…

    Prime Healthcare (Lynwood, CA)
    …education, credentials and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/171837/ 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
    Prime Healthcare (08/23/24)
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  • Case Management Specialist

    University of Utah Health (Salt Lake City, UT)
    …those with an increased LOS, high dollar and frequent utilizers. + Collaborate with unit case manager , utilization review nurse and other organization ... designates charges related to specific condition. + Participates in organization Utilization Review Committee, weekly Medicare IPPS Case Reviews & RAC Audit … more
    University of Utah Health (09/12/24)
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  • Utilization Management Case

    Cedars-Sinai (Los Angeles, CA)
    …named us one of America's Best Hospitals! **What You Will Do in This Role:** The Utilization Review Case Manager validates the patient's placement to be ... follows the UR process as defined in the Utilization Review Plan in accordance with the...continued employment. **Req ID** : 4300 **Working Title** : Utilization Management Case Manager -… more
    Cedars-Sinai (07/28/24)
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