- 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
- 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 (Lynwood, CA)
- …credentials and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/174454/* case - manager -rn-%2c- 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
- Lowe's (Charlotte, NC)
- …of experience in a clinical position. + 3-5 Years of Experience as a Case Manager or Utilization Review Nurse in worker's compensation + Experience in a ... Office + Unrestricted RN license in home State + CCM - Certified Case Manager + CRRN - Certified Rehabilitation Registered Nurse + CDMS - Certified Disability… more
- Trinity Health (Columbus, OH)
- …**Description:** ** Utilization Review RN, Casual / PRN** Position Purpose: RN Utilization Review Case Mgr ensures that services are delivered in a ... manner that balances quality of care with efficiency, cost-containment and compliance. Minimum Qualifications: * Graduate of an accredited Registered/Professional Nursing program. * Licensure as a Registered Nurse (RN) in Ohio. * 3+ years of relevant clinical… more
- 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
- Henry Ford Health System (Detroit, MI)
- …+ Innovative Team Structure: Benefit from our new dyad Social Work/RN Case Manager model and remote utilization review setup, allowing you to excel ... and dynamic environment? Join our team as a Registered Nurse (RN) Case Manager ! Who We're Looking For: Passionate, compassionate, and dedicated individuals who… 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
- Lucile Packard Children's Hospital Stanford (Palo Alto, CA)
- …responsibilities include coordinating all facets of a patient's admission/discharge; performing utilization review activities, including review of patient ... and performance/quality improvement activities that lead to optimal patient outcomes. A Case Manager differs from other roles in professional nursing/health care… more
- Prime Healthcare (Montclair, CA)
- …and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/175009/ case - manager -%28rn%29 utilization ... 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 (North Las Vegas, NV)
- …computer skills. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/174491/ case - manager -%28rn%29 utilization ... 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 (National City, CA)
- …and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/174432/** case - manager utilization ... to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity,...a related field. At least one year experience in case management, discharge planning or nursing management; + CCM… 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
- 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
- Emory Healthcare/Emory University (Atlanta, GA)
- …development, and leadership programs + And more **Description** We're seeking an **Assistant Manager , Utilization Review ** , responsible for supervising and ... coordinating activities of personnel in the Utilization Review Department, including: + Staff schedules...At least 3 years of healthcare experience required. + Case Management certification (CCM or ACM) preferred. + Leadership… 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