- University of Maryland Medical System (La Plata, MD)
- …experience in a healthcare setting. Must have previous Case Management and Utilization experience; CCM (Certified Case Manager ) or ACM (Accredited Case ... benefits support a healthy, balanced lifestyle. Job Description Lead Nurse Case Manager Full-time / Day-Shift (Mon-Fri...Plata, MD General Summary Under limited supervision, assists the manager of Case Management Services in overseeing… more
- Humana (Jefferson City, MO)
- **Become a part of our caring community and help us put health first** The Manager , Utilization Management Nursing utilizes clinical nursing skills ... communication of medical services and/or benefit administration determinations. The Manager , Utilization Management Nursing...to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) in IL, WI, MN, SD, ND, IA,… more
- Dartmouth Health (Lebanon, NH)
- Overview The Manager of Utilization Management ...These are just a few highlights of being a nurse at Dartmouth Hitchcock Medical Center and Clinics in ... is responsible for day to day operations of the utilization review program at multiple Dartmouth Health system hospitals...the success of our system through our shared governance nursing model. * We offer a rigorous, research-focused environment.… more
- UCLA Health (Los Angeles, CA)
- …the next level. You can do all this and more at UCLA Health. As a Manager for Medicare Advantage Utilization Management , you'll provide direct management ... RN licensure in CA required + Bachelors of Science, Nursing (BSN) degree required + Five or more years...(BSN) degree required + Five or more years of utilization management required + Four or more… more
- Prime Healthcare (National City, CA)
- …and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/174432/**case- manager utilization - management ... degree in a related field. At least one year experience in case management , discharge planning or nursing management ; + CCM or obtained within 6 months of… more
- Lucile Packard Children's Hospital Stanford (Palo Alto, CA)
- …performance/quality improvement activities that lead to optimal patient outcomes. A Case Manager differs from other roles in professional nursing /health care ... nature, level and purpose of the job. Case Managers are licensed nursing professionals responsible for coordinating continuum of care and discharge planning… more
- Veterans Affairs, Veterans Health Administration (St. Louis, MO)
- …Care System (VASTLHCS), St. Louis, Missouri. The Registered Nurse Case Manager ( Utilization Management ) demonstrates leadership, experience, and creative ... Summary This Staff Nurse position is located within Nursing ... Total Rewards The primary purpose of this Registered Nurse Case Manager (RNCM) is to deliver… more
- Cedars-Sinai (Los Angeles, CA)
- …thereafter as a condition of continued employment. **Req ID** : 4300 **Working Title** : Utilization Management Case Manager - 8 Hour Days Per Diem ... **Department** : Utilization Management **Business Entity** : Cedars-Sinai Medical Center **Job Category** : Patient Services **Job Specialty** : Case … more
- Elevance Health (Topeka, KS)
- …is a hybrid role.** The ** Manager of Behavioral Health - Kansas - Utilization Management (BH UM)** will manage a team of licensed clinicians and non-clinical ... or federal requirements that may apply; provided that the manager 's director has one of the types of licensure...and/or outpatient psychiatric and chemical dependency treatment and prior utilization management experience; or any combination of… more
- Prime Healthcare (Montclair, CA)
- …and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/175009/case- manager -%28rn%29 utilization - management ... years work experience post-graduation of an accredited school of nursing and a current state Registered Nurse ...experience preferred. At least one year experience in case management , discharge planning or nursing management… more
- Prime Healthcare (North Las Vegas, NV)
- …computer skills. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/174491/case- manager -%28rn%29 utilization - management ... years work experience post-graduation of an accredited school of nursing and a current state Registered Nurse ...experience preferred. At least one year experience in case management , discharge planning or nursing management… more
- Molina Healthcare (NV)
- …not a compact state at this time.** **Prior experience with managed care (Medicaid, Medicare) Utilization Management processes and 3 + years in management / ... performing one or more of the following activities: care review/ utilization management (prior authorizations, inpatient/outpatient medical necessity, etc.),… more
- Trinity Health (Silver Spring, MD)
- …acute healthcare setting required. + Extensive knowledge of payer mechanisms and clinical utilization management is required **Preferred:** + At least 5-7 years ... - 4:30pm + Reporting to the Director of Care Management + The RN Manager is responsible...status and insurance. **Responsibilities:** + Works collaboratively with the Nursing Director and Sr. Director of Care Management… more
- AdventHealth (Altamonte Springs, FL)
- … will oversee ED, Inpatient, and Specialist utilization , and manage care management outcomes. The Senior Manager of Utilization will provide support, ... RN on care management duties/assignments. The Senior Manager of Utilization will be responsible for...nursing with 4 years of experience. . Registered Nurse with an active and unrestricted license to practice… more
- BronxCare Health System (Bronx, NY)
- …and implementation of educational programs for Denial Prevention and Management . Responsibilities - Establish and maintain positive relationships with patients, ... includes data collection, analysis, implementation of and compliance with risk management and claims activities, support of and participation in Continuous Quality… 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 ... reports and manage computer applications and logs + Monitor members/patients followed by Case Management + Work directly with a nurse team lead + Review pending… more
- LA Care Health Plan (Los Angeles, CA)
- …Certification in Certified Professional in Utilization Review (CPUR), Certified Case Manager (CCM), Utilization Management or Compliance Salary Range ... the coordination of member care with internal LA Care departments such as Care Management (CM), Utilization Management (UM), Managed Long Term Services and… more
- Sharp HealthCare (San Diego, CA)
- …System Integrated Care Management (ICM) team the Transfer and Admissions Utilization Manager (UM) partners with the Centralized Patient Placement Center ... Commission for Case Manager Certification; California Registered Nurse (RN) - CA Board of Registered Nursing...Experience and understanding of federal and state regulations governing utilization management . + Accredited Case Manager… more
- ERP International (Corpus Christi, TX)
- **Overview** ERP International is seeking a **Registered Nurse (RN)** ** Utilization Manager ** for a full-time position in support of the **Naval Health ... as appropriate. * Participate in all phases of the Utilization Management Program (UMP) and ensure that...Management is required. Full time employment in a nursing field within the last 36 months is mandatory.… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position ... net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN...implement a successful discharge plan. Works with the UM Manager and Physician Advisor on case reviews for pre-service,… more
