- Healthfirst (NY)
- **Duties/Responsibilities:** + Provides case management services for assigned member caseloads which includes: + Pre-certification performing ... in a related discipline + Experience in managed care, case management , identifying alternative care options, and...identifying alternative care options, and discharge planning + Certified Case Manager + Interqual and/or Milliman knowledge… more
- Prime Healthcare (Chino, CA)
- …education, credentials and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/166768/ case - manager -%28rn%29 utilization - management ... Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred.3. Five years acute care...nursing experience preferred. At least one year experience in case management , discharge planning or nursing … more
- Prime Healthcare (National City, CA)
- …education, credentials and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/175861/** case - manager -rn utilization - management ... Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred.3. Five years acute care...nursing experience preferred. At least one year experience in case management , discharge planning or nursing … more
- Prime Healthcare (Montclair, CA)
- …education, credentials and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/175009/ case - manager -%28rn%29 utilization - management ... Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred.3. Five years acute care...nursing experience preferred. At least one year experience in case management , discharge planning or nursing … 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
- Guthrie (Sayre, PA)
- …outcomes in timely, coordinated, and cost- effective manner. The Manager -of Case Management supports utilization management , discharge planning, ... and care coordination scope of practice within the department. . . The Manager - Case Management collaborates cooperatively with members of the… more
- Mayo Clinic (Jacksonville, FL)
- …The RN Case Manager provides leadership through education on case management / utilization management concepts, committee work, research, and ... utilization management , care coordination, resource utilization , and clinical documentation. The RN Case ...resource utilization , and clinical documentation. The RN Case Manager will function within the Mayo… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Case Manager is responsible for all aspects of case management / utilization review for an assigned group of inpatients, ED ... management and the transition of care. The Case Manager actively participates in specific clinical...patients where utilization review, discharge planning, and/or case management will be needed using standardized… more
- Mayo Clinic (Rochester, MN)
- …The RN Case Manager provides leadership through education on case management / utilization management concepts, committee work, research, and ... utilization management , care coordination, resource utilization , and clinical documentation. The RN Case ...resource utilization , and clinical documentation. The RN Case Manager will function within the Mayo… more
- LA Care Health Plan (Los Angeles, CA)
- …in Certified Professional in Utilization Review (CPUR), Certified Case Manager (CCM), Utilization Management or Compliance Salary Range Disclaimer: ... current and unrestrited California License. Licenses/Certifications Preferred Certified Professional in Utilization Review (CPUR) Certified Case Manager … more
- Children's Hospital Boston (Boston, MA)
- …as a Case Manager (Discharge Planning and or Utilization Management ) preferred. Office/Site Location:BostonRegular, Temporary, Per Diem:Per Diem Remote ... 74825BRJob Posting Title:RN Case Manager , Inpatient & Ambulatory (Per...length of stay, resource allocation, funding sources, and capacity management to optimize delivery of appropriate services. + Actively… more
- Covenant Health (Lewiston, ME)
- …+ Minimum of five years of broad clinical experience preferred. + Case Management and/or Utilization Manager experience preferred. + Certification as CCM ... health needs while decreasing the incidence of duplication of care. The Case Manager works closely with, and delegates care to, the High-Risk Social Worker… 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 case ... of Iowa. + Bachelor's Degree required. BSN preferred + Utilization management focused certifications that are recognized...insurance coverage for acute care and skilled care + Case management experience preferred Special Skills and… more
- Prime Healthcare (Lynwood, CA)
- …and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/171837/* case - manager %2c-rn utilization ... Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred.3. Five years acute care...nursing experience preferred. At least one year experience in case management , discharge planning or nursing … 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 ... a vital role within a leading health organization. Help ensure smooth and efficient case management processes to support quality care. Take your expertise to the… more
- Prime Healthcare (Lynwood, CA)
- …licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/174454/* case - manager -rn-%2c- utilization ... Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred.3. Five years acute care...nursing experience preferred. At least one year experience in case management , discharge planning or nursing … more
- Trinity Health (Baker City, OR)
- …the position:** As a Clinical Resource Manager you will provide hospital case management / utilization review and discharge planning to determine care ... great opportunity available for a PRN** **Clini** **cal Resource Manager (hospital case management )** **to...to meet regulatory standards. + Promotes effective and efficient utilization of clinical resources from admission to discharge. +… more
- Molina Healthcare (NV)
- …one or more of the following activities: care review/ utilization management (prior authorizations, inpatient/outpatient medical necessity, etc.), case ... years in one or more of the following areas: utilization management , case management...Association** Any of the following: Certified Case Manager (CCM), Certified Professional in Healthcare Management … more
- Trinity Health (Silver Spring, MD)
- …BSN required; MSN Degree preferred. + At least 3 years of experience in hospital case management or related activity. + Minimum of 1-3 years management ... - 4:30pm + Reporting to the Director of Care Management + The RN Manager is responsible...required. + Extensive knowledge of payer mechanisms and clinical utilization management is required **Preferred:** + At… more
- AmeriHealth Caritas (Dublin, OH)
- ** Utilization Management Plan Oversight Manager...unrestricted RN license in OH. + 3+ years of utilization / case management experience in relevant ... Chief Medical Officer for the Ohio Market, this position is representing Utilization Management (UM) in state interactions/audits, validation of regulatory… more