- UTMB Health (Galveston, TX)
- …6 months. Assignment in healthcare facilities requires a Certified Healthcare Facility Manager (CHFM). Acceptance of other facility management certifications in ... (CEFP) or Certified Healthcare Facility Manager (CHFM), or Certified Facilities Manager (CFM). Acceptance of other facility management certifications in lieu… more
- University Health (Hondo, TX)
- …years recent, full time hospital experience preferred. Work experience in case management , utilization review, or hospital quality assurance experience is ... and clinicians in the Ambulatory setting by gathering information, coordinating utilization efforts, and reviewing HCC quality indicators, and RAF scores to… more
- One Medical (San Francisco, CA)
- …care services, on-site labs, and programs for preventive care, chronic care management , common illnesses and mental health concerns have been delighting people for ... demonstrating clinical excellence and practicing sustainability. In collaboration with your manager , the District Medical Director and your operations partner, the… more
- University Health (San Antonio, TX)
- …Three years recent, full-time hospital experience preferred. Work experience in case management , utilization review or hospital quality assurance experience is ... to practice as a registered nurse is required. National certification in related field is preferred. Case Manager Certification (CCM or ANCC) is highly desirable. more
- Baystate Health (Springfield, MA)
- …Minimum - Midpoint - Maximum $46.22 - $53.13 - $62.85 **Per Diem Hospital Case Manager / Utilization Management ** The **RN Hospital Case Manager ** ... of a designated population of patients. The Hospital Case Manager is responsible for overseeing an efficient plan that...for transitions + Leads the team to ensure appropriate utilization of patient resources and directs care to other… more
- Elevance Health (Washington, DC)
- …office 4 days each week. The office is located at 609 H. Street NE.** The ** Manager of Utilization Management ** **ll** is responsible for managing a team of ... and acuity. + Provides direct oversight and is responsible for Utilization Management execution/decision making for managed member populations. Primary… more
- Elevance Health (Tampa, FL)
- …is granted as required by law. *Must reside in the state of Florida* The ** Manager of Utilization Management ** is responsible for managing a team of ... physical and/or behavioral health practitioners responsible for coordinating member service, utilization , access, care management and/or concurrent review to… more
- Beth Israel Lahey Health (Plymouth, MA)
- …a job, you're making a difference in people's lives.** Full Time **Job Description:** ** Utilization Review & Denials management manager - Full Time** **Who ... of Experts and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager , you will:** + Directs staff performance regarding… more
- Intermountain Health (Las Vegas, NV)
- …including social work and complex care planning, transitions of care, and utilization management . The position ensures compliance with state, national, and ... 5:30 pm Holiday and weekend coverage when needed. The Manager of Care Management I leads and...Demonstrated care management experience. + Authorization or Utilization Management experience. + Leadership experience. **Preferred… more
- Highmark Health (Harrisburg, PA)
- …Inc. **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health ... setting **Preferred** + Experience in UM/CM/QA/Managed Care + Medical/Surgical experience + Utilization Management (UM) or (UR) Utilization Review experience… more
- Huron Consulting Group (Chicago, IL)
- …Join our team as the expert you are now and create your future. The Manager of Utilization Management is responsible for planning, organizing, developing, ... Review Plan and the overall operation of the Utilization Management Department in accordance with federal,...and may be implemented in the future._ **Position Level** Manager **Country** United States of America At Huron, we're… more
- Guthrie (Sayre, PA)
- …approaches and make recommendations for alternate levels of care. The Acute Case Manager also performs Utilization Management throughout the continuum of ... hospital inpatient admissions and short procedures by translating clinical information to Utilization Management requirements using pre ‐ determined criteria. b.… more
- Actalent (Duluth, GA)
- …Description Nurse will be working on site. Responsibilities will include: Case Manager / Utilization Management (90%) and Discharge Planning. Develop ... Case management & Utilization management ...Oregon. Required Skills At least 1 year of case management /care management Must be a RN (Registered… more
- Sanford Health (Rapid City, SD)
- …Schedule:** Full time **Weekly Hours:** 40.00 **Department Details** Join our team as a Utilization Review and Case Management Manager and lead a ... providing direct supervision of all departmental staff. Maintains a standardization of utilization management process to ensure all policies and procedures are… more
- Community Health Systems (Siloam Springs, AR)
- **Job Summary** The Care Manager - LPN supports effective utilization management and discharge planning by coordinating patient care activities under the ... services, escalating cases as needed to the Physician Advisor or Utilization Management (UM) committee. + Identifies avoidable hospital days and communicates… more
- Community Health Systems (Bentonville, AR)
- …live! **Job Summary** The Care Manager - LPN supports effective utilization management and discharge planning by coordinating patient care activities under ... services, escalating cases as needed to the Physician Advisor or Utilization Management (UM) committee. + Identifies avoidable hospital days and communicates… more
- Billings Clinic (Billings, MT)
- …issues, escalates to Supervisor, Manager , or Director * Insurance and Utilization Management * Maintains working knowledge of CMS requirements and ... care manager staff provide services consisting of comprehensive case management , care coordination, continuing care services, and clinical social work services… more
- Amergis (Orange, CA)
- …Case Manager to help support a health insurance agency! The Medical Case Manager (BHI Utilization Management ) will be responsible for reviewing and ... as those listed above may also be qualifying. Preferred Qualifications: + Utilization management reviewer experience. + Managed care experience. + Behavioral… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- … review functions. Oversees daily operations, which include supervising staff performing utilization management activities. The goal is to achieve clinical, ... *_SUMMARY:_* We are currently seeking a* Utilization Review Manager * to join ourTransitional...financial, and utilization goals through effective management , communication, and… more
- Aspirus Ironwood Hospital (Wausau, WI)
- …preferred, ie, Certified Professional in Healthcare Quality (CPHQ), Certified Case Manager (CCM), Certified Professional Utilization Management (CPUM), ... administration, or nursing. + Extensive knowledge of payer mechanisms and clinical utilization management is required. + A minimum of five years of experience in… more
