- Humana (Salem, OR)
- …require interpretation and independent determination of the appropriate courses of action. The Post - Acute Utilization Management Nurse 2: + Review ... caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing...state, with no disciplinary action + 2+ years of Post Acute clinical experience in a Skilled… more
- CVS Health (Sacramento, CA)
- …- Must possess 1+ years of clinical experience in acute or post acute setting - Utilization management is a 24/7 operation. Work schedules will ... may include weekends and holidays and evening rotations._ As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate, document… more
- CVS Health (Austin, TX)
- …state of residence + 1+ years of clinical experience in acute or post - acute setting + Utilization management is a 24/7 operation. Work schedules will ... solutions to make health care more personal, convenient and affordable. **Position Summary** Utilization Management is a 24/7 operation and work schedules may… more
- Sutter Health (Berkeley, CA)
- …change. This position coordinates the utilization management , resource management , discharge planning, post - acute care referrals and care ... interview patient/family and determine preferences for post - acute care services. Utilization Management . * Completes initial InterQual review screening… more
- Sutter Health (San Francisco, CA)
- …oversees the Case Management Assistants to determine preferences for post - acute care services. Utilization Management . * Reviews medical record to ... communicates to patient/family prior to transition. * Assures necessary paperwork for post - acute transfers to comply with state and federal regulatory… more
- ChenMed (Houston, TX)
- …Assists and coordinates, in conjunction with the transitional care team; hospital, SNF, post - acute , delegated utilization management and home-based ... Director/Manager, Center Managers, external sub-specialists and providers in hospitals and post - acute care facilities. **KNOWLEDGE, SKILLS AND ABILITIES:** +… more
- HCA Healthcare (Asheville, NC)
- …prevent readmissions, and lower total cost of care thru the appropriate utilization of Post - Acute services.** **Qualifications:** **Required Education: ... diversity and inclusion thrive? Submit your application for our Post Acute Clinical Specialist Long Term ...across the continuum by utilizing essential activities of care management in direct patient contact. They will maximize positive… more
- WellSpan Health (York, PA)
- …Full Time General Summary Supervises and oversees the operations of the utilization management department. Works with hospital, regional, medical group, ... Population Health, post - acute services, revenue services and system leadership...IT, Finance, and Regulatory Affairs to enhance WellSpan Health's utilization management capabilities and execution through the… more
- LA Care Health Plan (Los Angeles, CA)
- …in the acute setting. Works with UM leadership, including the Utilization Management Medical Director, on requests where determination requires extended ... Utilization Management Admissions Liaison RN II...Provides the primary clinical point of contact for inpatient acute care hospitals requesting Inpatient care/ post -stabilization admission… more
- Sharp HealthCare (San Diego, CA)
- …the episode of care and supports other members of the System Centralized Utilization Management team to ensure final status reconciliation. This position ensures ... ensure appropriate patient status and assists with repatriation and post -stabilization reviews for patients before the patient is bedded,...Degree in a health related field. + 3 Years Utilization Management or case management … more
- UNC Health Care (Smithfield, NC)
- …stay, and discharge reviews in accordance with federal regulations & the Hospitals? Utilization Management Plan. In addition, the Utilization Manager is ... and payors), and assesses the patient care progression from acute care episode through post discharge for...management referrals. Initiates appropriate social work referrals. 3. Utilization Management Process - Performs utilization… more
- Intermountain Health (Columbus, OH)
- …Care Managers or Utilization Review RNs, makes timely referrals to post - acute care providers, agencies, and community resources and/or communicates with ... dates for utilization review. + Transmits initial request information for Acute Rehab authorizations (SMG). + Communicates with post - acute agencies… more
- CVS Health (Jefferson City, MO)
- …solutions to make health care more personal, convenient and affordable. **Position Summary:** Utilization Management is a 24/7 operation and work schedules may ... one major and one minor holiday yearly. As a Utilization Management Nurse Consultant, you will utilize...of residence + 1+ years of clinical experience in acute or post acute setting… more
- Actalent (San Bernardino, CA)
- …of patient care as it relates to acute inpatient stay and post - acute facility stay. The Utilization Review RN Coordinates continuing care/outside ... Description: As a part of the Utilization Management team the Utilization...RN License BLS AHA Must be experienced with Care Management Prior Authorizations Acute Outpatient experience -… more
- CVS Health (Trenton, NJ)
- …personal, convenient and affordable. **Position Summary** This is a fulltime remote Utilization Management Nurse Consultant opportunity. Utilization ... external constituents in the coordination and administration of the utilization /benefit management function. + Typical office working...Registered Nurse + 1+ years of clinical experience in acute or post - acute setting +… more
- CVS Health (Sacramento, CA)
- …work-related meetings, training sessions or other events, as directed by their Leader. - Utilization Management is a 24/7 operation and the work schedule may ... external constituents in the coordination and administration of the utilization /benefit management function. -UMNC meets set productivity...a Registered Nurse -1+ years of clinical experience in acute or post - acute setting -May… more
- UNC Health Care (Rocky Mount, NC)
- …hospital, continued stay, and use of other hospital services in accordance with Utilization Management Plan, Conditions of participation (CoP) and other federal ... throughput from hospital admission through discharge and to the appropriate post - acute setting. **Responsibilities:** 1. Constantly maintains an environment of… more
- CVS Health (Raleigh, NC)
- …and deliver solutions to make health care more personal, convenient and affordable. Utilization Management is a 24/7 operation and work schedule may include ... external constituents in the coordination and administration of the utilization /benefit management function. + Typical office working...- Must possess 1+ years of clinical experience in acute or post acute setting… more
- Geisinger (Lewistown, PA)
- …and handling of equipment. + Participates in unit-based decision-making regarding the utilization of evidence- based practice. + Actively participates as a team ... vision, dental and domestic partners. Perhaps just as important, from senior management on down, we encourage an atmosphere of collaboration, cooperation and… more
- Geisinger (Lewistown, PA)
- …and handling of equipment. + Participates in unit-based decision-making regarding the utilization of evidence- based practice. + Actively participates as a team ... vision, dental and domestic partners. Perhaps just as important, from senior management on down, we encourage an atmosphere of collaboration, cooperation and… more