- Humana (Boise, ID)
- …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 (Columbus, OH)
- …state of residence + 1+ years of clinical experience in acute or post - acute setting + Utilization management is a 24/7 operation. Work schedules will ... schedules may include weekends, holidays, and evening hours_ As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate,… more
- CVS Health (Montgomery, AL)
- …- Must possess 1+ years of clinical experience in acute or post acute setting - Utilization management is a 24/7 operation. Work schedules will ... and external constituents in the coordination and administration of the utilization /benefit management function. + Typical office working environment with… 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
- Ascension Health (Baltimore, MD)
- …Services at Ascension Saint Agnes Hospital is responsible for overseeing the integration and management of Post Acute Care, Palliative Care, and Transitional ... treatment planning and core measures, Discharge Planning, tracking of the post - acute period and provision of disease management , and contracting internally… more
- Sharp HealthCare (San Diego, CA)
- …competency and individual development planning process.Maintain current knowledge of case management , utilization management , and discharge planning, as ... as Allscripts.Identify opportunities for cost reduction and participate in appropriate utilization management venues.Escalate and refers cases for consultation… 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 (Raleigh, 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
- CVS Health (Tallahassee, FL)
- …to make health care more personal, convenient and affordable. **Position Summary** Utilization management is a 24/7 operation. Work schedules may include ... holidays and evening rotations. This is a full-time remote Utilization Management Nurse Consultant opportunity. As a...Registered Nurse + 1+ years of clinical experience in acute or post - acute setting +… 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
- Munson Healthcare (Traverse City, MI)
- …of resources. + Assists in developing and revising policies to support utilization management activities, including criteria and guidelines for appropriate use ... colleagues and hospital associates at information meetings. + May represent Utilization Management on various committees, professional organizations, physician… more
- LA Care Health Plan (Los Angeles, CA)
- …clinical experience in an acute hospital setting. At least 2 years of Utilization Management /Case Management experience in a hospital or HMO setting . ... Utilization Management Nurse Specialist RN II...and Physician Advisor on case reviews for pre-service, concurrent, post -service and retrospective claims medical review. Monitors and oversees… more
- CVS Health (Columbus, OH)
- …convenient and affordable. **Position Summary** **This is a fulltime remote Utilization Management opportunity.** **The schedule is Monday through Friday, ... external constituents in the coordination and administration of the utilization /benefit management function. + UMNC meets set...Registered Nurse + 1+ years of clinical experience in acute or post - acute setting +… more
- Sutter Health (Sacramento, CA)
- …**Organization:** SHSO-Population Health Services-Valley **Position Overview:** This position facilitates utilization management (UM) processes to support that ... knowledge of laws, regulations and professional standards affecting case management practice in an integrated delivery system: including but...Manual, CDPH and TJC. A broad knowledge base of post - acute levels of care and associated regulatory… more
- Prime Healthcare (National City, CA)
- …With Us! (https://careers-primehealthcare.icims.com/jobs/180750/case-manager-rn utilization - management /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) ... programs and services to meet the changing needs of our community. Our 291-bed, acute care hospital features the San Diego Spine & Joint Center, a highly… 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
- Robert Half Office Team (Pearland, TX)
- Description We are offering a contract employment opportunity for a Utilization Management Representative in Pearland, Texas. The Utilization Management ... is primarily focused on providing office support within the Utilization Management and Population Health Department, with...and entry of bed day data and pre and post - acute certification requests for specific services. Requirements… more
- CVS Health (Jefferson City, MO)
- …unrestricted RN licensure in state of residence - Must possess 1+ years of clinical experience in acute or post acute setting - Must be willing and able to ... and external constituents in the coordination and administration of the utilization /benefit management function. - Typical office working environment with… more
- Prime Healthcare (Montclair, CA)
- …Us! (https://careers-primehealthcare.icims.com/jobs/181372/case-manager-%28rn%29 utilization - management /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) ... Overview Montclair Hospital Medical Center is a 106-bed acute care, not-for-profit community hospital, received the "100 Top Hospital" in the nation award from IBM… more