- Kaiser Permanente (Fontana, CA)
- …the interdisciplinary approach to providing continuity of care, including Utilization management , Transfer coordination, Discharge planning, and obtaining ... for outside services for patients/families.Conducts daily clinical reviews for utilization /quality management activities based on guidelines/standards for… more
- ChristianaCare (Wilmington, DE)
- …Management reviews patient status for appropriateness and anticipated payer coverage.CASE MANAGEMENT : Identify patients who have post - acute care, ... initiate, and establish a discharge plan for patients with post - acute care needs, collaborating with the physician,...18 months of eligibility. Complete 8 continuing education credits (CEU) per year in Utilization and/or Case Management… more
- Kaiser Permanente (San Francisco, CA)
- …and Medi-Cal benefits to specific patient situations.Participates in Utilization Management /Quality Assurance activities.Assist in coordinating communication ... team.Must have solid psychosocial assessment skills.Knowledge of chronic and acute disease and how it impacts patient and family functioning.Demonstrated… more
- Humana (Salt Lake City, UT)
- …require interpretation and independent determination of the appropriate courses of action. The Post - Acute Utilization Management Nurse 2 (VSP): + ... caring community and help us put health first** The Utilization Management Nursing Professional contributes to team...state, with no disciplinary action + 2+ years of Post Acute clinical experience in a SNF,… more
- Trinity Health (Wilmington, DE)
- …or Physical Therapy or a related field** , and 5 or more years of post - acute utilization management and/or integrated care coordination experience. + ... a member of Trinity Health Mid-Atlantic is seeking a Post - Acute Network Liaison to join our Accountable...in oral, written and electronic communication. + Competency in utilization management and transition of care … 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 (Chicago, IL)
- …Coordinates as needed with the transitional care team, hospital, skilled nursing facility, post - acute , utilization management , and home-based services ... PCP requests for external cardiology referrals and participates in delegated utilization authorizations; determines level of urgency of follow-up, referral /… 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
- Dignity Health (Northridge, CA)
- …400 care centers. Visit dignityhealth.org/northridgehospital for more information. The RN Utilization Management Coordinator (UMC) is responsible for assessing ... and collaboration with nursing physicians therapy services insurers and post acute service providers to pace the...+ Current CA Registered Nurse (RN) license + Prior Utilization Management experience in a clinical or… more
- Sutter Health (Sacramento, CA)
- …SHSO-Sutter Health System Office-Valley **Position Overview:** This position facilitates utilization management (UM) processes to support that the ... knowledge of laws, regulations and professional standards affecting case management practice in an integrated delivery system: including but...CDPH and TJC. + A broad knowledge base of post - acute levels of care and associated regulatory… more
- CVS Health (New York, NY)
- …state of NY. 5 years of nursing experience. 1 year experience in Utilization Management . Reliable transportation required.Mileage is reimbursed per our company ... + Responsible for performing other duties as requested by Associate Director, Post - Acute Care and MSHP Leadership Population Health Transitional Care… more
- Access Dubuque (Dubuque, IA)
- …**Experience:** . At least 2 years of experience in/with acute care with case management or post - acute care experience. . 3+ years of experience in/with ... to assist in appropriate length of stay and other utilization to ensure timely transitions and stewardship in continuum...acute care with case management or post - acute care experience… 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
- Hackensack Meridian Health (Hackensack, NJ)
- …standards, and regulatory/payor requirements. The role integrates and coordinates utilization management , care coordination, discharge planning functions and ... Collaborates with social work for a seamless transfer from acute to post acute care....Required: + Minimum of 4 years experience in Case Management in an acute care setting. +… 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
- Houston Methodist (Houston, TX)
- …provided as applicable. (EF) 2. Uses resources efficiently to maximize utilization of time and equipment. Self-motivated to independently manage time effectively ... taking appropriate action. Ensures own career discussions occur with appropriate management . Completes and updates the My Development Plan on an on-going… more
- Kelsey-Seybold Clinic (Pearland, TX)
- **Responsibilities** The Utilization Management Representative (UMR) provides office support for all units within the Utilization Management and/or ... direct communication with KSC Clinic Representatives as needed. The Utilization Management Representative is responsible for clerical...and entry of bed day data and pre and post - acute certification requests for specific services. Under… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- About The Role BHPS provides Utilization Management services to its clients. The Utilization Management Nurse performs daily medical necessity reviews. ... with or without notice. Primary Responsibilities + Performs concurrent utilization reviews ( Acute , SNF, LTACH, ARF) and...care appropriate for the members needs, acuity and determine post - acute needs of member including levels of… more
- Beth Israel Lahey Health (Burlington, MA)
- …the healthcare team to coordinate and facilitate patient discharge. 14) Works with the Post Acute Care Coordinator to facilitate timely patient access to post ... . 7) Works with patients and families to facilitate post hospital care and develop plans to meet short...of medical/surgical nursing care experience. -Two years of Case Management or Utilization Management experience… more
