- LifePoint Health (Las Cruces, NM)
- …state or local law./ **Job:** **Nursing* **Organization:** **Memorial Medical Center* **Title:** *RN Case Manager - UM - PRN* **Location:** *New Mexico-Las ... Memorial Medical Center is a 199-bed hospital offering a spectrum of care, including diagnostic, therapeutic, and rehabilitative services, both on an inpatient and outpatient basis. *Where We Are:* From national parks and monuments to one of the top-rated… more
- Children's Hospital Boston (Boston, MA)
- …Title:RN Case Manager , Utilization Review, Case Management UM /UR (24 hrs)Department:Patient Services-Patient Care ... coordination of care. + Supporting the functions of the UM department as assigned + Working 24 hours per...required, MSN preferred + 1 year at least of Case Management/UR experience preferred + Case Management… more
- Insight Global (Irvine, CA)
- Job Description Under the general direction of the Director of UM , UM Manager , and the UM Supervisor, the Prior Authorization LVN ensures that prior ... nationally recognized guidelines, criteria, and evidence based standards. Also assists UM management and Compliance team in preparation for audits and other… more
- Apex Health Solutions (Houston, TX)
- Summary: The UM Reviewer serves as a contact and resource person to Health Solutions' members for the utilization review (UR) of healthcare services. The UM ... or issues arise. To support care management initiatives, the UM Reviewer should also identify enrollees in need of... Reviewer should also identify enrollees in need of case /disease management services so that proactive interventions can occur.… more
- AmeriHealth Caritas (Orlando, FL)
- **Medical Director, UM Review, Family Medicine** Location: Orlando, FL Primary Job Function: Medical Management ID**: 31409 **Job Brief** Must be able to practice in ... within 3 months of employment. 5+ yrs clinical practice. UM /Care Coordination exp. preferred. Your career starts now. We...associates and Providers. + Serves as medical advisor and manager for all clinically related activities. + Assures that… more
- Molina Healthcare (Spokane, WA)
- …Clinical Social Worker (LCSW) + Advanced Practice Social Worker (APSW) + Certified Case Manager (CCM) + Certified in Health Education and Promotion (CHEP) ... the adult behavioral health system in Washington State and Utilization Management ( UM ) experience is highly preferred** . **_Further details to be discussed during… more
- Molina Healthcare (Nacogdoches, TX)
- …auditing of registered nurse and other clinical functions in Utilization Management ( UM ), Case Management (CM), Member Assessment Team (MAT), Health Management ... + May conduct staff trainings as needed. + Communicates with QA supervisor/ manager about issues identified and works collaboratively to resolve/correct them. **JOB… more
- Sharp HealthCare (San Diego, CA)
- …Nursing & Psychiatric Technicians -REQUIRED **Preferred Qualifications** + Experience as a case manager or discharge planner interacting with managed care ... payers. **Essential Functions** + Act as a resource Facilitates direct admissions to SNF from the Emergency Room, Physician offices, or home coordinating with the SNF admission liaison for authorization of level of care as appropriate. Assists with transfers… more
- Elevance Health (Nashville, TN)
- …with providers and external physicians. + May conduct peer-to-peer clinical appeal case reviews with attending physicians or other ordering providers to discuss ... to Medical Director Associates. + Works independently with oversight from immediate manager . + May be responsible for an entire clinical program and/or independently… more
- Elevance Health (Las Vegas, NV)
- …with providers and external physicians. + May conduct peer-to-peer clinical appeal case reviews with attending physicians or other ordering providers to discuss ... to Medical Director Associates. Works independently with oversight from immediate manager . May be responsible for an entire clinical program and/or independently… more
- Elevance Health (Atlanta, GA)
- …with providers and external physicians. + May conduct peer-to-peer clinical appeal case reviews with attending physicians or other ordering providers to discuss ... to Medical Director Associates. + Works independently with oversight from immediate manager . + May be responsible for an entire clinical program and/or independently… more
- Houston Methodist (Nassau Bay, TX)
- At Houston Methodist, the Manager Case Mgmt Social Svcs position is responsible for functional and operational aspects of the Case Mgmt./Social Work ... corporate and hospital administrators, medical staff, and defined customers related to the Case Mgmt. system. The Manager Case Mgmt./Social Work position… more
- Sharp HealthCare (San Diego, CA)
- …with direct reports.Ensure staff understanding and support the achievement of UM Department goals, effective case management while maintaining compliance ... **What You Will Do** Provide leadership and direct supervision for Utilization Management ( UM ) department staff. Accountable for results of the UM department as… more
- HCA Healthcare (Englewood, CO)
- …dedicated to its patients, colleagues and communities. Help guide our team as a(an) Manager Case Management and **help us improve more lives in more ways** ... Our Swedish Medical Center team is looking for a Manager for Case Management. HCA Healthcare is...in Nursing and/or Master's degree preferred + BLS + UM /CM certification preferred + One to three years charge/lead/supervisory/management… more
- ERP International (Yuma, AZ)
- **Overview** ERP International, LLC is seeking a **Registered Nurse - Case Manager ** for a full-time position at theCamp Pendleton **Branch Health Clinic** in ... for community resources. * Integrate CM and utilization management ( UM ) and integrating nursing case management with...for professional growth and development as related to the case manager position and maintenance of CM… more
- Omaha Children's Hospital (Omaha, NE)
- …team to assess for diagnosis, care needs, and discharge plans. * Introduces Nurse Case Management (NCM) role to family. * Completes NCM assessment and documents in ... processes. + Communicates and collaborates with the Utilization Management ( UM ) Nurse, or other NCMs as necessary to provide...and placement, as applicable. + Monitors system to report case management outcomes and works as a change agent… more
- Omaha Children's Hospital (Omaha, NE)
- …team to assess for diagnosis, care needs, and discharge plans. + Introduces Nurse Case Management (NCM) role to family. + Completes NCM assessment and documents in ... policies. + Communicates and collaborates with the Utilization Management ( UM ) Nurse, or other NCMs as necessary to provide...and placement, as applicable. + Monitors system to report case management outcomes and works as a change agent… more
- The Arora Group (Annapolis, MD)
- Registered Nurse Case Manager Nurse Currently recruiting a Registered Nurse Case Manager in Annapolis, Maryland to provide care to active duty American ... retirees at Naval Branch Health Clinic Annapolis. Registered Nurse Case Manager is full-time position, 80 hrs/2...community resources, etc. + Integrate CM and utilization management ( UM ) and integrate nursing case management with… more
- University of Michigan (Ann Arbor, MI)
- RN CASE MANAGER : University Hospital (Care Management) Apply Now **Summary** The RN Case Manager assesses, develops, implements, coordinates and monitors ... effective utilization of resources while promoting quality outcomes. **Organizational Relationships** The RN Case Manager reports directly to the Manager of… more
- The Arora Group (Coronado, CA)
- Registered Nurse Case Manager Nurse Currently recruiting a Registered Nurse (RN) Case Manager in Coronado, California, to work at Coronado Naval Base, ... between 7:30AM - 8:00PM. DUTIES OF THE REGISTERED NURSE CASE MANAGER (RN): + Perform a full...for community resources. + Integrate CM and utilization management ( UM ) and integrating nursing case management with… more