- CHRISTUS Health (Irving, TX)
- Description Summary: The Program Manager Perinatal Services assists in developing and implementing perinatal nursing initiatives for the CHRISTUS Health System. ... nursing standardization, evidence-based practices, operational excellence, and optimal patient care performance. Assists in establishing effective strategies for service… more
- CHRISTUS Health (Alamo Heights, TX)
- …patient care , patient experience and patient outcomes. Effectively manages utilization of staff and material resources so that the most therapeutically effective ... assigned areas; at CHRISTUS St. Patrick Hospital. The nurse manager affects departmental outcomes through interpretation, implementation, and evaluation...patient care is provided in a safe and cost effective… more
- Hartford HealthCare (Torrington, CT)
- …*your moment*. **Job:** **Professional Clinical* **Organization:** **Charlotte Hungerford Hospital* **Title:** * Utilization Review Social Work Care Manager ... Worker will work collaboratively with the IP Psychiatry Patient Care Team to assure Utilization Review activities...Review activities on a 17 bed Adult unit. The Care Manager will liaison with insurance companies… more
- UNC Health Care (Smithfield, NC)
- …through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management staff to ... care delivery is coordinated across the continuum. The Utilization Manager completes admission, continued stay, and...the Case Manager to manage level of care transitions & appropriate utilization of services.… more
- UPMC (Hanover, PA)
- **UPMC is hiring a Professional Care Manager to support the Utilization Review process! This is a full time, day shift position with a rotating weekend and ... This position is eligible for a generous Sign on Bonus! _** **Purpose:** The Care Manager (CM) coordinates the clinical and financial plan for patients. Performs… more
- CenterWell (Las Vegas, NV)
- …for managing populations and coordinating care to reduce acute and post-acute care utilization . The Manager role is hybrid with travel requirements ... and help us put health first** **The Role** The Care Integration Team Manager is responsible for...create action plans that will reduce acute and post-acute care utilization . + Solicits/shares feedback with market… more
- Humana (Salem, OR)
- …a part of our caring community and help us put health first** The Manager , Utilization Management Nursing utilizes clinical nursing skills to support the ... and communication of medical services and/or benefit administration determinations. The Manager , Utilization Management Nursing works within specific guidelines… more
- UNC Health Care (Hendersonville, NC)
- …daily with the Care Manager to manage level of care transitions & appropriate utilization of services. Coordinates with the appropriate staff/payers ... **Description** Job Summary The Utilization Manager (UM) assesses new admissions,...complex patients and identify trends. Formulates potential solutions with Care Manager and Social Worker and continuously… more
- UNC Health Care (Hendersonville, NC)
- …daily with the Care Manager to manage level of care transitions & appropriate utilization of services. Coordinates with the appropriate staff/payers ... the health and well-being of the unique communities we serve. Summary: The Utilization Manager (UM) assesses new admissions, continued stay and discharge review… more
- UNC Health Care (Raleigh, NC)
- …and functions of case management, utilization review and discharge planning. The Care Manager must be highly organized professional with great attention to ... the unique communities we serve. **Seeking full-time on-site RN Care Manager to work a variable schedule... Care Management Assistant. Consult Social Worker and/or Utilization Manager per established departmental protocol. Maintain… more
- Commonwealth Care Alliance (Boston, MA)
- … services,procedures, and facilities under the provisions of CCA's benefits plan.The Manager , Utilization Management is responsible for overseeing and managing ... compliance standards in the area of service decisions and organizational determinations.The Manager , Utilization Management reports to the Director of Clinical… more
- UNC Health Care (Chapel Hill, NC)
- …and functions of case management, utilization review and discharge planning. The Care Manager must be highly organized professional with great attention to ... from CAPP as appropriate. As necessary meet with the Utilization Manager (UM) and SW after the... Care Management Assistant. Consult Social Worker and/or Utilization Manager per established departmental protocol. Maintain… more
- Sharp HealthCare (San Diego, CA)
- …and safe patient handovers to next level of care ; work closely with ambulatory care manager (ACM) at the system level, in clinics, and homecare and sub-acute ... Degree in Nursing; Bachelor's Degree in Nursing; Certified Case Manager (CCM) - Commission for Case Manager ...utilization review demands to assure patients are receiving care in the appropriate setting and level of … more
- McLaren Health Care (Detroit, MI)
- **Position Summary:** Responsible for providing assistance to the Utilization Manager (UM) RN in the coordination of patient admission and continued stay ... based on medical necessity. 2. Performs concurrent and retrospective utilization management-related activities and functions to ensure that appropriate data… more
- UNC Health Care (Hendersonville, NC)
- …of care management, utilization review and discharge planning. The Care Manager must be highly organized professional with great attention to detail, ... well-being of the unique communities we serve. Summary: The Care Manager - RN provides ongoing support...complex patients and identify trends. Formulates potential solutions with Utilization Manager and Social Worker and continuously… more
- VNS Health (Manhattan, NY)
- … utilization management processes are followed by the service operations staff, utilization staff, and the interdisciplinary care team to ensure cost ... , staff productivity and coverage. * Generates management reports via the care / utilization management systems and demonstrates competency as a super user… more
- AmeriHealth Caritas (Dublin, OH)
- ** Utilization Management Plan Oversight Manager (Ohio Resident)** Location: Dublin, OH Primary Job Function: Medical Management ID**: 37872 **Job Brief** ... Your career starts now. We are looking for the next generation of health care leaders. At AmeriHealth Caritas, we are passionate about helping people get care… more
- Elevance Health (FL)
- **JR133557 Manager II Behavioral Health Services ( Utilization Management for Behavior Analysis Services)** Responsible for Behavioral Health Utilization ... support staff responsible to ensure medical necessity and appropriateness of care for inpatient/outpatient BH services; ensures appropriate utilization of… more
- Mount Sinai Health System (New York, NY)
- …in Nursing or health-related field preferred. + 5 years minimum of progressive acute care leadership and acute care utilization review experience. + ... **Job Description** The Utilization Review Manager for the Selikoff...area of nursing practice assigned; in this case, acute care utilization review. + Previous experience making… more
- Providence (Mission Hills, CA)
- …Nurse License + 5 years Healthcare management experience related to acute care utilization management or appeals management. **Preferred Qualifications:** + ... **Description** The Manager of Utilization Management provides a...direction for and leadership to a large team of Utilization Management RNs in the care of… more
