- Alameda Health System (Oakland, CA)
- …plans Role Overview: Alameda Health System is hiring! The Director of Utilization Management holds a critical role encompassing operational oversight, strategic ... hoc duties as needed. In essence, they orchestrate efficient utilization management to deliver high-quality patient care....in the classification. Lead and manage a team of utilization review professionals providing guidance, training, and… more
- Alameda Health System (San Leandro, CA)
- Clinical Nurse III, Acute Inpatient Behavioral Health Utilization Management + San Leandro, CA + John George Psychiatric Hospital + JGP Care Coordination + ... identified fields in EHR. 17. Maintains current knowledge of clinical practice and Utilization Management by literature review , membership in a professional… more
- Katmai (Fort Carson, CO)
- …(BSN) is required. + Minimum of two (2) years of prior experience in Utilization Management . + Must possess a current, active, full, and unrestricted Registered ... background checks. **DESIRED QUALIFICATIONS & SKILLS** + Certification by a Utilization Management -specific program such as Certified Professional in Healthcare… more
- Katmai (Fort Carson, CO)
- **SUMMARY** Provide a comprehensive utilization review (UR) and utilization management (UM) program for all TRICARE eligible beneficiaries within the ... standards for appropriate utilization of services. Perform utilization management / review for medical necessity...within the last four (4) years as a registered nurse in utilization management . +… more
- Commonwealth Care Alliance (Boston, MA)
- …clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring ... the Manager Utilization Management , the Nurse Utilization Management (UM) Reviewer...**Essential Duties & Responsibilities:** + Conducts timely clinical decision review for services requiring prior authorization in a variety… more
- ERP International (Luke AFB, AZ)
- … Management Society of America (CMSA); American Accreditation Healthcare Commission/ Utilization Review Accreditation Commission (URAC); CAMH; (AAAHC); Health ... **Overview** ERP International is seeking a full time **Registered Nurse - Case Management ** in support of...and databases for community resources. - Integrate CM and utilization management (UM) and integrating nursing case… more
- ERP International (San Diego, CA)
- **Overview** ERP International is seeking a temporary **Registered Nurse (RN) Health Educators** supporting **Naval Medical Center San Diego, CA ... sectors. We provide comprehensive enterprise information technology, strategic sourcing, and management solutions to DoD and federal civilian agencies in 40 states.… more
- ERP International (San Diego, CA)
- …sectors. We provide comprehensive enterprise information technology, strategic sourcing, and management solutions to DoD and federal civilian agencies in 40 states. ... of the room team members to ensure optimal patient care and effective utilization of resources (personnel, supplies, and equipment). + Verifies surgical site(s) and… more
- Katmai (Fort Carson, CO)
- …needed to provide direction in care management . + Plan and prioritize utilization review (UR) activities to ensure identified patient needs are addressed ... record data. + Facilitate the development and integration of utilization management (UM) review policies...last two (2) years as a practical or vocational nurse . + Current, full, active, and unrestricted license as… more
- Katmai (Usaf Academy, CO)
- …all levels of health care management to include outside agencies. Performs utilization management activities to optimize cost, quality, and access to care. ... those required of any military or government civil service nurse of similar experience and in similar duty assignments....and employ safe work habits. + Utilize available information management systems in daily practice for patient care and… more
- Battelle Memorial Institute (Tampa, FL)
- …within legal and professional parameters + Knowledge and skill in using pre-established utilization review criteria to recognize and report actual or potential ... by a recognized certifying organization, ie, Commission for Case Management Certification or American Nurse Credentialing Center...programs for equal treatment of all staff and full utilization of all qualified employees at all levels within… more
- ERP International (Camp Pendleton, CA)
- **Overview** ERP International, LLC is seeking a **Licensed Vocational / Practical Nurse ** for a full-time position supporting the **Branch Health Clinics** at ... sectors. We provide comprehensive enterprise information technology, strategic sourcing, and management solutions to DoD and federal civilian agencies in 40 states.… more
- Luke Staffing (Glendale, CO)
- **REGISTERED NURSE ** **SITE OF SERVICE:** Department of Veterans Affairs, Eastern Colorado Healthcare System (ECHCS), 4100 E. Mississippi Ave, Glendale, CO 80246 ... consider Part Time and Full Time Applicants** **POSITION OVERVIEW:** The Registered Nurse (RN) will provide on-site professional nursing services to beneficiaries of… more
- Baptist Memorial Health (Southaven, MS)
- …and/or life situation. Performs other duties as assigned. Responsibilities Utilization Review Discharge planning Readmission Reduction Participation Payer ... of patients throughout the continuum of care for appropriate utilization of resources, service delivery and compliance with federal...Manager Facility: BMH - Desoto Hospital Department: DC Case Management Admin BMH Desoto Category: Nurse RN… more
- University Health (Hondo, TX)
- …Three years recent, full time hospital experience preferred. Work experience in case management , utilization review , or hospital quality assurance experience ... and clinicians in the Ambulatory setting by gathering information, coordinating utilization efforts, and reviewing HCC quality indicators, and RAF scores to… more
- Stanford Health Care (Palo Alto, CA)
- …**Locations** Stanford Health Care **What you will do** + Inpatient & SNF Utilization Management & Care Coordination: + Support proactive hospital discharge ... Provide regular feedback to providers, inpatient case managers, and utilization management coordinators on the appropriateness of...to deal with technical queries. + Demonstrated ability to review utilization reports and data. + Ability… more
- Stanford Health Care (Palo Alto, CA)
- …responsibilities include coordinating all facets of a patient's admission/discharge; performing utilization review activities, including review of patient ... other interdisciplinary team members; arranges followup care as appropriate. + Utilization Review -- Reviews prospectively, concurrently and retrospectively all… more
- University Health (Hondo, TX)
- …Three years recent, full-time hospital experience preferred. Work experience in case management , utilization review or hospital quality assurance experience ... hire date. LICENSURE/CERTIFICATION Current license from the Board of Nurse Examiners of the State of Texas to practice...the State of Texas to practice as a registered nurse is required. National certification in related field is… more
- Stanford Health Care (Palo Alto, CA)
- …job.** **A Brief Overview** Provides the opportunity to develop and practice management and leadership skills. Includes direction and education for the clinical and ... + Partners with the Medical Director and unit nursing management team, participates in a wide variety of clinical,...and adherence to policy through practice analysis and case review of APPs with physicians. + Investigates and responds… more
- Stanford Health Care (Palo Alto, CA)
- …responsibilities include coordinating all facets of a patient's admission/discharge; performing utilization review activities, including review of patient ... provide requested clinical and psychosocial information to assurereimbursement. + Utilization Review -- Reviews prospectively, concurrently and retrospectively… more
