- Elliot Health System (Litchfield, NH)
- …experienced Nurses who meet the requirements below! Apply today! About the Job: The Case Manager RN will collaborate with other members of the health care team ... On Bonus paid in 3, 6, and 12 months RN Case Manager Who We Are: The...pride in serving their community, patients, and families. Our Nurse Case Managers observe best practices and strive to… more
- Southern New Hampshire Health (East Merrimack, NH)
- …organizational goals. Who You Are: Graduate from an accredited school of nursing (BSN required) Registered Nurse , licensed in the state of NH Minimum of two (2) ... CLINICAL TEACHER / NURSE EDUCATOR - EMERGENCY DEPARTMENT Who We Are:...the ED is prepared to accommodate additional patients through utilization of hallway beds and a triage fast-track area.… more
- UNC Health Care (Raleigh, NC)
- …_We are currently seeking an experienced nurse to join our dynamic team as an RN Utilization Manager . Role is full time, 40 hours per week, on site._ ... care episode through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management… more
- UNC Health Care (Chapel Hill, NC)
- …care episode through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management ... and care delivery is coordinated across the continuum. The Utilization Manager completes admission, continued stay, and...date. **Licensure/Certification Requirements:** * Licensed to practice as a Registered Nurse in the state of North… more
- University of Miami (North Miami, FL)
- …of Miami UHealth - CTU at SoLe Mia has an exciting opportunity for a Utilization Case Manager . CORE JOB FUNCTIONS + Adhere and perform timely reviews for ... services requiring an authorization for continuation of care + Follows the authorization process using established criteria as set forth by the payer or clinical guidelines + Accurate review of coverage benefits and limitations to determine continued… more
- Dignity Health (Phoenix, AZ)
- …Nevada markets. Must have current Arizona unrestricted RN license.** The Utilization Management (UM) Manager is responsible for managing day-to-day UM ... necessity determinations; processes appeals and reconsiderations. Act as a working manager within Utilization Management, performing essential duties and… more
- Humana (Columbus, OH)
- …**Required Qualifications:** **Must meet** **one** **of the following:** + Active unrestricted registered nurse license in the state of Virginia or reside ... manager required. **Additional Information:** **Workstyle:** Remote work at Home **Location for Registered Nurse :** must reside in the state of Virginia or… more
- Catholic Health Services (Melville, NY)
- …Health was named Long Island's Top Workplace! Job Details Position Summary: The Utilization and Appeals Manager (UAM) proactively conducts clinical reviews and ... from payors for additional clinical documentation. Acts as liaison between the Utilization and Appeals Management Department and the physician of record, as… more
- Catholic Health Services (Melville, NY)
- …Health was named Long Island's Top Workplace! Job Details Position Summary: The Utilization and Appeals Manager (UAM) proactively conducts clinical reviews and ... from payors for additional clinical documentation. |Acts as liaison between the Utilization and Appeals Management Department and the physician of record, as… more
- Beth Israel Lahey Health (Burlington, MA)
- … Utilization Review Nurse **Job Description:** The Inpatient Registered Nurse ( RN ) Case Manager for Hospital at Home Care Transitions coordinates ... to meet the needs of the department. **Minimum Qualifications:** Education: * Registered Nurse , Bachelors Degree or commensurate experience preferred. Licensure,… more
- Beth Israel Lahey Health (Plymouth, MA)
- …a job, you're making a difference in people's lives.** Full Time **Job Description:** ** Utilization Review & Denials management manager - Full Time** **Who We ... Our Team of Experts and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager , you will:** + Directs staff performance… more
- Trinity Health (Silver Spring, MD)
- …Type:** Full time **Shift:** Day Shift **Description:** **Position Purpose:** As a Case Manager in Utilization Management, you will be the key to ensuring ... care plans to align with clinical and regulatory standards. By optimizing resource utilization and maintaining the highest standards of care, you will contribute to… more
- UCLA Health (Los Angeles, CA)
- …next level. You can do all this and more at UCLA Health. As a Manager for Medicare Advantage Utilization Management, you'll provide direct management to a team ... a self-motivated, detail-oriented, service-driven leader with: + Current unrestricted RN licensure in CA required + Bachelors of Science,...(BSN) degree required + Five or more years of utilization management required + Four or more years 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 ... Functions and Responsibilities as Assigned:** 1. Collaborates with the UM RN to determine the appropriate hospital setting (inpatient vs. observation) based… more
- Elevance Health (Washington, DC)
- Manager ll HCMS - Utilization and Case Management (JR142403) **Location:** This position requires travel to our Washington, DC office 4 days each week. The ... reside within 50 miles and a 1 hour commute of the above office. The ** Manager ll HCMS** is responsible for managing a team of physical health practitioners in the… more
- Trinity Health (Lavonia, GA)
- **Employment Type:** Full time **Shift:** **Description:** The RN Case Manager ( RN CM), works in collaboration with a multidisciplinary team by identifying ... care throughout hospitalization in compliance with CMS and organizational utilization management requirements. RN CM helps to ensure medical necessity is met by… more
- Sharp HealthCare (San Diego, CA)
- …Certification; Accredited Case Manager (ACM) - American Case Management Association (ACMA); California Registered Nurse ( RN ) - CA Board of Registered ... in a hospital and/or Managed Care setting. + California Registered Nurse ( RN ) - CA...Collaboration and teamwork Provides consultation and direction for Case Manager Utilization Management, and non-clinical support team… more
- Pacific Medical Centers (Renton, WA)
- …order to assure cost effective, appropriate utilization of health care resource. Utilization Nurse / Case Manager manages, directs, and coordinates the ... best people, we must empower them. **Required Qualifications:** + Upon hire: Washington Registered Nurse License. + 5 years Clinical experience. + Utilization… more
- Ochsner Health (Lafayette, LA)
- …medical management, or other related MCO departments/functions. **Certifications** Required - Current registered nurse ( RN ) license in state of practice. ... *MSW accepted in lieu of registered nurse ( RN ) licensure. Preferred - Certification in Case Management (CCM) or Certified Professional in Healthcare… more
- UNC Health Care (Hendersonville, NC)
- …issues with complex patients and identify trends. Formulates potential solutions with Utilization Manager and Social Worker and continuously monitor cases/follow ... of the unique communities we serve. Summary: The Care Manager - RN provides ongoing support and...Required * Must be licensed to practice as a Registered Nurse in the state of North… more
