- Sharp HealthCare (San Diego, CA)
- …You Will Do** As a member of the System Integrated Care Management (ICM) team the Utilization Manager ( UM ) II position supports utilization review ... Guidelines (MCG) + Experience and understanding of federal and state regulations governing utilization management + Accredited Case Manager (ACM) - American Case… more
- Elevance Health (FL)
- …must live within 50 miles of an Elevance Health PulsePoint office. This utilization management role is responsible for utilization management review for Behavior ... healthcare in a cost effective setting in accordance with UM Clinical Guidelines and contract. + Refers cases to...is licensed staff supervision. + Previous experience in case management/ utilization management with a broad range of experience with… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II ...and implement a successful discharge plan. Works with the UM Manager and Physician Advisor on case ... support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and approves… more
- Sharp HealthCare (San Diego, CA)
- …of the System Integrated Care Management (ICM) team the Transfer and Admissions Utilization Manager ( UM ) partners with the Centralized Patient Placement ... preferred.** + Experience and understanding of federal and state regulations governing utilization management. + Accredited Case Manager (ACM) - American Case… more
- Veterans Affairs, Veterans Health Administration (Lebanon, PA)
- …Verification, Veteran Services, Compliance, Providers, Health Information Management (HIM), Utilization Management ( UM ), and Community Care. Collects, analyzes, ... Summary The Revenue Utilization Review (RUR) nurse is under the supervision of the Nurse Manager and ANM. The RUR nurse is an active member of the revenue cycle… more
- Hackensack Meridian Health (Hackensack, NJ)
- …and provide assistance and support in overall medical management effectiveness, benchmarked utilization and cost management ( UM ) goals and clinical improvement ... **Overview** The Senior Utilization Review Specialist collaborates with the healthcare team...formal educational lectures and engage in frequent informal meetings ii . Retrospective Medical Record Documentation Review iii. Clarifying ambiguous… more
- Hackensack Meridian Health (Hackensack, NJ)
- …provide assistance** **and** **support in overall medical management effectiveness, benchmarked utilization and cost** **management** **( UM ) goals and clinical ... **Overview** **The Utilization Review Physician collaborates with the healthcare team...formal educational lectures and engage in frequent informal meetings** ** ii . Retrospective Medical Record Documentation Review** **iii. Clarifying ambiguous… more
- Elevance Health (Columbus, OH)
- …insightful analytics to improve the delivery of care._ **Behavioral Health Care Manager II - Applied Behavioral Analysis** **Location:** Virtual position, ... Must have a Clinical License Or BCBA certification The **Behavioral Health Care Manager II ** is responsible for managing psychiatric and applied behavioral… more
- Elevance Health (Columbus, OH)
- …during regular business hours, 8:30 am - 5:00 pm.** **The Transplant Nurse II ** is responsible for providing case management and/or medical management ( UM /UR) ... with providers, claims or service issues. Assists with development of utilization /care management policies and procedures. + Within the medical management role… more
- Dignity Health (Los Angeles, CA)
- …years of nursing experience. + Certified Case Manager (CCM), Accredited Case Manager (ACM-RN), or UM Certification preferred + Knowledge of managed care and ... Los Angeles. The hospital offers a full complement of services including a Level II trauma center the Los Angeles Center for Womens Health obstetrics and pediatric… more
- ChenMed (Philadelphia, PA)
- …performance of the center, as the true dyad partner to the Center Manager /Center General Manager . Directly supervise, performance manage and train PCPs in ... Leads SH and Transforming Care Meeting (TCM) weekly, as well as supports Center Manager /Center General Manager in other center meetings. SMD partners with Center… more