- Hartford HealthCare (Meriden, CT)
- …matters. And this is*your moment*. **Job:** **Professional Non-Clinical* **Organization:** **Rushford* **Title:** * Utilization Review Care Manager - ... We offer a wide range of programs including Acute Care and Evaluation, Residential Addiction Treatment, Individual, Group &...Assists with process of appeals as directed by the Manager - Utilization Review . 7.… more
- Hartford HealthCare (Torrington, CT)
- …**Job:** **Professional Clinical* **Organization:** **Charlotte Hungerford Hospital* **Title:** * Utilization Review Social Work Care Manager (LCSW) - ... Worker will work collaboratively with the IP Psychiatry Patient Care Team to assure Utilization Review... activities on a 17 bed Adult unit. The Care Manager will liaison with insurance companies… more
- UNC Health Care (Chapel Hill, NC)
- …of case management, utilization review and discharge planning. The Care Manager must be highly organized professional with great attention to detail, ... processing) to Care Management Assistant. Consult Social Worker and/or Utilization Manager per established departmental protocol. Maintain knowledge of… more
- UNC Health Care (Raleigh, NC)
- …of case management, utilization review and discharge planning. The Care Manager must be highly organized professional with great attention to detail, ... processing) to Care Management Assistant. Consult Social Worker and/or Utilization Manager per established departmental protocol. Maintain knowledge of… more
- UNC Health Care (Chapel Hill, NC)
- …of case management, utilization review and discharge planning. The Care Manager must be highly organized professional with great attention to detail, ... processing) to Care Management Assistant. Consult Social Worker and/or Utilization Manager per established departmental protocol. Maintain knowledge of… more
- UNC Health Care (Hendersonville, NC)
- … 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...based on approved criteria and standards per the Hospital Utilization Review Plan. Directs delivery of notifications… more
- Trinity Health (Silver Spring, MD)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** **Job Title:** Manager Care Mgt & Util Review **Employment Type:** Full Time **Shift:** ... 8am - 4:30pm + Reporting to the Director of Care Management + The RN Manager is...the activities of RN Case Managers for in inpatient care coordination and utilization review .… more
- The Mount Sinai Health System (New York, NY)
- **JOB DESCRIPTION** The Utilization Review Manager for the Selikoff Centers for Occupational Health is responsible for the management of program operations ... internal and external regulatory and survey requirements. + The Utilization Review Manager collaborates with...of progressive acute care leadership and acute care utilization review experience. +… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …development, and leadership programs + And more **Description** We're seeking an **Assistant Manager , Utilization Review ** , responsible for supervising and ... coordinating activities of personnel in the Utilization Review Department, including: + Staff schedules to ensure appropriate department coverage, equitable… more
- Elevance Health (Topeka, KS)
- ** Manager of Utilization Review - Kansas** **Location:** This position will work a hybrid model (remote and office). Must reside in Kansas and within 50 ... Elevance Health location (Olathe, Kansas City, or Topeka). The ** Manager of Utilization Review ** is...responsible for coordinating member service, utilization , access, care management and/or concurrent review to ensure… 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 ... met and care delivery is coordinated across the continuum. The Utilization Manager completes admission, continued stay, and discharge reviews in accordance… more
- Trinity Health (Mason City, IA)
- …**Hours:** Monday-Friday 0630-1430; no weekends or holidays **About The Job** The Utilization Review Case Manager responsibilities include case screening, ... experience as a registered nurse involving community contact, knowledge of managed care , resource utilization criteria, Medicaid, insurance coverage for acute … more
- Billings Clinic (Billings, MT)
- …, CMS 2 Midnight Rule, or payer authorization for status and level of care Priority 2: Performs Utilization Review (UR) Activities Completes concurrent ... prior to starting. Click here (https://billingsclinic.csod.com/ats/careersite/search.aspx?site=15&c=billingsclinic) to learn more! Utilization Review RN Billings Clinic (Billings Clinic… more
- Hackensack Meridian Health (Hackensack, NJ)
- **Overview** The Senior Utilization Review Specialist collaborates with the healthcare team in the management and resolution of activities that assure the ... patient population and HackensackUMC. These include but are not limited to utilization review , hospital reimbursement, clinical compliance, case management, and… 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 … 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,...in accordance with federal regulations and the health system's Utilization Review Plan. Responsibilities And Scope +… more
- VHC Health (Arlington, VA)
- Case Manager ( Utilization Review ) Job...family to ensure a timely, smooth, and clinically appropriate care planning process. The Case Manager also ... available resources to promote quality cost-effective outcomes. Additionally, the Case Manager ensures that identified and referred patients have a coordinated… more
- Prime Healthcare (Lynwood, CA)
- …and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/171837/case- manager %2c-rn utilization - review ... to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity,...Work for Licensed Clinical Social Worker. However, RN Case Manager preferred.3. Five years acute care nursing… more
- Hackensack Meridian Health (Belle Mead, NJ)
- …on a case by case basis. Applies case management and utilization review principles in monitoring the delivery of care and promoting optimal communication ... primary therapists and discharge planners regarding transition to alternative levels of care . + Perform concurrent utilization review applying identified… more
- Tenet Healthcare (Detroit, MI)
- …appropriate level of care Mentor and monitor work delegated to Utilization Review LVN/LPN and/or Authorization Coordinator as needed. (5% daily, essential) ... RN Utilization Review Full Time Days -...coordination to help patients achieve optimal health, access to care and appropriate utilization of resources, balanced… more