- Interim HealthCare (Greenwood, IN)
- …as a Registered Nurse (RN) in home health or similar setting; previous case management/ utilization review experience preferred. OASIS experience preferred. ... your community, you'll change lives every day. As a Registered Nurse Case Manager (RNCM), you will: Conduct In Person patient interviews and comprehensive… more
- Dallas Behavioral Healthcare Hospital (Desoto, TX)
- The Utilization Review Case Manager is responsible for working with insurance companies and managed care systems for the authorization, concurrent and ... help patients access the full range of their benefits through the utilization review process. + Conducts admission reviews. + Conducts concurrent and extended… more
- Eastern Connecticut Health Network (Manchester, CT)
- POSITION SUMMARY: The Utilization Review Case Manager (UR CM) works in collaboration with the physician and interdisciplinary team to support the ... in the acute-care setting. + Minimum of 1 year Utilization Review experience preferred via industry clinical...Care and status on all patients through collaboration with Case Manager . + Demonstrates thorough knowledge in… more
- Prime Healthcare (Lynwood, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/236088/rn- case - manager ... to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity,...Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred.3. Five years acute care… more
- Mount Sinai Health System (New York, NY)
- …homecare, long term care or utilization review preferred. Discharge Planner or Case Manager preferred. Manager or a minimum of 3-5 years experience ... **Job Description** **RN/ Case Manager MSH Case ...a. Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case… more
- Mount Sinai Health System (New York, NY)
- …preferred. + Previous experience as in homecare, long term care or utilization review preferred. + Discharge Planner or Case Manager preferred. + ... **Job Description** **RN/ Case Manager (Inpatient) Mount Sinai Morningside...1. Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case… more
- UNC Health Care (Kinston, NC)
- … case management, utilization review and discharge planning. The Case Manager must be highly organized professional with great attention to detail ... adaptable to frequent change, and compliant with regulatory and departmental guidelines and policies. Responsibilities: + Patients/Families, Hospital staff, Medical staff, Community agencies, and Insurance Companies are served by conducting interpersonal… more
- Dignity Health (Long Beach, CA)
- …conferences when appropriate, discharge planning activities, and coordination with the multidisciplinary team/ Utilization Review Case Manager for ... general guidance of the Director of Rehabilitation Services and Therapy Manager ; the Physical Therapist administers patient evaluations, plans and implements patient… more
- Mayo Clinic (Rochester, MN)
- …physicians and multi-disciplinary teams. Major Functions of the RN Case Manager include: Utilization Review , including concurrent admission status and ... Retirement: Competitive retirement package to secure your future. **Responsibilities** The RN Case Manager provides ongoing support to Mayo Clinic Rochester and… more
- Houston Methodist (Houston, TX)
- …+ Five years of hospital clinical nursing experience, which includes three years in utilization review and/or case management **LICENSES AND CERTIFICATIONS - ... At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position...ensures prompt notification of any denials to the appropriate case manager , denials, and pre-bill team members,… more
- Tenet Healthcare (Detroit, MI)
- RN Utilization Review - Case Management - 2506004107 Description : Join our dedicated healthcare team where compassion meets innovation! As a Registered ... care and appropriate level of care Mentor and monitor work delegated to Utilization Review LVN/LPN and/or Authorization Coordinator as needed. (5% daily,… more
- Helio Health Inc. (Syracuse, NY)
- …to track, review , and analyze data relating to continuous quality improvement. The Utilization Case Manager will work on a Full-Timebasis supporting our ... issues. To support the mission of Helio Health, theUtilization Case Manager will enhance the program's efforts...Licensed/credentialed applicants preferred. + Two years of experience in utilization review in a hospital, health care,… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- *_SUMMARY:_* We are currently seeking a* Utilization Review Manager * to join ourTransitional Care Team.This is a full-time role and will be required to work ... following: CPHM (Certified Professional in Healthcare Management), CCM (Certified Case Manager ), ACM (Accredited Case ...required or completed within three years of hire **Title:** * Manager - Utilization Review * **Location:**… more
- Children's Mercy Kansas City (Kansas City, MO)
- …of, and training oversight of programs and services. Responsible for effective utilization review and proper resource management of patients, including patient ... quality, and Lean process improvements, and facilitating the quarterly Utilization Review Committee meetings. Provides evidence based...days of hire + One of the following: American Case Management, Certified Case Manager … 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 ... and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager...administration or related field preferred or commensurate experience and Case Management Certification required + Minimum of 3 years… more
- LifeCenter Northwest (Bellevue, WA)
- …- $159,600.00 Salary Position Type Full Time Description and Qualifications The Manager , Organ Utilization (OUM) provides strategic leadership and operational ... Responsibilities + Lead and engage daily with the Organ Utilization Coordinator (OUC) team in donor case ...identify areas for improvement. + Partner with the Organ Utilization Program Manager (OUPM) on OUCT staffing,… more
- Community Health Systems (Franklin, TN)
- …discharge planning, and payer requirements. + Documents all utilization review activities in the hospital's case management software, including clinical ... reconsiderations or coordinating peer-to-peer reviews. + Communicates effectively with utilization review coordinators, case managers,...and/or Compact State Licensure required + CCM - Certified Case Manager preferred or + Accredited … more
- University of Utah Health (Salt Lake City, UT)
- …and as a team member. **Qualifications** **Qualifications** **Required** + One year Utilization Review or Case Management experience. **Licenses Required** ... UR committee any case that surpasses expected LOS, expected cost, or over/under- utilization of resources. + Performs verbal/fax clinical review with payer as… more
- Commonwealth Care Alliance (Boston, MA)
- 013650 CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management (UM) Reviewer ... review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring...RN **Desired Licensing (nice to have):** + CCM (Certified Case Manager ) **Required Experience (must have):** +… more
- Community Health Systems (Franklin, TN)
- …authorizations and reduce potential denials, utilizing input from the Utilization Review Clinical Specialist. + Monitors and updates case management software ... **Job Summary** The Utilization Review Coordinator ensures efficient and...with hospital, corporate, and payer requirements. Documents outcomes in case management systems. + Reviews and closes out cases… more
