- Trinity Health (Mason City, IA)
- …its goals **Hours:** Monday-Friday 0630-1430; no weekends or holidays **About The Job** The Utilization Review Case Manager responsibilities include ... in the state of Iowa. + Bachelor's Degree required. BSN preferred + Utilization management focused certifications that are recognized in the state of Iowa preferred… more
- Cedars-Sinai (Los Angeles, CA)
- …named us one of America's Best Hospitals! **What You Will Do in This Role:** The Utilization Review Case Manager validates the patient's placement to be ... follows the UR process as defined in the Utilization Review Plan in accordance with the...continued employment. **Req ID** : 4300 **Working Title** : Utilization Management Case Manager -… more
- VHC Health (Arlington, VA)
- Case Manager ( Utilization Review ) Job Description Purpose & Scope: The Case Manager is responsible for the collaborative process of assessment, ... and available resources to promote quality cost-effective outcomes. Additionally, the Case Manager ensures that identified and referred patients have… more
- University of Miami (Miami, FL)
- …UHealth System, Department of Utilization Management, has an exciting opportunity for an Utilization Review Case Manager to work remote. The ... and retrospective chart reviews for clinical utilization and authorization. The Utilization Review Case Manager coordinates with the healthcare team… more
- Avera (Yankton, SD)
- …the efficient and effective operations of case management and utilization review . The Case Manager is responsible for timely discharge planning, ... opportunities for career growth. **Avera is looking for a RN - Case Manager to join our Team!** **_Position Highlights:_** + **Work collaboratively with other… more
- The Mount Sinai Health System (New York, NY)
- …but are not limited to: + Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case management will be needed ... **JOB DESCRIPTION** **RN/ Case Manager MSH Case ...in homecare, long term care or utilization review preferred. + Discharge Planner or Case ... review preferred. + Discharge Planner or Case Manager preferred. + Manager … more
- The Mount Sinai Health System (New York, NY)
- …are not limited to: 1. Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case management will be needed ... experience as in homecare, long term care or utilization review preferred. + Discharge Planner or Case Manager preferred. + Manager or a minimum… more
- Henry Ford Health System (Wyandotte, MI)
- …therapy experience, safety planning, psychiatric assessment, COPE and DWIHN knowledge, utilization review . GENERAL SUMMARY: The Case Manager is a member ... meet an individual's and family's health care needs. The goals of the case manager are to promote patient safety, quality of care and cost-effective outcomes.… more
- Prime Healthcare (Lynwood, CA)
- …education, credentials 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,...Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred.3. Five years acute care… more
- Providence (Medford, OR)
- …based on population focus. Duties also include complex discharge planning and utilization review . The Nurse Case Manager must be competent to analyze ... at Providence Medford Medical Center, in Medford, OR.** **Full-Time/Day Shift** The RN Case Manager is an expert professional registered nurse who is responsible… more
- University of Utah Health (Salt Lake City, UT)
- …those with an increased LOS, high dollar and frequent utilizers. + Collaborate with unit case manager , utilization review nurse and other organization ... designates charges related to specific condition. + Participates in organization Utilization Review Committee, weekly Medicare IPPS Case Reviews & RAC Audit … more
- LA Care Health Plan (Los Angeles, CA)
- …California License. Licenses/Certifications Preferred Certified Professional in Utilization Review (CPUR) Certified Case Manager (CCM) Required ... Information Preferred: Certification in Certified Professional in Utilization Review (CPUR), Certified Case Manager (CCM), Utilization Management or… more
- Lucile Packard Children's Hospital Stanford (Palo Alto, CA)
- …responsibilities include coordinating all facets of a patient's admission/discharge; performing utilization review activities, including review of patient ... and performance/quality improvement activities that lead to optimal patient outcomes. A Case Manager differs from other roles in professional nursing/health care… more
- Alight (NJ)
- …+ 5+ years medical advisory experience in occupational health, worker compensation, disability, health case management, or utilization review . + 2+ years as ... Additionally, demonstrate excellent problem-solving skills when questioned on your case management plans. + Consulting on medical, behavioral health,...a Clinical Case Manager + Have ability to work in hybrid environment… more
- Sutter Health (Burlingame, CA)
- …acute care patient experience. This position works in collaboration with the Physician, Utilization Manager , Medical Social Worker and bedside RN to assure the ... case management within a managed care environment. Comprehensive knowledge of Utilization Review , levels of care, and observation status. Awareness of… more
- Prime Healthcare (Montclair, CA)
- …and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/170680/ case - manager -%28rn%29 utilization ... 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
- Prime Healthcare (National City, CA)
- …and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/174432/ case - manager utilization ... to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity,...a related field. At least one year experience in case management, discharge planning or nursing management; + CCM… more
- Stanford Health Care (Palo Alto, CA)
- …and performs duties associated with Prior Authorization. + Reviews and reports out on Utilization Review (UR) trending. + Ensures quality of services through UR, ... leading process redesign work necessary to implement improvements. + Directs the utilization management, concurrent review , prior authorizations medical claims … more
- The Mount Sinai Health System (New York, NY)
- **JOB DESCRIPTION** The Utilization Review Manager for...in the area of nursing practice assigned; in this case , acute care utilization review . ... internal and external regulatory and survey requirements. + The Utilization Review Manager collaborates with...review for medical and pharmacy claims. + Prepares case reports, summaries, or other related documents required to… more
- Trinity Health (Silver Spring, MD)
- …activities of RN Case Managers for in inpatient care coordination and utilization review . Oversees interactions of staff with outside activities and agencies ... Type:** Full time **Shift:** Day Shift **Description:** **Job Title:** Manager Care Mgt & Util Review **Employment...in an acute healthcare setting. + Designation Changes and Utilization Review + Knowledge of pertinent regulatory,… more