- State of Connecticut, Department of Administrative Services (East Hartford, CT)
- Utilization Review Nurse Coordinator (40 Hour) Office/On-site Recruitment # 241106-5613FP-001 Location East Hartford, CT Date Opened 11/7/2024 12:00:00 AM ... (https://portal.ct.gov/dds/searchable-archive/northregion/north-region/welcome-to-the-north-region?language=en\_US) - is accepting applications for a full-time Utilization Review Nurse Coordinator… more
- Travelers Insurance Company (Albany, NY)
- …**What Is the Opportunity?** This position is responsible for conducting in-house utilization review with emphasis on determining medical necessity for ... do and where you do it. **Job Category** Claim, Nurse - Medical Case Manager **Compensation Overview** The annual...to the compensable injury and for adhering to multi-jurisdictional Utilization Review criteria. **What Will You Do?**… more
- Bitterroot Health (Hamilton, MT)
- …in beautiful Hamilton, Montana!! Bitterroot Health is seeking candidates to fill a Utilization Review (UR) Coordinator Registered Nurse position. The UR ... The UR Coordinator will serve as a resource to the Case Managers and Social Workers to assist with the discharge plan of the patient. They will also be available… more
- Lincoln Financial Group (Columbus, OH)
- …and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management preferred skills ... We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position...in a career at Lincoln, we encourage you to review our current openings and apply on our website.… more
- Trinity Health (Springfield, MA)
- …and assists the physician, bedside Registered Nurse , ICC and Social Worker with utilization management and clinical coordination of the patient's hospital ... **Shift:** Rotating Shift **Description:** Requires BSN At **Mercy Medical Center** the ** Utilization Review /Appeals & Denials** **RN** performs utilization … more
- LifePoint Health (Danville, VA)
- *Registered Nurse , RN - Utilization Review ...and Case Manager RN, in conjunction with a Social Worker . *About our Health System* SOVAH Danville is a 250 ... Bonus Eligibility for Full-Time, Bedside RNs* ** Must have Utilization Review experience.** ** * ** *Your...as an employee, but as a person. As a*registered nurse (RN)*joining our team, you're embracing a vital mission… more
- Sharp HealthCare (San Diego, CA)
- …or case management experience + 3 Years recent case management, utilization review , care coordination experience + California Registered Nurse (RN) - CA ... position requires the ability to combine clinical/quality considerations with regulatory/financial/ utilization review demands to assure patients are receiving… more
- Hackensack Meridian Health (Belle Mead, NJ)
- …NJ State Professional Registered Nurse License or NJ Licensed Social Worker **Job ID** _2024-150722_ **Department** _CC Utilization Review_ **Site** _HMH ... caseload. Collaborates with the attending LIP, Clinical Case Manager, nurse , and other members of the treatment team, ACCESS...a case by case basis. Applies case management and utilization review principles in monitoring the delivery… more
- Trinity Health (Silver Spring, MD)
- …Type:** Full time **Shift:** **Description:** The Interim Manager of Care Management & Utilization Review , under the supervision and in collaboration with the ... activities of hospital staff in inpatient care coordination and utilization review . Oversees interactions of staff with...applicable):** + State of Maryland license as a Registered Nurse + RN with BSN or RN with >… more
- 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 ... records, and internal and external regulatory and survey requirements. + The Utilization Review Manager collaborates with multiple professionals to support and… more
- Stanford Health Care (Palo Alto, CA)
- …and Abilities** + Knowledge of principles and best practices of case management, utilization review , social work, care coordination and discharge planning. + ... Here, your leadership, coaching, and mentoring would further develop our robust, Utilization Management team. Are you driven by health care innovation, partnerships,… more
- Centene Corporation (Raleigh, NC)
- …and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with providers and ... a fresh perspective on workplace flexibility. **Position Purpose:** Performs a clinical review and assesses care related to mental health and substance abuse.… more
- Mount Sinai Health System (New York, NY)
- **Job Description** ** Utilization Review Admission Specialist (OR Scheduler), Operating Room Surgical Scheduling, Mount Sinai West - Full Time, Days** The ... Utilization Review Specialist coordinates scheduling of all...and operating room procedures. Seeks the assistance of the Nurse Manager in identifying cases, which require pre admission… more
- Brighton Health Plan Solutions, LLC (New York, NY)
- About The Role Brighton Health Plan Solutions (BHPS) provides Utilization Review /Medical and Case Management services for Group Health and Workers ' ... and other Casualty clients. The Workers ' Compensation Nurse Case Reviewer collaborates with medical care providers, employers,...for timely return to work. + Provides case management, utilization review , continued stay reviews, and based… more
- Sharp HealthCare (San Diego, CA)
- …BLS Healthcare) - American Heart Association; California BBS Licensed Clinical Social Worker (LCSW) - CA Board of Behavioral Sciences; California BBS Licensed ... (LMFT) - CA Board of Behavioral Sciences; California Registered Nurse (RN) - CA Board of Registered Nursing **Hours**...practices. **What You Will Do** Perform admission and concurrent review of patients, based upon needs regardless of payor… more
- Stanford Health Care (Palo Alto, CA)
- …records to ensure the necessity and appropriateness of care provided. 3. Utilization Review : Conduct thorough utilization reviews, applying evidence-based ... remote Stanford Health Care job.** **A Brief Overview** The Utilization Management Registered Nurse (UM RN) will...utilization management principles. + Experience in case management, utilization review , or related healthcare roles. +… more
- UNC Health Care (Hendersonville, NC)
- … reviews in accordance with federal regulations and the health system's Utilization Review Plan. Responsibilities: * Uses approved criteria and conducts ... the health and well-being of the unique communities we serve. Summary: The Utilization Manager (UM) assesses new admissions, continued stay and discharge review … more
- Humana (Columbus, OH)
- …and external customers and stakeholders. **Preferred Qualifications** + Experience with utilization review process. + Experience with behavioral change, health ... put health first** Humana Healthy Horizons in Kentucky is seeking a Utilization Management Behavioral Health Professional 2 who utilizes behavioral health knowledge… more
- Prime Healthcare (Montclair, CA)
- …serving an underserved community. Come Join a Team of Dedicated Healthcare Workers Montclair Hospital Medical Center is nationally recognized, locally preferred, and ... to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity,...accredited school of nursing and a current state Registered Nurse license.2. Grandfathered prior to April 1, 2015. Minimum… more
- Veterans Affairs, Veterans Health Administration (Kapolei, HI)
- …Vacancy Announcements: Mental Health Manager (Supervisory Social Worker ): CBSW-12589371-25-CT Mental Health Manager (Psychologist): CBSW-12591655-25-CT Mental ... Health Manager (Psychiatrist): CBSW-12603560-25-TV Mental Health Manager ( Nurse Practitioner): CBSW-12603671-25-CT Responsibilities VA Careers - Social Work:… more