- Hartford HealthCare (Torrington, CT)
- … Review Social Worker will work collaboratively with the IP Psychiatry Patient Care Team to assure Utilization Review activities on a 17 bed ... *your moment*. **Job:** **Professional Clinical* **Organization:** **Charlotte Hungerford Hospital* **Title:** * Utilization Review Social Work Care Manager… more
- Sharp HealthCare (San Diego, CA)
- …1 **Shift Start Time** **Shift End Time** Bachelor's Degree; Associate's Degree in Nursing; California Registered Nurse ( RN ) - CA Board of Registered ... compliance with all local, state and federal regulations governing utilization review activities and/or care ...clinical experience as defined by the CBA. + California Registered Nurse ( RN ) - CA… more
- UNC Health Care (Rocky Mount, NC)
- …- acute care (acute hospital setting) + 0-2 healthcare/medical - - utilization review (or other healthcare-related experience) Preferred Experience: + 3-5 ... recent acute hospital experience with relevant experience and working knowledge in Utilization Review , including managed care /commercial payers and… more
- Trinity Health (Maywood, IL)
- …quality of care , mitigate cost trends through supporting optimization of utilization review for medical necessity using established care guidelines ... at the Westmont office Join our small but mighty team to guide and manage Utilization Review and Management for the Loyola Physician Partners LPP) Health Plan, a… more
- Trinity Health (Silver Spring, MD)
- … Managers. Manages the activities of RN Case Managers for in inpatient care coordination and utilization review . Oversees interactions of staff with ... will need:** + State of Maryland license as a Registered Nurse + BSN required; MSN Degree...in an acute healthcare setting. + Designation Changes and Utilization Review + Knowledge of pertinent regulatory,… more
- Corewell Health (Dearborn, MI)
- …to five years' experience in care management, utilization review , home care and/or discharge planning. Preferred + Registered Nurse ( RN ) - ... of all hospitalized patients. 1. Identifies patients that need care management services (ie utilization review...accredited school of nursing. + Preferred Will consider non-BSN RN if actively pursuing a bachelor's degree in nursing… more
- ERP International (Corpus Christi, TX)
- **Overview** ERP International is seeking a ** Registered Nurse ( RN )** ** Utilization Manager** for a full-time position in support of the **Naval Health ... Perform a full range of utilization management services including referrals, care coordination, utilization review , discharge planning, continued stay… more
- CVS Health (Frankfort, KY)
- …behavioral health clinician with Kentucky state licensure (LCSW, LPCC, LMFT, LPAT) or a Registered Nurse ( RN ) with active current and unrestricted Kentucky ... schedule based on business needs **Preferred Qualifications** + Managed care / utilization review experience + Ability...OR Minimum of an Associate's in Nursing or Diploma RN for Registered Nurses **Pay Range** The… more
- CVS Health (Baton Rouge, LA)
- …clinician (ie LCSW, LCPC, LMFT, LPCC, LPAT, LPC) in state of Louisiana or a Registered Nurse ( RN ) with unrestricted compact state license with psychiatric ... weekend and holiday schedules. Preferred Qualifications: + Managed care / utilization review experience preferred +...licensure (LCSW, LCPC, LMFT, LPCC, LPAT, LPC) or a Registered Nurse ( RN ) with unrestricted… more
- Corewell Health (Grosse Pointe, MI)
- …five years' experience in care management, utilization review , home care and/or discharge planning. Preferred + LIC- Registered Nurse ( RN ) - ... planning of all hospitalized patients. Essential Functions + Identifies patients that need care management services (ie utilization review ; care … more
- CVS Health (Denver, CO)
- …Qualifications** * Knowledge of mental health and substance abuse disorders * Managed care / utilization review experience * Crisis intervention skills * ... of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at… more
- LA Care Health Plan (Los Angeles, CA)
- …such as ambulatory care , home care , or case management. OR experience in Utilization Review or Care Management will be considered in lieu of direct ... disabilities in a case/ care management environment. Preferred: Experience in utilization review , skilled nursing, home health, discharge planning, behavioral… more
- Virginia Mason Franciscan Health (Bremerton, WA)
- …Key Job Responsibilities** 1. Conducts admission and continued stay reviews per the Care Coordination Utilization Review guidelines to ensure that the ... regarding review outcomes. 5. Collaborates with facility RN Care Coordinators to ensure progression of...experience. **Required Licensure and Certifications:** Current licensure as a Registered Nurse in the state of Washington.… more
- New York State Civil Service (New York, NY)
- …Bachelor's degree in a human services field and 3 years of utilization review experience in a health care facility regulated by Centers for Medicare and ... NY HELP Yes Agency Mental Health, Office of Title Utilization Review Coordinator, (NY HELPS), New York...requirements of non-competitive promotion are met.Promotional Field consists of Registered Nurse 1 Psychiatric (including all language… more
- Sutter Health (Sacramento, CA)
- …school of nursing + Bachelor's in Nursing preferred. **CERTIFICATION & LICENSURE:** + RN - Registered Nurse of California Upon Hire **TYPICAL EXPERIENCE:** + ... experience. This position works in collaboration with the Physician, Utilization Manager, Medical Social Worker and bedside RN...managed care environment. + Comprehensive knowledge of Utilization Review , levels of care ,… more
- Trinity Health (Silver Spring, MD)
- **Employment Type:** Full time **Shift:** **Description:** The Manager- Care Management & Utilization Review , under the supervision and in collaboration with ... Managers. Manages the activities of hospital staff in inpatient care coordination and utilization review ....(if applicable):** + State of Maryland license as a Registered Nurse + RN with… more
- Trinity Health (Syracuse, NY)
- …department experience preferred. **Position Purpose:** The Registered Nurse Utilization Review (UR), Clinical Care Manger (CCM) actively manages ... the utilization review process and patient progression from Admission to Discharge....and Physician Advisors to determine appropriate patient status/level of care and ensure timely transition of care … more
- Pipeline Health System, LLC (Gardena, CA)
- Case Manager Registered Nurse RN -...a wide variety of tasks and functions. These include utilization review , discharge planning, care ... with the multidisciplinary team to ensure coordination of patient care and wise utilization of resources. +...+ Minimum of 2-3 years in Case Management Acute Care setting Licensure/Certifications: + Current RN licensed… more
- UCLA Health (Los Angeles, CA)
- …with clinical regulatory standards, and enhancing the overall utilization review process to optimize patient care and manage resources effectively. ... on a key leadership role within an award-winning health care system. Advance world-class nursing care in...more at UCLA Health. In this role as a Utilization Review Supervisor within our utilization… more
- UNC Health Care (Hendersonville, NC)
- …of care and cost effectiveness through the integrating and functions of care management, utilization review and discharge planning. The Care ... based on approved criteria and standards per the Hospital Utilization Review Plan. Directs delivery of notifications...Required * Must be licensed to practice as a Registered Nurse in the state of North… more