- University of New Mexico - Hospitals (Albuquerque, NM)
- …* Subject to an annual contract and performance appraisal * Tuberculosis testing is completed upon hire and additionally as requiredDepartment: Registered Nurse ... to experience, education, and other business and organizational considerations.Department: Utilization Management - UHFTE: 1.00Full TimeShift: DaysPosition Summary:Responsible for… more
- University Health (San Antonio, TX)
- …Board of Nurse Examiners of the State of Texas to practice as a registered nurse is required. National certification in related field is desirable. Case ... and clinicians in the Ambulatory setting by gathering information, coordinating utilization efforts, and reviewing HCC quality indicators, and RAF scores to… more
- University Health (Pleasanton, CA)
- …Board of Nurse Examiners of the State of Texas to practice as a registered nurse is required. National certification in related field is preferred. Case ... families. EDUCATION/EXPERIENCE Graduation from an accredited school of nursing with current RN licensure in the State of Texas, BSN preferred. National certification… more
- UNC Health Care (Raleigh, NC)
- …care episode through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management ... and care delivery is coordinated across the continuum. The Utilization Manager completes admission, continued stay, and...date. **Licensure/Certification Requirements:** * Licensed to practice as a Registered Nurse in the state of North… more
- UNC Health Care (Hendersonville, NC)
- …the health and well-being of the unique communities we serve. Summary: The Utilization Manager (UM) assesses new admissions, continued stay and discharge review ... met and care delivery is coordinated. The UM completes utilization reviews in accordance with federal regulations and the...Required + Must be licensed to practice as a Registered Nurse in the state of North… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …in confidentiality, integrity, creativity, and initiative */License/Certifications:/* * Current Registered Nurse licensure upon hire * National certification ... *_SUMMARY:_* We are currently seeking a* Utilization Review Manager * to join ourTransitional...to 5) years of professional leadership experience (ie, charge nurse , team leader, preceptor, committee chair, etc.) * Five… more
- Baystate Health (Springfield, MA)
- …Case Manager / Utilization Management** The ** RN Hospital Case Manager ** is a registered nurse responsible for the coordination of clinical care, ... of a designated population of patients. The Hospital Case Manager is responsible for overseeing an efficient plan that...for transitions + Leads the team to ensure appropriate utilization of patient resources and directs care to other… more
- Huron Consulting Group (Chicago, IL)
- …our team as the expert you are now and create your future. The Manager of Utilization Management is responsible for planning, organizing, developing, and ... directing implementation of the Utilization Review Plan and the...Criteria and Milliman Care Guidelines (MCG) preferred. + Current RN license from Maryland Board of Nursing. + CCM… 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 We ... Our Team of Experts and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager , you will:** + Directs staff performance… more
- CVS Health (Baton Rouge, LA)
- …we do it all with heart, each and every day. **Position Summary** The Utilization Management Manager of Prior Authorization oversees a team of clinical ... to ensure the efficient, compliant, and high-quality delivery of utilization management processes. This leader supports organizational goals by implementing… more
- Hartford HealthCare (Willimantic, CT)
- …**Windham Hospital* **Title:** * Registered Nurse Case Manager ( RN ) - Utilization Management* **Location:** *Connecticut-Willimantic-Windham ... of hospital resources. Works under the direction of the Manager of Continuing Care and Utilization Management...management experience preferred. *LICENSURE/CERTIFICATION* * Current license as a registered nurse in the State of Connecticut.… more
- Elevance Health (Washington, DC)
- …4 days each week. The office is located at 609 H. Street NE.** The ** Manager of Utilization Management** **ll** is responsible for managing a team of physical ... and acuity. + Provides direct oversight and is responsible for Utilization Management execution/decision making for managed member populations. Primary duties may… more
- Elevance Health (Tampa, FL)
- …is granted as required by law. *Must reside in the state of Florida* The ** Manager of Utilization Management** is responsible for managing a team of physical ... and/or behavioral health practitioners responsible for coordinating member service, utilization , access, care management and/or concurrent review to ensure cost… more
- Sanford Health (Rapid City, SD)
- …experience preferred. Experience in medical necessity review preferred. Currently holds an unencumbered registered nurse ( RN ) license with the State Board of ... Hours:** 40.00 **Department Details** Join our team as a Utilization Review and Case Management Manager and...Nursing and/or possess multistate licensure if in a Nurse Licensure Compact (NLC) state. Obtains and subsequently maintains… more
- Intermountain Health (Las Vegas, NV)
- …+ Continuous Improvement + Scheduling **Physical Requirements:** **Minimum Qualifications** + Current Registered Nurse ( RN ) license in state of practice ... Monday-Friday 8:00 - 5:30 pm Holiday and weekend coverage when needed. The Manager of Care Management I leads and collaborates with care management operations across… more
- Children's Mercy Kansas City (Kansas City, MO)
- …experience + Experience in Utilization Review + One of the following: Licensed RN - MO, Registered Nurse Multistate License Missouri required upon hire ... training oversight of programs and services. Responsible for effective utilization review and proper resource management of patients, including...+ One of the following: Licensed RN - Kansas, Registered Nurse … more
- Prime Healthcare (Lynwood, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/237903/ rn -case- manager ... an accredited school of nursing and a current state Registered Nurse license.2. Grandfathered prior to April...Of Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred.3. Five years acute… more
- Highmark Health (Harrisburg, PA)
- …Inc. **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health care ... services, application of criteria to ensure appropriate resource utilization , identification of opportunities for referral to a Health Coach/case management, and… more
- Sutter Health (Roseville, CA)
- …patient experience. This position works in collaboration with the Physician, Utilization Manager , Medical Social Worker and bedside RN to assure the timely ... **EDUCATION:** Graduate of an accredited school of nursing **CERTIFICATION & LICENSURE:** RN - Registered Nurse of California Upon Hire **TYPICAL EXPERIENCE:**… more
- Sutter Health (San Francisco, CA)
- …patient experience. This position works in collaboration with the Physician, Utilization Manager , Medical Social Worker and bedside RN to assure the timely ... + Graduate of an accredited school of nursing **CERTIFICATION & LICENSURE:** + RN - Registered Nurse of California Upon Hire **TYPICAL EXPERIENCE:** +… more
