- TrackFive (Hilo, HI)
- …by assisting in collaboration, development, implementation, revision and reporting of the case management program. Acts as a liaison between the patient, family, ... for acute care.Discusses with physicians, the appropriateness of resource utilization , consultations, treatment plan, estimated length of stay and discharge… more
- Morgan Stephens (Long Beach, CA)
- …- Must reside and be licensed in California Job Type: Full-Time Department: Care Management / Utilization Management Salary: $90,000 Position Summary: A ... member needs and Medi-Cal guidelines. Serve as the main liaison between the health plan, facility admissions ...prior authorization processes and confirm Medicaid eligibility. Collaborate with Utilization Management and Case Management … more
- Regal Medical Group, Inc. (Northridge, CA)
- …the delivery of appropriate linkage of care, prevention of avoidable in-patient admissions and re- admissions , and provision of longitudinal care, including ... education and resources to promote informed decision-making. Acts as a liaison with dialysis centers, skilled nursing facilities, and other health providers,… more
- Front Porch Communities and Services (Palo Alto, CA)
- …Residential and Assisted Living residents. Implements policies, procedures and management systems. Coordinates nursing services with care centers, physicians, ... Residential and Assisted Living residents. Implements policies, procedures and management systems. Coordinates nursing services with care centers, physicians,… more
- Amberwell Health (Atchison, KS)
- …a clinician in an acute care nursing unit or experience in a Health Information Management field with Utilization Review job duties necessary. At least two years ... Locations Job Shift Day Job Category Nursing - Hospital Description The Utilization Review/Case Manager will assure maximum coverage by third party payers for… more
- State of Colorado (Denver, CO)
- …dietary, operator, lab, hospital security, and housekeeping. Functions as a liaison between off-hour nursing staff and nursing service administration and ... and hospital/nursing committees. Assist staff in handling complications about off-hour admissions . May escort patients to activities and appointments on the grounds… more
- Regal Medical Group, Inc. (West Covina, CA)
- …RN, or LVN license, current CPR certification. 3 years acute care or case management experience preferred. 2-3 years of utilization or HMO experience preferred. ... appropriate level-of-care is provided, to prevent in patient admission and re- admissions , and ensure that the members' medical, environmental, and psychosocial needs… more
- Wedgemere Healthcare (Taunton, MA)
- …increase likelihood of patient referrals Establish a relationship with the Liaison to create mutually-understood expectations regarding admissions Ensure ... demand) and determine equipment for special needs Educate the Liaison on the clinical capabilities of the facility so...quality care to the residents Accountable for Jazz HR utilization to ensure that every applicant is tracked and… more
- BlueCross BlueShield of Tennessee (Chattanooga, TN)
- …ideally be within 25 miles of Murfreesboro, Tennessee. Job Responsibilities Supporting utilization management functions for more complex and non-routine cases as ... The caseload is fluid, adapting to changes in facility admissions and referrals. Please note this role will require...needed. Serving as a liaison between members, providers and internal/external customers in coordination… more
- Veterans Health Administration (Augusta, GA)
- …Collaborate with the Admissions Coordinator to ensure safe and appropriate CLC admissions , maximize the utilization of CLC beds, and maintain transparency in ... staff and operations. Provide direct patient/resident care including comprehensive management of the physical, psychological, emotional, social, and spiritual needs… more
- Veterans Health Administration (Jackson, MS)
- …Collaborate with the Admissions Coordinator to ensure safe and appropriate CLC admissions , maximize the utilization of CLC beds, and maintain transparency in ... treatment of residents in the CLC. Collaborate with CLC management to advise the CLC administration regarding adequacy and...Approved schools are: Schools of medicine accredited by the Liaison Committee on Medical Education (LCME) for the year… more
- Kaweah Health (Visalia, CA)
- …with physician offices and all appropriate departments to discuss new admissions , demographic information, and other data pertinent to the patient/family which ... within 30 days of admission to determine needs and develop a Care Management Plan to address Social Determinants of Health (SDOH) barriers. Planning Establishes a… more
- University of Mississippi Medical Center (Jackson, MS)
- …patients and family members on treatment and conditions of patients. To act as liaison between case managers, home health nurses, utilization review, etc. To ... performed and are not meant to be construed as exclusive or all-inclusive. Management retains the right to add or change duties at any time. Physical… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Admissions Liaison RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 ... required to achieve that purpose. Job Summary The Utilization Management (UM) Admissions Liaison RN II is primarily responsible for receiving/reviewing… more
- The Arc Erie County NY (Williamsville, NY)
- …information with regards to supports and services offered + Monitoring program utilization with regards to admissions /discharges + Participates and follows up ... , Discharges, etc., and updates these as necessary. + Monitors program utilization with regards to admissions /discharges + Participates and follows up… more
- University of Rochester (Rochester, NY)
- …Subtype: Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 500016 Admissions Center-SMH Work Shift: UR - Rotating (United States of America) Range: ... **Responsibilities:** GENERAL SUMMARY Coordinates or manages inpatient and outpatient admissions , including bed assignments and the completion of preliminary… more
- University of Rochester (Rochester, NY)
- …Subtype: Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 500016 Admissions Center-SMH Work Shift: UR - Rotating (United States of America) Range: ... financial eligibility, secures account for billing and coordinates account management through discharge Completes appropriate forms to complete Death Certificate… more
- Ochsner Health (New Orleans, LA)
- …(CCM), Certified Professional Utilization Review (CPUR), Certified Professional in Utilization Management (CPUM) or Certified Professional in Healthcare ... in the delivery of patient care. Preferred - Experience in case management or utilization review. **Certifications** Required - Current Registered Nurse… more
- Alameda Health System (Oakland, CA)
- System Utilization Management SUM Utilization Review RN + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Evening ... FTE:1 + Posted:July 14, 2025 **Summary** **SUMMARY:** The System Utilization Management [SUM] Utilization Review...each individual in the classification. 1. Acts as a liaison between payers, billing, and medical staff by supplying… more
- Alameda Health System (Oakland, CA)
- System Utilization Management SUM Specialist + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day + Care ... FTE:1 + Posted:July 18, 2025 **Summary** **SUMMARY:** The System Utilization Management (SUM) Care Without Delay RN...each individual in the classification. 1. Acts as a liaison between payers, billing, and medical staff by supplying… more
