- CareFirst (Baltimore, MD)
- …location based on business needs and work activities/deliverables that week. The Director , Utilization Management provides strategic leadership of the ... utilization management team and is responsible for the design, assessment,...addition to the required work experience. **Licenses/Certifications:** + Health Services\ RN - Registered Nurse -… more
- Catholic Health Initiatives (Lexington, KY)
- …can happen both inside our hospitals and out in the community. **Responsibilities** The Utilization Management (UM) Director is responsible for the market(s) ... development, implementation, evaluation and direction of the Utilization Management Program and staff in support of the CommonSpirit Health Care Coordination… more
- Point32Health (Canton, MA)
- …we are at Point32Health, click here (https://youtu.be/S5I\_HgoecJQ) . **Job Summary** The Director , Utilization Management is responsible for directing, ... leadership. The Director oversees and leads medical management activities related to precertification utilization ...**Education, Certification and Licensure** + Master's degree preferred. + RN ( Registered Nurse ) with unrestricted… more
- Commonwealth Care Alliance (Boston, MA)
- **Why This Role is Important to Us:** The Director of Utilization Management leads and manages all utilization management (UM) functions for physical ... state and federal regulatory requirements and all applicable accreditation standards. The Director of Utilization Management is responsible for setting… more
- WellSpan Health (York, PA)
- …Utilization Management Review Committees. Co-chair's System Utilization Management Committee. + Works closely with Medical Director to identify trends ... Committee Meetings with payers. + Organizes and assists Medical Director with System Utilization Management ... Management Experience. Preferred Licenses: + Licensed Registered Nurse Preferred Knowledge, Skills, and Abilities:… more
- Prime Healthcare (Ontario, CA)
- …Responsibilities The Corporate Director of Clinical ... individual and Company performance. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/172723/corporate- director -of-clinical- utilization - management /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilityPrime Healthcare… more
- Hackensack Meridian Health (Belle Mead, NJ)
- …third party payers and communicate potential or identified concerns to the treatment team, Director of Utilization Management , and the Medical Director . ... and serve as a leader of positive change. The Utilization Management Coordinator utilizes clinical knowledge and...Degree **Licenses and Certifications Preferred:** + NJ State Professional Registered Nurse License or NJ Licensed Social… more
- Carle (Urbana, IL)
- …of multidisciplinary team members and the medical staff. + Collaborates with the System Director Utilization Management and Clinical Denial Management . + ... Director of Regional Care Management East/South...Bachelor's Degree in Nursing CERTIFICATION & LICENSURE REQUIREMENTS + Registered Professional Nurse ( RN ) License… more
- St. Luke's University Health Network (Easton, PA)
- …not limited to: RN and Social Work care managers, assistants, coordinators, utilization management staff, and director . + Facilitates communication among ... we serve, regardless of a patient's ability to pay for health care. The Registered Nurse or Social Worker Care Manager is responsible for coordinating the… more
- UTMB Health (Galveston, TX)
- …and reports trends of inappropriate resource utilization to Director /Assistant Director of Utilization Management . + Maintains a documentation system ... school of professional nursing and current Texas Nursing licensure as a professional registered nurse . Minimum of three years of full time wage earning… more
- St. Luke's University Health Network (Bethlehem, PA)
- …management , including but not limited to: Social workers, assistants, coordinators, utilization management staff, and director . + Facilitates ... a patient's ability to pay for health care. The Registered Nurse or Social Worker Care Manager...Care Manager coordinates the overall progression of care, resource utilization , and discharge planning for designated patient populations across… more
- Monte Nido (Miami, FL)
- …+ Understanding of Medicare medical necessity criteria; consult with Admissions staff and Director of Utilization Management on all evaluations for Medicare ... providing the opportunity for people to realize their healthy selves. ** Utilization Review Clinician** **Monte Nido** **Remote** **Monte Nido has been delivering… more
- Banner Health (Phoenix, AZ)
- …commitment to the latest health care advancements and excellent patient care. As the **Associate Director Registered Nurse RN Operating Room** , you will ... the unit to ensure smooth and efficient patient care management and resource utilization . 2. Leads change...improvement initiatives of the department in conjunction with the director . Seeks and utilizes input from staff and oversees… more
- Banner Health (Tucson, AZ)
- …and ratings of hospitals' performance in 20 procedures and conditions. As the **Associate Director Registered Nurse RN Outpatient** , you will ... the unit to ensure smooth and efficient patient care management and resource utilization . 2. Leads change...improvement initiatives of the department in conjunction with the director . Seeks and utilizes input from staff and oversees… more
- Banner Health (Sterling, CO)
- …or admiring unique public art. Sterling Regional MedCenter is looking for a full-time Registered Nurse Associate Director in Sterling, Colorado. In this ... the unit to ensure smooth and efficient patient care management and resource utilization . 2. Leads change...improvement initiatives of the department in conjunction with the director . Seeks and utilizes input from staff and oversees… more
- St. Luke's University Health Network (Easton, PA)
- …management , including but not limited to: Social workers, assistants, coordinators, utilization management staff, and director . + Facilitates ... a patient's ability to pay for health care. The Registered Nurse or Social Worker Care Manager...of Pennsylvania or seeking Pennsylvania licensure through reciprocity. NJ RN licensure required for Warren Campus. Advanced degree preferred.… more
- Access Dubuque (Dubuque, IA)
- Registered Nurse ( RN ) - Emergency...reflects a flat structure. The professional registered nurse reports to the Clinical Director , who in ... standards and guidelines, relevant statutes, rules, and regulations. Standard 15. Resource Utilization The registered nurse utilizes appropriate resources to… more
- Point32Health (Canton, MA)
- …liaises with the interdisciplinary care team, to improve member outcomes (ie, Utilization Management , Medical Director , pharmacy, community health workers, ... - what you need to perform the job** **Education, Certification and Licensure** + Registered Nurse with current unrestricted license in state of residence + May… more
- Trinity Health (Dubuque, IA)
- …Therefore, the nursing organization reflects a flat structure. The professional registered nurse reports to the Clinical Director , who in turn reports to the ... standards and guidelines, relevant statutes, rules, and regulations. Standard 15. Resource Utilization The registered nurse utilizes appropriate resources to… more
- HCA Healthcare (Houston, TX)
- **Description** **Introduction** Do you have the PRN career opportunities as a(an) Registered Nurse RN PACU PRN you want with your current employer? We have ... of colleagues. Do you want to work as a(an) Registered Nurse RN PACU PRN...Summary and Qualifications** Under the direct supervision of the Director of Surgical Support Services, the RN … more