- Appcast (Randallstown, MD)
- …schools. This requirement will be lifted for LBH candidates employed as a Utilization Review Nurse, Clinical Care Coordinator, Patient Care Integrator or RN ... Inpatient Care Manager Sign On Bonus Potential: 10,000 Randallstown, MD...Care Manger strives to promote patient wellness, improved care outcomes , efficient utilization of health services and… more
- Laurel Pointe Senor Living (Reading, PA)
- …office staff, hospital staff including social workers, discharge planners, utilization review , volunteer coordinators, rehabilitation director, chaplain service, ... Programs. In addition, they will monitor referral source satisfaction and outcomes . They are responsible for communicating market conditions and opportunities to… more
- GIBSON AREA HOSPITAL (Gibson City, IL)
- …LPN is a professional practitioner who functions as both a caregiver and care manager . In the caregiver role, the LPN assumes responsibility for a group of patients ... or individualizes a predefined, goal consistent and continuous manner by utilization of and adherence to pre-determined standards which define the structure,… more
- GIBSON AREA HOSPITAL (Gibson City, IL)
- …RN is a professional practitioner who functions as both a caregiver and care manager . In the caregiver role, the RN assumes responsibility for a group of patients ... use of self. In the dominant role of care manager , the RN directs and oversees the care of...individualizes a predefined, goal consistent and continuous manner by utilization of and adherence to pre-determined standards which define… more
- GIBSON AREA HOSPITAL (Gibson City, IL)
- …RN is a professional practitioner who functions as both a caregiver and care manager . In the caregiver role, the RN assumes responsibility for a group of patients ... use of self. In the dominant role of care manager , the RN directs and oversees the care of...individualizes a predefined, goal consistent and continuous manner by utilization of and adherence to pre-determined standards which define… more
- GIBSON AREA HOSPITAL (Gibson City, IL)
- …RN/LPN is a professional practitioner who functions as both a caregiver and care manager . In the caregiver role, the RN/LPN assumes responsibility for a group of ... use of self. In the dominant role of care manager , the RN directs and oversees the car of...individualizes a predefined, goal consistent and continuous manner by utilization of and adherence to pre-determined standards which define… more
- GIBSON AREA HOSPITAL (Gibson City, IL)
- …or individualizes a predefined, goal consistent and continuous manner by utilization of and adherence to pre-determined standards which define the structure, ... process, and desired patient outcomes of nursing process. Demonstrates competency in select psychomotor...levels through use of data resources and compliance peer review monitoring. Demonstrates willingness and ability to effectively coordinate… more
- GIBSON AREA HOSPITAL (Gibson City, IL)
- …RN is a professional practitioner who functions as both a caregiver and care manager . In the caregiver role, the RN assumes responsibility for a group of patients ... use of self. In the dominant role of care manager , the RN directs and oversees the care of...in a knowledgeable, skillful, consistent and continuous manner by utilization of/adherence to pre-determined standards which define the structure,… more
- Virtua Health (Pennsauken, NJ)
- …necessity tools to maintain compliance and achieve cost effective and positive patient outcomes .Acts as a resource to other team members including UR Tech and AA ... to support UR and revenue cycle process.Position Responsibilities: Utilization Management* Utilizes Payer specific screening tools as a resource to assist in the… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- *_SUMMARY:_* We are currently seeking a* Utilization Review Manager * to join ourTransitional Care Team.This is a full-time role and will be required to work ... ) required or completed within three years of hire **Title:** * Utilization Review Manager * **Location:** *MN-Minneapolis-Downtown Campus* **Requisition… 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 ... who provide expert nutritional interventions to improve patient health outcomes . **Join Our Team of Experts and Serve Your...and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager… more
- Children's Mercy Kansas City (Kansas City, MO)
- …of, and training oversight of programs and services. Responsible for effective utilization review and proper resource management of patients, including patient ... reporting, quality, and Lean process improvements, and facilitating the quarterly Utilization Review Committee meetings. Provides evidence based and outcome… more
- University of Utah Health (Salt Lake City, UT)
- …and as a team member. **Qualifications** **Qualifications** **Required** + One year Utilization Review or Case Management experience. **Licenses Required** + ... of InterQual Criteria, knowledge of ICD-9, DRG's and CPT Codes. + Utilization Review Certification designation. + Knowledge of CMS Regulations. **Working… more
- State of Indiana (Indianapolis, IN)
- …role of Utilization Management Manager oversees the integration of utilization review , clinically appropriate care and risk management for the purpose of ... Utilization Management Manager Date Posted: Sep...you will ensure Indiana Medicaid members achieve positive health outcomes through access to high quality care and services.… more
- Texas Health Resources (Arlington, TX)
- Director Utilization Management-Clinical Review _Are you looking for a rewarding career with family-friendly hours and top-notch benefits? We're looking for ... leader for system services for wholly owned and Partner hospitals for utilization management. Job Duties OPERATIONS: Plans, organizes and delegates activities as… more
- Humana (Augusta, ME)
- …Registered Nurse (RN) license in the state of Michigan. + Previous experience in utilization management and/or utilization review . + Minimum of two (2) ... caring community and help us put health first** The Manager , Utilization Management Nursing (LTSS Utilization...and mitigate inefficiencies and provide solutions to improve clinical outcomes . + Collect and analyze data as necessary to… more
- Molina Healthcare (GA)
- …performance of one or more of the following activities: care review , care management, utilization management (prior authorizations, inpatient/outpatient medical ... in some or all of the following functions: care management, utilization management, behavioral health, care transitions, long-term services and supports (LTSS),… more
- Prime Healthcare (Ontario, CA)
- …school of nursing and a current state Registered Nurse license. + Minimum 3 years RN Utilization Manager working for a Health Plan. + At least 3 years of ... outcomes and to perform a holistic and comprehensive review of the medical record for the medical necessity,...experience in utilization review , referrals, authorizations, denials and appeals.… more
- Catholic Health Services (Melville, NY)
- …why Catholic Health was named Long Island's Top Workplace! Job Details The Utilization and Appeals Manager (UAM) proactively conducts clinical reviews and ... compassionate care and utilize evidence based practice to improve outcomes - to every patient, every time. We are...additional clinical documentation. + Acts as liaison between the Utilization and Appeals Management Department and the physician of… more
- Northeast Alabama Regional Medical Center (Anniston, AL)
- …years of clinical experience required. Leadership experience preferred. CM or Utilization Review experience preferred. Extensive knowledge and understanding of ... stay reviews to assure hospitalizations meet payor requirements. Maintains records of review information and outcomes for billing purposes and for compliance… more
