- Tenet Healthcare (Detroit, MI)
- …on strategic initiatives and will provide subject matter expertise for Case Management – Utilization Review regulations and standards, including ensuring ... necessary to support and advance Tenet’s Case Management strategy with the specific focus on Utilization Review for the designated Market. Will support… more
- Baptist Memorial (Meridian, MS)
- …Required: RN with 3 years of clinical experience Preferred/Desired: RN with Case Management or Utilization Review experience in a hospital or payer ... Overview RN Utilization Review Weekender Job Code: 22818...against standard criteria per payer guidelines + Prioritizes observation case review + Assists with level of… more
- CoreCivic (Brentwood, TN)
- …a 10% bonus eligible._ **SUMMARY:** The Manager, Utilization Management / Case Management provides Utilization Review and Case Management ... the organization under the direction of the Senior Director, Case Management and within the established policies...Collaborates with management for oversight of the utilization review process to ensure services being… more
- HCA Healthcare (Nashville, TN)
- …nursing or behavioral health experience required + 1- 3 years relevant case management / utilization review experience preferred + Must hold and maintain ... **Introduction** Do you have the career opportunities as a Behavioral Health Utilization Review Specialist you want with your current employer? We have an… more
- HCA Healthcare (Nashville, TN)
- …years nursing or behavioral health experience required + 1-3 years relevant case management / utilization review experience preferred + Must hold and ... to join an organization that invests in you as a Behavioral Health Utilization Review Specialist? At Parallon, you come first. HCA Healthcare has committed up to… more
- Stanford Health Care (Palo Alto, CA)
- …Qualifications: - 5+ years of experience as an RN - 3+ years of experience in case management / utilization review Why work at Stanford Medicine | Stanford ... Knowledge, Skills and Abilities** + Knowledge of principles and best practices of case management , utilization review , social work, care coordination and… more
- McLaren Health Care (Detroit, MI)
- …in coding/medical records/billing or healthcare related field + Two years of case management or utilization review , billing, or coding experience + Three ... observation) based on medical necessity. 2. Performs concurrent and retrospective utilization management -related activities and functions to ensure that… more
- RWJBarnabas Health (Newark, NJ)
- …settings. Additionally, candidates must have at least 3 years of recent experience in Case Management , Utilization Review , or Discharge Planning, and ... leadership experience required. This role focuses on clinical resource management , utilization review , discharge planning,...federal guidelines and is accountable for case management outcomes as outlined in the Utilization … more
- Ochsner Health (New Orleans, LA)
- …well as efficiently in high pressure situations. Preferred- Experience in Case Management or Utilization Review Business and Financial Knowledge as well ... by the physician and applies hospital approved medical necessity criteria to review appropriate admissions, levels of care and continued stay. Documents completed… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Case Manager is responsible for all aspects of case management / utilization review for an assigned group of inpatients, ED ... all new admissions to identify patients where utilization review , discharge planning, and/or case management will be needed using standardized criteria… more
- HCA Healthcare (Anchorage, AK)
- …required. + 2+ years of supervisory experience preferred. + Certification in Case Management or Utilization Review preferred. + Ability to establish and ... care facilitation, discharge planning functions and utilization management . + You will lead the Case ...compelling, we encourage you to apply for our Manager Case Management opening. We promptly review… more
- Stanford Health Care (Palo Alto, CA)
- …**Required Knowledge, Skills and Abilities** + Knowledge of principles and best practices of case management , utilization review , social work, care ... employee evaluations, and program development for the Department of Social Work and Case Management . Additionally, this position serves as a resource for problem… more
- Seattle Children's (Seattle, WA)
- …caring for children with medical complexity Current or previous hospital case management or utilization review experience Current or previous case ... provides leadership, supervision, and oversight of day-to-day operations of the Case Management department. Serves as the central resource to the director to… more
- Covenant Health (Nashua, NH)
- …in-services are attended /documented. + Annual goals are achieved. + Attends pertinent case management / utilization review programs to maintain current ... medical necessity (whether based on initial or continuing stay review ) to determine whether a level of care change...Minimum of five years broad clinical experience preferred + Case management and/or Utilization … more
- Rady Children's Hospital San Diego (San Diego, CA)
- …and implementing the utilization management process for acute inpatients. Case Managers perform concurrent review and denials management based on ... Degree in Nursing 4 years nursing in an acute hospital or 2 years Case Management , Utilization Review , or Discharge Planning experience in an acute… more
- Ellis Medicine (Schenectady, NY)
- …services provided by the Case Manager include, but are not limited to, utilization review , case management , care transition, collaboration with ... years of inpatient experience in a hospital environment preferred. + Previous case management , utilization review , and discharge planning experience… more
- HCA Healthcare (Lake City, FL)
- …We want your knowledge and expertise! **Job Summary and Qualifications** Provides hospital case management / utilization review and discharge planning to ... in case management and/or supervisory/ management position involving case management / utilization review /responsibility in an acute care… more
- McLaren Health Care (Port Huron, MI)
- …+ Associates degree in healthcare related field. + Two years of case management or utilization review experience * Three years of recent experience ... timeframes. 2. Ability to understand, interpret, explain, and use data for case management activities. 3. Ability to work with diverse teams and individuals,… more
- Prime Healthcare (Inglewood, CA)
- …supervision to case managers, social workers and case management coordinators/discharge planners, utilization review coordinators and utilization ... experience, education, credentials and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/200257/director-of- case - management utilization - management /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306)… more
- HCA Healthcare (Richmond, VA)
- …work experience in an acute care setting preferred. + Previous case management or utilization review experience preferred. CJW Medical Center ... finances and/or physical disabilities. + As a member of Case Management team you will provides crisis...payers and maintain legible documentation as directed by the Utilization Management Plan. **What qualifications you will… more