- Catholic Health (Buffalo, NY)
- …with Weekend and Holiday Rotation Hours: 8:00 am to 4:00 pm Summary: The Registered Nurse (RN) Care Manager - Utilization Review, as an active member of the ... nursing clinical skills and discharge planning principles, the RN Care Manager , Utilization Review collaborates with the interdisciplinary team to maintain… more
- UPMC (Hanover, PA)
- **UPMC is hiring a part time Professional Care Manager for our Utilization Review department in Hanover! This is a part time, day shift position with a rotating ... weekend and holiday schedule.** **Purpose:** The Care Manager (CM) coordinates the clinical and financial plan for patients. Performs overall utilization … more
- Veterans Affairs, Veterans Health Administration (Little Rock, AR)
- Summary Under the supervision of the Nurse Manager , the Utilization Management Nurse will ensure that patients meet appropriate admission and continued ... follow-up has been determined and implemented. Responsibilities Under the supervision of the Nurse Manager , the Utilization Management Nurse will… more
- Elevance Health (Woodbridge, VA)
- RN Utilization Review Nurse (Washington DC Medicaid) JR149756 **Location** : This role requires associates to be in-office 4 days per week, Monday - Thursday, ... located at 609 H. Street NE. The **Medical Management Nurse ** is responsible for review of the most complex...management experience and requires a minimum of 2 years clinical , utilization review, or managed care experience;… more
- Adecco US, Inc. (Houston, TX)
- …. Preferred certifications include Certified Case Manager (CCM) or Certified Utilization Review Nurse (CURN). **Pay Details:** $85,000.00 to $110,000.00 per ... & Life Sciences is assisting a client hire a Utilization Review Nurse in Houston, TX! This...License in Texas . 2 to 3 years of clinical nurse /case management experience . 2 to… more
- University of Utah Health (Salt Lake City, UT)
- …to UR committee any case that surpasses expected LOS, expected cost, or over/under- utilization of resources. + Performs verbal/fax clinical review with payer as ... advancement, and overall patient outcomes. **Responsibilities** + Applies approved utilization criteria to monitor appropriateness of admissions with associated… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position ... net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates,...implement a successful discharge plan. Works with the UM Manager and Physician Advisor on case reviews for pre-service,… more
- Dignity Health (Gilbert, AZ)
- …of the Director of Care Management, performs criteria-based concurrent and retrospective utilization review to support and encourage the efficient and effective use ... with applicable standards and regulations and provide information and education to clinical care providers in order to achieve optimal clinical , financial,… more
- Beth Israel Lahey Health (Plymouth, MA)
- …establish the appropriate level of care using Interqual criteria. + Integrates clinical knowledge with billing knowledge to review, evaluate, and appeal clinical ... the denial management, documentation, and appeals process. + Collaborates with UR Manager and/or physician advisor regarding cases that do not meet established… more
- Beth Israel Lahey Health (Burlington, MA)
- …taking a job, you're making a difference in people's lives.** Joint role of Case Manager and Utilization Review Nurse Onsite at Lahey Hospital and Medical ... 8:00am-4:30pm Weekend and holiday rotations required **Job Description:** The Inpatient Registered Nurse (RN) Case Manager for Hospital at Home Care Transitions… more
- Community Health Systems (Naples, FL)
- **Job Summary** Under the direction of the UR Director/ Manager the UR Nurse reviews all admissions for medical necessity, correct orders based on medical ... Nursing, ASN required or + Bachelor's Degree BSN required + 2-4 years clinical practice experience required + Experience in HEDIS, MIPS, PQRS, ACO, STARS preferred… more
- Humana (Frankfort, KY)
- …and help us put health first** The Manager , Behavioral Health Utilization Management uses clinical knowledge, communication skills, and independent critical ... + 2 + years of experience working in Utilization Management processing clinical authorizations + Licensed Registered Nurse (RN) in the state of Kentucky… more
- Fresenius Medical Center (New York, NY)
- …closely with, providing oversight as needed to, the Clinical Coordinator/Charge RN or Nurse Supervisor acting as nurse manager , the Medical Director, and ... and regulatory requirements and programs. Collaborates with the Medical Director and the Clinical Coordinator /Charge Nurse or Nurse Supervisor regarding the… more
- CenterWell (San Diego, CA)
- …us put health first** + Develops, plans, implements, analyzes, and organizes clinical operations for a specific location managed. + Conducts/delegates the assessment ... goals. + Participates in sales and marketing initiatives. + Supervises all clinical employees assigned to a specific location. Responsible for the overall direction,… more
- Hartford HealthCare (Bridgeport, CT)
- …**Health Professionals* **Organization:** **Hartford HealthCare at Home* **Title:** *Hospice Nurse Manager (RN, Registered Nurse , Clinical Manager ) - ... to become part of Connecticut's most comprehensive healthcare network as a Hospice Clinical Team Manager . Hartford HealthCare at Home, the largest provider of… more
- Stanford Health Care (Palo Alto, CA)
- …to delivering evidence-based and patient-centered care. We are seeking a results-driven manager to further develop the framework for clinical , operational, and ... - 08 Hour (United States of America) Department: Oth Ancillary Svcs - Utilization Mgmt Commitment: Full-time (1.0 FTE) 8-hr. Days Schedule: 8-hr, Day Shift Strongly… more
- WellSpan Health (York, PA)
- Manager Clinical Operations - Registered Nurse - Heart & Vascular Center York Location: WellSpan Medical Group, York, PA Schedule: Full Time Schedule Full ... Works with the Practice Managers and Site Directors to advance and standardize clinical operations throughout the system, within a culture of quality, safety and… more
- Houston Methodist (The Woodlands, TX)
- …Methodist, the Case Manager PRN (CM) position is a licensed registered nurse (RN) who comprehensively plans for case management of a target patient population on ... and assures that admission and continued stay are medically necessary and communicates clinical information to payors to ensure reimbursement. The CM PRN helps drive… more
- Actalent (White Plains, NY)
- Clinical Assessment Manager - (UAS Nurse ) Job Description This position will ensure the effective and efficient completion of tasks associated with the ... completion, comprehensive assessment, medication review, and post-hospital discharge evaluation. The Clinical Assessment Manager will follow all Department of… more
- Texas A&M University System (College Station, TX)
- Job Title Clinical Research Nurse Manager Agency Texas A&M Agrilife Research Department Institute for Advancing Health through Agriculture-Project Management ... producers and the environment. The Research Nurse Coordinator/ Manager , operating under the direction of the Clinical...Serves as the primary point of contact for the utilization of the IHA Research Clinic, engaging with internal… more
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