- Guthrie (Sayre, PA)
- Position Summary: The Utilization Management (UM) Reviewer, in collaboration with other internal and external offices, payors, and providers and staff, is ... responsible for the coordinates Utilization Management (UM) processes and requirements for...the level of care or service for hospital inpatient admissions and short procedures by translating clinical information to… more
- Chatham Hills Subacute Care Center (Chatham, NJ)
- Admissions Director The Director ...seven years of recent clinical experience. + Preferred case management experience + Must read, write and speak the ... language + Experience in business/development preferred. + Prior experience in utilization review or discharge planning preferred. The salary for this position… more
- Genesis Healthcare (Hanover, NH)
- …recent clinical experience is required. Must have a valid driver's license. Utilization review, case management , and discharge planning experience is preferred ... Experience in business development preferred. Certifications: CCM, CRRN or CIRS preferred. To protect the health and safety of our patients, residents, employees, family members, and the communities we serve, Genesis has implemented a universal COVID-19… more
- Virginia Mason Franciscan Health (Bremerton, WA)
- …annual bonus eligibility, and more! **Responsibilities** **Job Summary / Purpose** 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… more
- Universal Health Services (Streamwood, IL)
- Responsibilities Director of Utilization Management Full-Time The Director of Utilization Management is responsible for the oversight of the ... utilization management department. Responsibilities include monitoring team members to initiate...consumer, including the clinical screening for appropriation of potential admissions , and appropriate level of care, initiation of treatment… more
- Acacia Network (Bronx, NY)
- …concurrent review package. + . Submitting concurrent review package and follow up with Utilization Management team at the Managed Care Plan for status. + . ... of referrals. + . Circulate current medical reports for Medical Director to review and approve for admissions . + . Ensure signatures are in consent forms for new… more
- Universal Health Services (San Antonio, TX)
- …to the next shift of patients still in process and reports regularly to the Director of Care Management / Admissions on matters of departmental and personnel ... and uses this information to improve the delivery and utilization of care to best meet the clinical and...requests and coordinates care with referral sources. + Milieu management in admissions : keeps staff members and… more
- Providence (San Pedro, CA)
- …Services (CMS) guidelines and regulations. Under the direction of the Medical Director the Admissions Coordinator evaluates internal and external referrals for ... rehabilitation services. This position is accountable for monitoring of appropriate utilization of unit services in accordance with current Center for… more
- Universal Health Services (San Antonio, TX)
- …Standards, providing on-site education to manage difficult cases, and assisting the Director of Utilization Management with department processes and ... Key Responsibilities: + Maintains knowledge of all facets of Utilization Management + Supports Director ...payers and analysis of various reports. + Collaborates with Admissions , Business Office, and Health Information Management … more
- YesCare Corp (Bartow, FL)
- …Below is a list of your responsibilities as a ** Utilization Management Coordinator** with YesCare: + Confirms admissions with outside hospitals and ... notifies the Utilization Management Department of need to report justification for admission...report is sent to each site and participates in Utilization Review with Clinical Director and other… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist LVN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position ... support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist LVN II will facilitate, coordinate and approve… 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 ... support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II will facilitate, coordinate, and approve… more
- Geisinger (Danville, PA)
- …action plans for improvement and continued success in conjunction with Regional Managers, Director , Medical Management and Senior Medical Director . + ... Job Summary Assures appropriate level of care for preplanned admissions and observation status. Coordinates readmission review. Conducts Inpatient and Outpatient… more
- Actalent (Sunrise, FL)
- Utilization Management Nurse Job Description In this role, you will be responsible for reviewing requests for service authorizations to assist with ... physicians and other team members on issues related to utilization review (UR) including appropriate admissions and...You will work under the supervision of the Medical Director and/or Medical Management supervisor and as… more
- State of Indiana (Indianapolis, IN)
- …Nurse (RN) in the State of Indiana. * Two years prior experience with utilization management . * Demonstrated competence in quality assurance and case ... Utilization Review Coordinator Date Posted: May 31, 2024...outpatient precertification/preauthorization. Responsible for evaluating the appropriateness of patient admissions /continued stays/discharge criteria and assign Length of Stay (LOS)… more
- Albany Medical Center (Albany, NY)
- …Management /Social Work Work Shift: Day (United States of America) Responsible for Utilization Management , Quality Screening and Delay Management for ... assigned patients. Salary: $65,062.40 - $107,348.80 * Completes Utilization Management and Quality Screening for assigned patients.* Applies MCG criteria to… more
- Martin's Point Health Care (Portland, ME)
- …Nurse required; BSN preferred. + 3+ (total) years clinical nursing experience + Utilization management experience in a managed care or hospital environment ... as a "Great Place to Work" since 2015. Position Summary Job Description The Utilization Review Nurse works as a member of a team responsible for ensuring the… more
- Albany Medical Center (Albany, NY)
- …Management /Social Work Work Shift: Day (United States of America) Responsible for Utilization Management , Quality Screening and Delay Management for ... assigned patients. Salary Range: $31.28 - $51.61 per hour * Completes Utilization Management and Quality Screening for assigned patients.* Applies MCG criteria… more
- …compile concurrent review package. + Submitting concurrent review package and follow up with Utilization Management team at the Managed Care Plan for status. + ... current medical reports for Director of Nursing to review and approve for admissions . + Ensure signatures are in consent forms for new admissions & picture… more
- University of Colorado (Denver, CO)
- ** Director of Case Management and Associate...(CART) and serve as a consultant to the Special Admissions Committee. This role will work closely with the ... Dean of Students** **University of Colorado Denver** Director of Case Management and Associate Dean...for seeking help; create avenues for increased awareness and utilization ; and advise campus leaders on population health-related issues.… more