- Swedish Health Services (Renton, WA)
- …offer you the chance to focus on what really matters - our patients. The nurse case manager coordinates the care and service of selected patient populations ... Acts as resource and provides oversight for the Case Management Associate for discharge planning and utilization ...upon attaining the BSN degree Upon hire: Washington Registered Nurse License 3 years Registered nursing experience… more
- University of New Mexico - Hospitals (Corrales, NM)
- …patient outcomes are achieved within established time frames and with efficient utilization of resources. Conduct initial and ongoing assessments, initiate disease ... management protocols, determine and manage outcomes, ensure continuity of...manage outcomes, ensure continuity of care through discharge planning, utilization of resources and analysis of variances. Function as… more
- University of New Mexico - Hospitals (Albuquerque, NM)
- …limited to experience, education, and other business and organizational considerations. Department: Utilization Management - UH Read on to fully understand what ... appropriate patients within designated specialty area requiring patient case management interventions by utilizing established procedures including census review,… more
- University of New Mexico - Hospitals (Albuquerque, NM)
- …experience, education, and other business and organizational considerations. Department: Utilization Management - UHFTE: 1.00Full TimeShift: DaysPosition ... appropriate patients within designated specialty area requiring patient case management interventions by utilizing established procedures including census review,… more
- beBeeCare (Albuquerque, NM)
- …quality patient outcomes within established time frames and with efficient utilization of resources. The successful candidate will have excellent communication and ... this role, you will conduct initial and ongoing assessments, initiate disease management protocols, determine and manage outcomes, ensure continuity of care through… more
- University Health (San Antonio, TX)
- …years recent, full time hospital experience preferred. Work experience in case management , utilization review, or hospital quality assurance experience is ... and clinicians in the Ambulatory setting by gathering information, coordinating utilization efforts, and reviewing HCC quality indicators, and RAF scores to… more
- University Health (San Antonio, TX)
- …Three years recent, full-time hospital experience preferred. Work experience in case management , utilization review or hospital quality assurance experience is ... skills for serving in the liaison roles with medical staff, nursing , and patients and families. EDUCATION/EXPERIENCE Graduation from an accredited school… more
- Elevance Health (Washington, DC)
- …office 4 days each week. The office is located at 609 H. Street NE.** The ** Manager of Utilization Management ** **ll** is responsible for managing a team of ... acuity. + Provides direct oversight and is responsible for Utilization Management execution/decision making for managed member...+ Assists and provides back up coverage to Case Management team **Minimum Requirements:** + BA/BS in Nursing… more
- State of Indiana (Indianapolis, IN)
- Utilization Management Manager Date Posted: Nov 30, 2025 Requisition ID: 462259 Location: Indianapolis, IN, US, 46204 Work for Indiana Begin a fulfilling ... care and their communities. Role Overview: The role of Utilization Management Manager oversees the...for this role will have a bachelor's degree in nursing , public administration, public policy, public health or related… 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 ... and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager...+ Current MA RN Licensure required; Bachelor's degree in nursing , health care administration or related field preferred or… more
- Commonwealth Care Alliance (Boston, MA)
- …CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management , the Nurse Utilization Management (UM) ... service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has...accurate documentation of clinical decisions and works with UM Manager to ensure consistency in applying policy + Works… more
- Huron Consulting Group (Chicago, IL)
- …Join our team as the expert you are now and create your future. The Manager of Utilization Management is responsible for planning, organizing, developing, ... Review Plan and the overall operation of the Utilization Management Department in accordance with federal,...goals. **Requirements** + BSN is required. Master's Degree in nursing or related field preferred. + 5 years recent… more
- Sanford Health (Rapid City, SD)
- …Schedule:** Full time **Weekly Hours:** 40.00 **Department Details** Join our team as a Utilization Review and Case Management Manager and lead a ... supervision of all departmental staff. Maintains a standardization of utilization management process to ensure all policies...nurse (RN) license with the State Board of Nursing and/or possess multistate licensure if in a … more
- Guthrie (Sayre, PA)
- …approaches and make recommendations for alternate levels of care. The Acute Case Manager also performs Utilization Management throughout the continuum of ... Arts (BA) degree in addition to a degree in Nursing . A registered nurse with five (5)...admissions and short procedures by translating clinical information to Utilization Management requirements using pre ‐ determined… more
- Actalent (Duluth, GA)
- Case management & Utilization management registered nurse opportunity! Description Nurse will be working on site. Responsibilities will include: Case ... Manager / Utilization Management (90%) and Discharge... Manager / Utilization Management (90%) and Discharge Planning. Develop...At least 1 year of case management /care management Must be a RN (Registered Nurse )… more
- Access Dubuque (Dubuque, IA)
- …Management and Accreditation Program Manager UnityPoint Health Finley Hospital Utilization Management Nurse Cottingham & Butler/ SISCO CNA Psychiatric ... Utilization Management CNA **Cottingham & Butler/... Utilization Management CNA **Cottingham & Butler/ SISCO** 1 Positions...will also triage the call to determine if a Utilization Review Nurse is needed to complete… more
- Community Health Systems (Siloam Springs, AR)
- **Job Summary** The Care Manager - LPN supports effective utilization management and discharge planning by coordinating patient care activities under the ... supervision of a Registered Nurse or physician. This role involves reviewing medical records...clinical nursing experience required + Experience in utilization review, case management , or discharge planning… more
- Community Health Systems (Bentonville, AR)
- …live! **Job Summary** The Care Manager - LPN supports effective utilization management and discharge planning by coordinating patient care activities under ... the supervision of a Registered Nurse or physician. This role involves reviewing medical records...clinical nursing experience required + Experience in utilization review, case management , or discharge planning… more
- Billings Clinic (Billings, MT)
- …issues, escalates to Supervisor, Manager , or Director * Insurance and Utilization Management * Maintains working knowledge of CMS requirements and ... manager staff provide services consisting of comprehensive case management , care coordination, continuing care services, and clinical social...assigned patients * Attends 1400 afternoon huddles with charge nurse and nurse care manager … more
- Houston Methodist (Houston, TX)
- …of hospital clinical nursing experience, which includes three years in utilization review and/or case management **LICENSES AND CERTIFICATIONS - REQUIRED** + ... At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position...to physicians, nurses, and other health care providers on utilization management topics. + Initiates improvement of… more
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