- 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 ... Manager for Hospital at Home Care Transitions coordinates utilization review , discharge planning and monitors quality...staffs. -Case Manager experience as well as Utilization Review experience ( review medical… 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
- 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 ... Our Team of Experts and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager , you will:** + Directs staff performance… more
- Ochsner Health (Lafayette, LA)
- …+ Determines appropriate staffing levels and the interviewing, hiring, performance review , and termination of employees within practice unit(s); maintains employee ... schedules to assure appropriate coverage. + Develops departmental specific systems to assure an environment that emphasizes patient courtesy and responsive service delivery. + Performs other related duties as required. The above statements describe the general… more
- Dallas Behavioral Healthcare Hospital (Desoto, TX)
- The Utilization Review Case Manager is responsible for working with insurance companies and managed care systems for the authorization, concurrent and ... help patients access the full range of their benefits through the utilization review process. + Conducts admission reviews. + Conducts concurrent and extended… more
- Trinity Health (Mason City, IA)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** **JOB SUMMARY:** The Utilization Review Case Manager responsibilities include case ... members of care team to effectively ensure appropriate acute utilization management + Interacts with outside review ...acute utilization management + Interacts with outside review agencies and payors to inform them of extended… more
- Prime Healthcare (Lynwood, CA)
- …and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/204105/case- manager %2c-rn utilization - review ... effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity of service… more
- Houston Methodist (The Woodlands, TX)
- At Houston Methodist, the Case Manager PRN (CM) position is a licensed registered nurse (RN) who comprehensively plans for case management of a target patient ... for the department and the hospital. **SERVICE ESSENTIAL FUNCTIONS** + Performs review for medical necessity of admission, continued stay and resource use,… more
- Ascension Health (Baltimore, MD)
- …Manage activities, workflow and resources of assigned nursing travelers. + Ensure compliance with regulatory and accreditation requirements for their assigned team. + ... **Details** + **Department:** Ascension Travel Program & Interim Leadership + **Schedule:** Full-time + **Hospital:** St. Agnes + **Location:** Baltimore, MD * Rates may vary by location and specialty. Stipends follow GSA guidelines based on the zip code of… more
- Trinity Health (Lavonia, GA)
- **Employment Type:** Full time **Shift:** **Description:** The RN Case Manager (RN CM), works in collaboration with a multidisciplinary team by identifying and ... level of care throughout hospitalization in compliance with CMS and organizational utilization management requirements. RN CM helps to ensure medical necessity is… more
- Lowe's (Charlotte, NC)
- …years of experience in a clinical position. + 3-5 Years of Experience as a Case Manager or Utilization Review Nurse in worker's compensation + Experience in ... **Your Impact** The Care Manager is a telephonic medical case management position...claims per year for its US operations. The Care Manager will be responsible for medically managing a minimum… more
- Ascension Health (Baltimore, MD)
- …salary range at the time of the offer._ **Responsibilities** Manage effective utilization review processes, including management of patient statusing processes ... implement quality review programs and key performance indicators for all utilization review activities. + Interact with medical, nursing, and executive… more
- Billings Clinic (Billings, MT)
- …and coordinates care with the RN Care Manager , Social Services Care Manager , Utilization Review RN, Physician Advisor and Care Management Assistant. ... at high risk for readmission. * Interfaces effectively with the Utilization Review department to stay current on patient's eligibility for admission, continuing… more
- CoreCivic (Brentwood, TN)
- …- $97,400 with a 10% bonus eligible._ **SUMMARY:** The Manager , Utilization Management/Case Management provides Utilization Review and Case Management ... better the public good. CoreCivic is currently seeking a ** Manager , Health Services Audits** located at our corporate office...requests. + Collaborates with management for oversight of the utilization review process to ensure services being… more
- Baptist Memorial (Jackson, MS)
- …Preferred/Desired + Healthcare/Medical-Case Manager Preferred, or Healthcare/Medical - Utilization Review Preferred. Education Minimum Required + Graduate of ... the first 24 hours of arrival to complete an initial review . Collaborate with physicians, Manager of Case Management and physician advisors to resolve conflicts.… more
- Nuvance Health (Sharon, CT)
- …for this full time RN Case Manager position includes include utilization review , discharge planning and care transitions. Candidates require a CT ... state RN license, Bachelors Degree in Nursing or related field, a minimum of 1 year Case Management experience in an acute care setting. CCM, PRI and Screen certifications preferred. We are an equal opportunity employer Qualified applicants are considered for… more
- Tenet Healthcare (Detroit, MI)
- Group Utilization Review Director - 2506000536 Description : The Detroit Medical Center (DMC) is a nationally recognized health care system that serves patients ... diverse employers in Southeast Michigan. Summary Description SUMMARY: The Group Director, Utilization Review will perform the functions necessary to support and… more
- Alameda Health System (Oakland, CA)
- System Utilization Management SUM Utilization Review RN + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day + ... #:41907-31045 + FTE:1 + Posted:Today **Summary** **SUMMARY:** The System Utilization Management [SUM] Utilization Review ...in orientation of fresh staff as requested by the Manager of Utilization Management. 17. Maintains knowledge… more
- South Central Regional Medical Center (Laurel, MS)
- …patients admitted through the ED - work collaboratively with the inpatient care manager and the utilization review department to support transitions ... SUMMARY Through the Quality Care Management department, the Quality Care Manager supports clinical workflow that integrates value-based performance criteria. The… more
- Baptist Memorial (Meridian, MS)
- Overview RN Utilization Review Weekender Job Code: 22818 FLSA Status Job Family: NURSING Job Description Title: RN Utilization Review Weekender Job ... necessity and appropriateness of healthcare services and treatment as prescribed by utilization review standards. The UR Nurse works with providers, insurance… more
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