- SR International, Inc. (Phoenix, AZ)
- … nursing practice, medical case management protocols, quality management and utilization review protocols as related to all populations including Maternal ... to the AHCCCS program *Good written and communication skills *Computer skills * Utilization Review skills * Medical Claims Review skills *Producing work… more
- GIBSON AREA HOSPITAL (Gibson City, IL)
- …Full Time Salary Range $32.00 - $48.00 Hourly Description JOB TITLE: UTILIZATION REVIEW /CASE MANAGEMENT - Nurse DEPARTMENT: CASE MANAGEMENT (QUALITY) GENERAL ... SUMMARY The Utilization Review /Case Management Nurse is directly responsible...effective discharge planning is provided. Working closely with the Medical Staff and Nursing units in this effort, effective… more
- HealthCare Support (Houston, TX)
- Utilization Review RN HealthCare Support is...guidelines. Refers cases that do not meet criteria to Medical Director for review . 2. Assists in ... actively seeking a Utilization Review RN to fill an opening with a Prestigious...services and if not meeting criteria, refer to the Medical Director. 3. Participates in Community Nursing Rounds if… more
- HireMaster (Lincoln, NE)
- …vision, beliefs and consistently demonstrates our core values. 2. *Performs utilization review activities, including concurrent and retrospective reviews as ... SUMMARY: Conducts day-to-day activities for the clinical, financial and utilization coordination of the patients hospital experience. Proactively consults with… more
- Health eCareers (Maryville, TN)
- …of care and timely implementation of plan of care in accordance with hospital(s) Utilization Review Plan and CMS regulation. Maintains expert level knowledge of ... regarding payor and regulatory guidelines. Promotes effective and efficient utilization of clinical resources, ensuring quality, cost effective care. Provides… more
- Providence Little Company of Mary Medical Center - San Pedro (San Pedro, CA)
- …to perform discharge planning and utilize interqual criteria - Experience in utilization review and concurrent reviews Description: This position requires ... Details Client Name Providence Little Company of Mary Medical Center - San Pedro Job Type Travel...- Case Manager @ Providence Little Company of Mary Medical Center San Pedro - Case Management Weekly Pay… more
- Geisinger (Scranton, PA)
- Job Title: RN - Graduate Registered Nurse (Geisinger Community Medical Center, Scranton)Location: Scranton, PennsylvaniaJob Category: Inpatient RN - Registered ... here to learn more about the units belowAdvanced Acute Care ( Medical & Oncology, Surgical Trauma, Cardiac/Telemetry, Orthopedics)Cardiac Special Care UnitChildbirth… more
- Providence Little Company of Mary Medical Center San Pedro-… (San Pedro, CA)
- …License Certifications: BLS - AHA Must-Have: Strong assessment, discharge planning, and utilization review skills Description: The RN Case Manager coordinates ... Details Client Name Providence Little Company of Mary Medical Center San Pedro- Case Management Job Type Travel Offering Nursing Profession RN Specialty Case Manager… more
- GIBSON AREA HOSPITAL (Gibson City, IL)
- …$25.00 - $45.00 Hourly Description JOB TITLE: RN (CLINICAL) DEPARTMENT: GIBSON AREA MEDICAL CLINIC GENERAL SUMMARY The staff RN is a professional practitioner who ... or individualizes a predefined, goal consistent and continuous manner by utilization of and adherence to pre-determined standards which define the structure,… more
- ONSLOW MEMORIAL HOSPITAL (Jacksonville, NC)
- …cost effectiveness through the integrating and functions of case management, utilization review and discharge planning. Collaborates with the multidisciplinary ... Education required and a License in Clinical Social Work preferred. Experience: Two (2) years of medical care management experience as a Social Worker preferred. more
- CoxHealth (Springfield, MO)
- …feedback for the following Committees: 1) Coding and Documentation Committee 2) Utilization Review Committee 3)SOI Scorecard Committee 4) Educational sessions ... Healthcare Innovation's Top Companies to Work for in Healthcare in 2025. Benefits Medical , Vision, Dental, Retirement Plan with employer match, and many more! For a… more
- Plante Moran (Denver, CO)
- …the office/region and department Collaborate with office leadership to achieve office utilization goals of staff and meet recommended industry group mix requirements ... Assist Talent Deployment Manager in reporting on and evaluating tax/assurance utilization (firmwide) Closely monitor assurance/tax staff hours and schedules Assist… more
- UnitedHealth Group (Cape Coral, FL)
- …in their awareness of preferred contracts and providers and facilitiesRefers cases to Medical Director as appropriate for review or requests not meeting criteria ... reviews at the designated network or out of network facilities. Documents medical necessity and appropriate level of care utilizing national recognized clinical… more
- Legend Biotech USA, Inc. (Raritan, NJ)
- …of site operational models to better understand and assess resource utilization , equipment utilization , change impact, etc.Support assessment of facility ... own, assess and participate in the creation, revision and review of change controls, SOPs, and other documentation.RequirementsBachelor's degree in… more
- Vantive (Deerfield, IL)
- …plans (RCCP) to optimize production efficiency and working capital utilization .Monitor and manage supply constraints, inventory levels, and replenishment plans ... key supply chain performance metrics, including service levels, capacity utilization , and inventory performance.Lead supply network contingency planning, ensuring… more
- Monster (Findlay, OH)
- …and coordination of care, as needed. Duty 10: The Social Worker performs ongoing utilization review of patients admitted to the psychiatric unit to ensure ... behavioral health related needs for patients being treated in the Emergency Department, Medical Surgical Units, Intensive Care Units of BVH and Orchard Hall as… more
- Geisinger (Danville, PA)
- …As one of the Top 8 Most Innovative Healthcare Systems in Becker's Hospital Review , we're working to create a national model for improving health. Today, we're ... is a unique opportunity to join our Care Coordination team supporting Geisinger Medical Center (GMC) inpatient care areas. This RN role is full time, exempt,… more
- InterDent (Ariel, WA)
- …region Organizational Support Partner with the Group President on contract review , provider agreements, and vendor partnerships Communicate regularly with clinical ... implement, and monitor clinical guidelines, quality improvement initiatives, and utilization management processes to enhance patient outcomes and optimize resource… more
- Geisinger (Wilkes-Barre, PA)
- …heart rooms for valve proceduresExpanding clinic space and cardiac imageryTransitioning the medical center to 100% private rooms58 new medical /surgical inpatient ... new skills focused on the specialized practice settingFree Princeton NCLEX Review Questions (on-line, self paced)!Temporary Practice Permit (TPP) reimbursement +… more
- CoxHealth (Springfield, MO)
- …responsible for facilitating timely and accurate physician documentation in the medical record through concurrent chart review . Interdisciplinary communication ... Healthcare Innovation's Top Companies to Work for in Healthcare in 2025. Benefits Medical , Vision, Dental, Retirement Plan with employer match, and many more! For a… more
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