- AmeriHealth Caritas Health Plan (Philadelphia, PA)
- …services. Discover more about us at www.amerihealthcaritas.com. Join a mission-driven Utilization Management team where your clinical expertise helps shape ... experience in ICU, ED, Med-Surg, pediatrics, behavioral health, or similar. Prior Utilization Management or managed care experience preferred. Strong analytical,… more
- UHS (Bethlehem, PA)
- …for seniors, adults and adolescents. Hanover is seeking an experienced Director of Utilization Management and Review. This is a fantastic opportunity to join ... Master Degree Required 5-8 year of experience Required of Utilization Review and Management Pennsylvania RN License or LMHC/LCSW preferred EEO Statement: All… more
- Boston Childrens Hospital (Boston, MA)
- …preferred. Experience as a Case Manager (Discharge Planning and or Utilization Management ) preferred. Licensure/ Certifications: Current Massachusetts license as ... of payer denials. They identify and implement initiatives to manage utilization trends, collaborating with the hospital's discharge planning case managers,… more
- Alameda Health System (Oakland, CA)
- SUMMARY: The System Utilization Management [SUM] Utilization Review RN is responsible for ensuring the appropriate use of healthcare resources while ... in orientation of fresh staff as requested by the Manager of Utilization Management . 17. Maintains knowledge of current trends and changes in healthcare delivery… more
- Sanford Health (Bemidji, MN)
- …minimum of five years of clinical practice. Knowledge and experience in case management , utilization management and/or Coding highly preferred. Currently ... written/verbal communication, critical thinking, creative problem solving, and conflict management skills. Must be proficient in organization and planning. Must… more
- American Traveler (Salem, MA)
- …*BLS certification through AHA required, *ACLS certification through AHA required, *Case Management , Utilization Management , and Discharge Planning skill set ... American Traveler is hiring an experienced RN Case Manager with strong case management and discharge planning skills for a dayshift inpatient role. Job Details *Work… more
- HEALTH FIRST CAREERS (Melbourne, FL)
- …reimbursement analysts as necessary. Is an active member of the Utilization Management Committee. Work Experience MINIMUM QUALIFICATIONS Education: Associate's ... Emergency Department Nursing Knowledge/Skills/Abilities: Current working knowledge of care transitions, utilization management , case management and managed… more
- Medical Solutions (Omaha, NE)
- …Barbara, CA is seeking its next amazing RN (Registered Nurse) to work in Case Management ( Utilization Review). Read on if this sounds like your perfect fit! ... Nurses and allied healthcare professionals are in high demand nationwide, and our team of industry-leading, traveler-favorite recruiters can get you where you want to go - personally and professionally. Wherever you may roam, travel healthcare helps you hone… more
- Kaiser Permanente (Los Angeles, CA)
- …the interdisciplinary approach to providing continuity of care, including Utilization management , Transfer coordination, Discharge planning, and obtaining ... B21|AFSCME|SCNSC Job Level: Individual Contributor Department: Sunset Medical Center - Utilization Management - 0801 Pay Range: $60.79 - $74.4 / hour Travel:… more
- Kaiser Permanente (Sacramento, CA)
- …assigned areas. Essential Responsibilities: Assists in the coordination of the quality management / utilization management department activities. Acts as a ... consultant for appropriate departments on quality management , utilization management and risk management activities. Assists with quality management … more
- EvergreenHealth (Kirkland, WA)
- …arrange for equipment, and arrange for additional services in the community. Utilization Management /Case Management Nurses provide clinical information to ... illness and level of service provision. Job Summary Working under department management , specializes in assessing hospital admissions for status per defined criteria… more
- Curative HR LLC (Austin, TX)
- …teams, including Nurse Practitioners, Care Coordinators, and Operations, to optimize utilization management processes and improve member outcomes. Contribute to ... development, review, and revision of medical policies, clinical guidelines, and utilization management protocols. Participate in quality improvement initiatives,… more
- Valley Health System (Paramus, NJ)
- …and Commercial payors guidelines. Monitors and intervenes on LOS, resource utilization and denial management / prevention within the assigned caseload. ... cents experience in clinical nursing, minimum of 3 years in case management / utilization . SPECIAL SKILLS: Registered Nurse, Licensed in State of New Jersey,… more
- Sharp HealthCare (La Mesa, CA)
- …competency and individual development planning process. Maintain current knowledge of case management , utilization management , and discharge planning, as ... and provides information to the department head as indicated. Utilization review and utilization management The RN CM will: Conduct initial review… more
- NorthShore (Arlington Heights, IL)
- …Management Program is responsible for the case management , care coordination management , and utilization management of his/her population of patients ... for appropriate consultations and support services within established protocols Completes Utilization Management for assigned patients. Applies Milliman Care… more
- NursingPro Staffing (Orange Park, FL)
- …payer regulations, quality control and process improvement activities as related to Utilization Management . Supports the facility by ensuring effective and ... standards pertaining Joint Commission, Local Fl, and CMS. Oversee and manage the Utilization Management functions and staff. What you will do in this role: *You… more
- Tenet Health (Nacogdoches, TX)
- …national standards for case management scope of services including: Utilization Management supporting medical necessity and denial prevention; Transition ... This position may qualify for a sign-on bonus Summary Responsible for hospital utilization performance improvement and operational management of the Case … more
- WellSpan Health (York, PA)
- …Responsibilities Essential Functions: Reviews assigned patients for medical necessity, utilization management , and appropriateness of setting for continued ... to support continuous quality and cost of care efforts. Liaisons between utilization management team, third party payers, and the treatment team regarding the… more
- Surgery Partners (Bryan, TX)
- …Current Registered Nurse (RN) license in the state of practice Experience in utilization review, acute hospital case management , or quality assurance is required ... Job Summary: We are seeking a Part-Time Utilization Review Nurse to join our dedicated healthcare...resources in advocating for patient needs with judicious resource management Assures the patient is in the appropriate status… more
- HEALTH FIRST CAREERS (Palm Bay, FL)
- …in a acute care hospital. Knowledge/Skills/Abilities: Knowledge of care transitions, utilization management , case management , performance improvement and ... significant support personnel to achieve optimal clinical outcomes through effective utilization of resources and discharge planning for all hospital admissions.… more
Related Job Searches:
Coordinator Utilization Management,
Director Utilization Management,
Management,
Manager Utilization Management,
Registered Nurse Utilization Management,
Utilization,
Utilization Management Behavioral Health,
Utilization Management Nurse Consultant,
Utilization Management Nurse RN,
Utilization Management Representative II