- Sharp HealthCare (San Diego, CA)
- …of the System Integrated Care Management (ICM) team the Transfer and Admissions Utilization Manager (UM) partners with the Centralized Patient Placement Center ... Guidelines (MCG) + Experience and understanding of federal and state regulations governing utilization management + Accredited Case Manager (ACM) - American Case… more
- UNC Health Care (Chapel Hill, NC)
- …is to improve the health and well-being of the unique communities we serve. Utilization Manager Psych Team completes clinical reviews for all areas: Inpatient, ... care episode through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management… more
- EM Key Solutions, Inc. (Eglin AFB, FL)
- Eglin AFB, FL, USA | Full Time Registered Nurse - Utilization Manager Onsite Position EM Key Solutions is seeking Registered Nurse (RN) for a full-time ... + Monitors active duty, reserve/guard admissions to civilian hospitals and notifies Utilization Manager and Patient Administration Element as required. + Serves… more
- EM Key Solutions, Inc. (Eglin AFB, FL)
- Eglin AFB, FL, USA | Hourly | Full Time Registered Nurse - Utilization Manager Location: Eglin Hospital at Eglin AFB, Fort Walton Beach, FL. Position Type- ... Monitors active duty and reserve/guard admissions to civilian hospitals and notifies Utilization Manager and Patient Administration Element as required. + Serves… more
- Samaritan Daytop Village (Rhinebeck, NY)
- …and goal of sustaining high quality care/service delivery to persons served, the Utilization Manager works to assist CASAC Counselors and supervisory staff as ... needed with assuring compliance with external and internal utilization review/quality and appropriateness requirements. What qualifications do you need: + Bachelor… more
- Trinity Health (Fresno, CA)
- …responsible for management, leadership, and coordination of the departments of the Utilization Manager Team to ensure payor reimbursement for services rendered ... while supporting the healing mission of Saint Agnes Medical Center. The Manager Utilization Management will ensure the timely delivery of utilization review,… more
- The Mount Sinai Health System (New York, NY)
- The Utilization Review Manager for the Selikoff Centers for Occupational Health is responsible for the management of program operations within a particular ... records, and internal and external regulatory and survey requirements. + The Utilization Review Manager collaborates with multiple professionals to support and… more
- Cedars-Sinai (Los Angeles, CA)
- **Job Description** **Job Summary: Key Job Responsibilities** The Utilization Review Case Manager validates the patient's placement to be at the most appropriate ... Eye/Hand/Foot Coordination **Req ID** : 1072 **Working Title** : CSMC 8750000 Utilization Management Utilization Review Case Manager FR 48010 Allen 429 1.00… more
- Universal Health Services (Dearborn, MI)
- Responsibilities Utilization Management Case Manager Beaumont Behavioral Health (a UHS Facility) A growing 144-bed behavioral health facility - Beaumont ... For more information, please visit our website: https://beaumontbh.com/ PositionSummary The Utilization Management Case Manager is primarily responsible for… more
- Trinity Health (Fresno, CA)
- **Employment Type:** Full time **Shift:** **Description:** **Are you an experience RN Manager , Utilization Review of Acute Care seeking your next adventure?** ... **Duration:** 13-week Assignment The Interim Utilization Management , RN Manager is responsible for management, leadership, and coordination of the … more
- Catholic Health (Lockport, NY)
- …Holiday Rotation Hours: 8:00a-4:00p, 9:00a-5:00p, 10:00a-6:00p, 11:00a-7:00p Summary: The RN Care Manager , Utilization Review/ Transitions of Care, as an active ... member of the Care Management and interdisciplinary care team, provides comprehensive Utilization Review and transitions of care services to patients and families in… more
- University of Miami (Miami, FL)
- …. The University of Miami is currently seeking Utilization Review Case Manager to work at ... chart reviews for clinical utilization and authorization. The Utilization Review Case Manager coordinates with the healthcare team for optimal and efficient… 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 ... to help patients access the full range of their benefits through the utilization review process. + Conducts admission reviews. + Conducts concurrent and extended… more
- Children's Mercy Kansas City (Kansas City, MO)
- …improve the lives of children beyond the walls of our hospital. Overview The Manager of Utilization Review will provide leadership to integrated inpatient teams ... InterQual and/or MCG screening guidelines, and oversight of clinical denials/appeals. The Manager of Utilization Review participates in department and hospital… more
- Beth Israel Lahey Health (Burlington, MA)
- …Hours:** 40 **Work Shift:** Day (United States of America) Joint role of Case Manager and Utilization Review Nurse Hospital at Home Full Time Days 8:00am-4:30pm ... Case Manager for Hospital at Home Care Transitions coordinates utilization review, discharge planning and monitors quality assurance for Lahey Clinic inpatient… more
- Mountains Community Hospital (Lake Arrowhead, CA)
- Full Time - Exempt position SUMMARY The Case Manager is responsible for utilization management and case management of patient admissions at MCH by collecting and ... recording all information and data needed for utilization review as requested and required by third party payers. Monitors and audits medical record charts for… more
- Elevance Health (Winston, NC)
- ** Manager I, Utilization Review Management** **Location: Candidates must live in the state of North Carolina.** **Hours: Monday through Friday, 8am-5pm.** ... **Build the Possibilities. Make an extraordinary impact.** Responsible for the daily management of the department. **How you will make an impact:** + Supervises workflow and performance of associates. + Assists in coordination and development of UM quality… more
- UCLA Health (Los Angeles, CA)
- …next level. You can do all this and more at UCLA Health. As a Manager for Medicare Advantage Utilization Management, you'll provide direct management to a team ... (BSN) degree required * Five or more years of utilization management required * Four or more years of...off-site meetings and conferences * ACM - Accredited Case Manager preferred * CCM - Certified Case Manager… more
- Providence (Missoula, MT)
- **Description** **Care Manager RN in Utilization Review Unit at Providence St. Patrick Hospital Missoula, MT** The Nurse Case Manager (NCM) is responsible to ... management experience **Preferred Qualifications:** + Upon hire: Current Case Manager Certification **Why Join Providence?** Our best-in-class benefits are uniquely… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …to meet the healthcare needs of the patients using the functions of Utilization Resource Management, Transition of Care, Discharge Planning, and Case Management. + ... and family. + Assists in identifying and reporting variances in utilization of resources, avoidable days/denials. Works in collaboration with Appeals… more
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