• Utilization Review Case

    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
    Dallas Behavioral Healthcare Hospital (03/14/25)
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  • Utilization Review Case

    Trinity Health (Mason City, IA)
    **Employment Type:** Full time **Shift:** Day Shift **Description:** **JOB SUMMARY:** The Utilization Review Case Manager responsibilities include ... 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
    Trinity Health (04/19/25)
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  • Utilization Review Case

    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
    Trinity Health (03/08/25)
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  • Case Manager Utilization

    Beth Israel Lahey Health (Burlington, MA)
    …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...Case Manager experience as well as Utilization Review experience ( review medical… more
    Beth Israel Lahey Health (04/16/25)
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  • Staff Nurse- Case Manager - Mount…

    Mount Sinai Health System (New York, NY)
    **Job Description** The Case Manager is responsible for all aspects of case management/ utilization review for an assigned group of inpatients, ED ... experience as in homecare, long term care or utilization review preferred. + Discharge Planner or Case Manager preferred. + Manager or a minimum… more
    Mount Sinai Health System (04/16/25)
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  • RN/ Case Manager -MSH- Case

    Mount Sinai Health System (New York, NY)
    …Requirements** + Previous experience as in homecare, long term care or utilization review preferred. + Discharge Planner or Case Manager preferred. + ... **Job Description** **RN/ Case Manager MSH Case ...a. Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case more
    Mount Sinai Health System (04/15/25)
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  • Case Manager RN- Mount Sinai West-…

    Mount Sinai Health System (New York, NY)
    …preferred. + Previous experience as in homecare, long term care or utilization review preferred. + Discharge Planner or Case Manager preferred. + ... **Job Description** The Case Manager (CM) will be responsible...1. Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case more
    Mount Sinai Health System (04/22/25)
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  • Case Manager , RN…

    Prime Healthcare (Lynwood, CA)
    …education, credentials and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/204105/ case - manager %2c-rn utilization - review ... to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity,...Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred.3. Five years acute care… more
    Prime Healthcare (04/17/25)
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  • Lowe's Care Nurse - Case Manager

    Lowe's (Charlotte, NC)
    …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 a ... Office + Unrestricted RN license in home State + CCM - Certified Case Manager + CRRN - Certified Rehabilitation Registered Nurse + CDMS - Certified Disability… more
    Lowe's (04/06/25)
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  • Case Manager (RN) - PRN…

    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 ... l criteria, initiates discussion with attending physicians, coordinates with the external case manager to facilitate discharge planning, seeks assistance from… more
    Houston Methodist (02/08/25)
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  • Utilization Case Manager

    Helio Health Inc. (Syracuse, NY)
    …to track, review , and analyze data relating to continuous quality improvement. The Utilization Case Manager will work on a Full-Timebasis supporting our ... issues. To support the mission of Helio Health, theUtilization Case Manager will enhance the program's efforts...Licensed/credentialed applicants preferred. + Two years of experience in utilization review in a hospital, health care,… more
    Helio Health Inc. (04/02/25)
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  • Manager , Utilization Management/…

    CoreCivic (Brentwood, TN)
    …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
    CoreCivic (04/29/25)
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  • Utilization Mgmt Case Manager

    LifePoint Health (Gallatin, TN)
    …management or related healthcare field. **Job:** **Nursing* **Organization:** ** **Title:** * Utilization Mgmt Case Manager FT* **Location:** ... Monitors adherence to the hospital's utilization review plan to ensure appropriate...admissions and extended hospitals stays. Reports to: Director - Case Management Minimum Education Associate's, Bachelor's degree or RN… more
    LifePoint Health (04/28/25)
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  • Case Manager - PVH…

    Prime Healthcare (National City, CA)
    …and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/205657/ case - manager pvh- utilization ... to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity,...a related field. At least one year experience in case management, discharge planning or nursing management; + CCM… more
    Prime Healthcare (04/25/25)
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  • Case Manager - Utilization

    Prime Healthcare (Anaheim, CA)
    …and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/199249/ case - manager utilization ... to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity,...related field or at least one year experience in case management, discharge planning or nursing management; + CCM… more
    Prime Healthcare (03/08/25)
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  • Manager - Utilization Review

    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...administration or related field preferred or commensurate experience and Case Management Certification required + Minimum of 3 years… more
    Beth Israel Lahey Health (04/29/25)
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  • Utilization Review Nurse (RN)…

    Ascension Health (Baltimore, MD)
    …specialist for staff in the areas of utilization criteria, appeal and review process, and case management system documentation. + Conduct hiring, training, ... salary range at the time of the offer._ **Responsibilities** Manage effective utilization review processes, including management of patient statusing processes… more
    Ascension Health (03/26/25)
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  • Group Utilization Review Director

    Tenet Healthcare (Detroit, MI)
    …and advance Tenet’s Case Management strategy with the specific focus on Utilization Review for the designated Market. Will support the advancement of ... strategic initiatives and will provide subject matter expertise for Case Management – Utilization Review ...presentation skills including ability to use PowerPoint. · Accredited Case Manager (ACM) or Certified Public Accountant… more
    Tenet Healthcare (04/20/25)
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  • Professional Care Manager

    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
    UPMC (04/17/25)
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  • System Utilization Management SUM…

    Alameda Health System (Oakland, CA)
    System Utilization Management SUM Utilization Review RN + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day + ... Nursing + Req #:41907-31045 + FTE:1 + Posted:Today **Summary** **SUMMARY:** The System Utilization Management [SUM] Utilization Review RN is responsible for… more
    Alameda Health System (04/29/25)
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