- HealthCare Support (Houston, TX)
- …processing authorization requests. Accurately enters the required information into the managed care platform, adhering to UM policies and procedures. 5. Assists ... Texas License Three years clinical experience in acute setting. 3 years of UR / UM Highlight lines of business worked- Texas Medicaid, CHIP, marketplace Highlight… more
- Magellan Health Services (Boise, ID)
- …and implement solutions that directly influence quality of care . General Job Information Title Care Manager ( UM / UR ) - Remote, Idaho Licensed Grade 24 ... + Maintains an active work load in accordance with National Care Manager performance standards. + Works with community agencies as appropriate. Proposes… more
- Sharp HealthCare (San Diego, CA)
- …and CMS. Develops and implements new programs under the direction of the manager of in-patient care management and the Director of Utilization Management. ... and goals.Consults with Hospitalists in a timely and effective manner.Document UR / UM processes according to SCMG policies and procedures.Demonstrates positive… more
- Swedish Health Services (Seattle, WA)
- …a remote role. You MUST live in the state of Washington (WA) to be considered_** ** Care Manager RN** **Per diem / On call** **Day shift** The Utilization Review ... ( UR ) Nurse has a strong clinical background blended with...with a well-developed knowledge and skills in Utilization Management ( UM ), medical necessity and patient status determination. This individual… more
- Stony Brook University (Stony Brook, NY)
- Case Manager - Per Diem **Position Summary** At Stony Brook Medicine, a ** Care Manager ** is a valuable member of our team, who provides clinical services to ... to our high standard of excellence. **Duties of a Care Manager in the Care ...review screen for inpatient and observation cases. Activity includes UR from the Emergency Room or on the unit… more
- Genesis Healthcare (Bethlehem, PA)
- …agencies, attorneys, and write off as applicable; 15. Attends center morning meetings, IDT/ UM / UR meetings and other center or RCM required meetings and calls; ... the lives we touch through the delivery of high-quality care and exceptional service. As a leading provider in...in the communities we serve. Responsibilities The Business Office Manager "BOM" must be familiar with company policies and… more
- Corewell Health (Dearborn, MI)
- …+ May review cases for medical necessity, uses InterQual and/or other UR / UM Committee-approved medical necessity screening criteria, when appropriate. Works ... the position is to enhance the quality of patient care and engagement, to promote continuity of care...(BLS) - ARC American Red Cross preferred + Case Manager , Certified (CCM) - CCMC Commission for Case … more
- Catholic Health Services (Melville, NY)
- …and human services agencies. Our health system has over 16,000 employees, six acute care hospitals, three nursing homes, a home health service, hospice and a network ... we treat and serve our communities. We work collaboratively to provide compassionate care and utilize evidence based practice to improve outcomes - to every patient,… more
