- Beth Israel Lahey Health (Burlington, MA)
- …you're making a difference in people's lives.** Joint role of Case Manager and Utilization Review Nurse **Job Description:** The Inpatient Registered ... 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
- Covenant Health (Nashua, NH)
- …policies and procedures. + Maintains/enhances professional development/skills required to function as a Utilization Review Case Manager + Completes all ... health care team. + Annual goals are achieved. + Attends pertinent case management/ utilization review programs to maintain current knowledge of UR practices.… more
- Children's Hospital Boston (Boston, MA)
- 80451BRJob Posting Title:Per Diem RN Case Manager , Utilization Management/ReviewDepartment:Patient Services-Patient Care ... required, pediatric experience preferred. + Experience as a Case Manager (Discharge Planning and or Utilization Management) preferred. Licensure/… more
- Providence (Anchorage, AK)
- …Medical Surgical or Inpatient setting. + IRR or annual competency testing in Utilization Review . **Preferred Qualifications:** + Bachelor's Degree in Nursing or ... specialty. + 1 year experience in care management or utilization review in any setting or successful...any setting or successful completion of TIPS program or Case Management Orientation Program. **Why Join Providence?** Our best-in-class… more
- Prime Healthcare (Lynwood, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/212260/ case - manager %2c-rn ... 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
- Mayo Clinic (Rochester, MN)
- …physicians and multi-disciplinary teams. Major Functions of the RN Case Manager include: Utilization Review , including concurrent admission status and ... resource utilization , and clinical documentation. The RN Case Manager will function within the Mayo...within a creative and challenging work environment. Experience in utilization review , ability to navigate medical records,… more
- Holzer Health System (Gallipolis, OH)
- …organizational and financial outcomes. Serves as a clinical expert and resource in Utilization Review and Case Management. Partners with Social Workers ... field will be taken into consideration. . Professional experience with case management, utilization review , or discharge planning highly desirable. .… more
- Penn Medicine (Philadelphia, PA)
- …+ Registered Nurse - PA (Required) + 5yrs prior experience as a Nurse Case Manager with knowledge of utilization review and 3rd Party Payors (Required) + ... * And 5+ years Prior experience as a nurse case manager with knowledge of utilization review and third-party payors. We believe that the best care… more
- Ochsner Health (New Orleans, LA)
- …license in state of practice. Preferred - Commission for Case Manager (CCM), Certified Professional Utilization Review (CPUR), Certified Professional ... in the delivery of patient care. Preferred - Experience in case management or utilization review . **Certifications** Required - Current Registered Nurse… more
- Baptist Memorial (Jonesboro, AR)
- …+ Healthcare/Medical- Case Manager Preferred, or Healthcare/Medical - Utilization Review Preferred. Education Minimum Required + Graduate of School ... to complete an initial review . Collaborate with physicians, Manager of Case Management and physician advisors to resolve conflicts. Coordinate with bed… more
- Mohawk Valley Health System (Utica, NY)
- …to our diverse member population. Provides direct oversight of the case manager 's daily operations of utilization review practice, processes and ... Management - SNH is responsible for the oversight of the case management staff's authorization/coordination/ utilization and provision of member services. Duties… more
- Arnot Health (Elmira, NY)
- …to the management of patient care. The Case Manager will review all patients for utilization management and appropriate discharge planning. The Case ... Job Description MAIN FUNCTION: The Case Manager coordinates, negotiates, procures services... case managers. f. The Case Manager tracks and trends LOS, resource utilization ,… more
- Ellis Medicine (Schenectady, NY)
- …by the Case Manager include, but are not limited to, utilization review , case management, care transition, collaboration with physicians and social ... SECTION I BASIC FUNCTION: The RN Case Manager has responsibility for ...inpatient experience in a hospital environment preferred. + Previous case management, utilization review , and… more
- Houston Methodist (The Woodlands, TX)
- At Houston Methodist, the Utilization Review Nurse (URN) PRN position is a licensed registered nurse (RN) who comprehensively conducts point of entry and ... ensures prompt notification of any denials to the appropriate case manager , denials, and pre-bill team members,...work experience in a hospital or insurance company providing utilization review services + Knowledge of Medicare,… more
- Nuvance Health (Sharon, CT)
- …health to the patient. Responsibilities for this full time RN Case Manager position includes include utilization review , discharge planning and care ... license, Bachelors Degree in Nursing or related field, a minimum of 1 year Case Management experience in an acute care setting. CCM, PRI and Screen certifications… more
- 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
- Trinity Health (Silver Spring, MD)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** **Job Title:** RN Case Manager - Utilization Management **Employment Type:** Full Time ... **Location** : Holy Cross Hospital **Position Purpose:** As a Case Manager in Utilization Management,...coordinate care and address clinical documentation needs for accurate case review and status determination. + Oversee… more
- Prime Healthcare (Montclair, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/215040/ case - manager -%28rn%29 ... 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 (San Dimas, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/214914/ case - manager -%28rn%29 ... 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
- Children's Mercy Kansas City (Kansas City, MO)
- …of, and training oversight of programs and services. Responsible for effective utilization review and proper resource management of patients, including patient ... quality, and Lean process improvements, and facilitating the quarterly Utilization Review Committee meetings. Provides evidence based...days of hire + One of the following: American Case Management, Certified Case Manager … more