- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …discharge. + Provides after hour safe discharge coverage for all hospital units. + Participates in utilization management initiatives/opportunities for ... to meet the healthcare needs of the patients using the functions of Utilization Resource Management, Transition of Care, Discharge Planning, and Case Management. +… more
- Beth Israel Lahey Health (Burlington, MA)
- …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 weekend ... for Hospital at Home Care Transitions coordinates utilization review , discharge planning and monitors quality...staffs. -Case Manager experience as well as Utilization Review experience ( review medical… more
- Catholic Health Initiatives (Omaha, NE)
- …discharge for appropriate status determination. 2. Ensures compliance with principles of utilization review , hospital policies and external regulatory ... Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. **Preferred** Certified Case Manager (CCM), Accredited Case … more
- Glens Falls Hospital (Glens Falls, NY)
- …can be foundhere. **Job:** **Nursing - Case Management* **Title:** *Registered Nurse - Utilization Review Nurse - Care Management (Sign-On Bonus for Full-Time & ... timely and accurate information to payers. The role integrates and coordinates utilization management and denial prevention by focusing on identifying and removing… more
- Universal Health Services (Panama City, FL)
- Responsibilities Utilization Review Manager Opportunity Emerald Coast Behavioral Hospital provides inpatient treatment services to children, adolescents ... TMS therapy for chronic depression. Visit us on-line at: https://emeraldcoastbehavioral.com/ The Utilization Review Manager is responsible for oversight of… more
- Catholic Health (Lewiston, NY)
- …1100-1900/8am - 4pm, 9am - 5pm, 10am - 6pm, 11am - 7pm 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...review experience in the role of a Care Manager or Disease Manager , Population Health ,… more
- Baptist Memorial (Memphis, TN)
- …Case Management Preferred-RN with 7 years of clinical experience with Utilization Review or Case Management experience in a hospital or payer setting ... education + Employee referral program Job Summary: Position: 18373 - System Manager - Utilization Review Facility: BMHCC Corporate Office Department: HS… 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...Utilization Management will ensure the timely delivery of utilization review , discharge planning and support case… more
- Emanate Health (Covina, CA)
- …United States, and the #19 ranked company in the country. **Job Summary** The Manager Utilization Review /MediCal Specialist will develop and maintain a full ... continuum of care from pre-admission through post-discharge for Medi-Cal patients. The Manager Utilization Review /MediCal Specialist will manage the program… more
- Actalent (Florence, AL)
- Hiring a Utilization Review Case Manager for a great hospital FULLY REMOTE. Great culture and environment! MUST HAVE ACTIVE CA RN LICENSE, EPIC, AND ... Care management, Acute care, Rn license, Health care, Epic, Discharge Planning, Utilization review , Utilization management, interqual Top Skills Details:… 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 ... medical records, and internal and external regulatory and survey requirements. + The Utilization Review Manager collaborates with multiple professionals to… more
- Mountains Community Hospital (Lake Arrowhead, CA)
- …admissions at MCH by collecting and recording all information and data needed for utilization review as requested and required by third party payers. Monitors ... Full Time - Exempt position SUMMARY The Case Manager is responsible for utilization management and case management of patient… more
- Billings Clinic (Billings, MT)
- …starting. Click here (https://billingsclinic.csod.com/ats/careersite/search.aspx?site=15&c=billingsclinic) to learn more! Utilization Review RN CARE MANAGEMENT ... loan reimbursement Under the direction of department leadership, the Utilization Review / Management RN. This position is...*Priority 5: Escalation *Refers cases that require second level review to Physician Advisor, Manager , and Director… more
- Hackensack Meridian Health (Hackensack, NJ)
- …patient population and HackensackUMC. These include but are not limited to utilization review , hospital reimbursement, clinical compliance, case management, ... **Overview** The Senior Utilization Review Physician Specialist collaborates with...vs. Inpatient c. Liaison to the Medical Staff supporting Utilization Management Committee processes d. Hospital Based… more
- UNC Health Care (Chapel Hill, NC)
- …to improve the health and well-being of the unique communities we serve. RN Utilization Manager position specifically for a Utilization Manager /Clinical ... care episode through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management… more
- 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 ... transfer requests and direct admission requests. This position supports utilization review functions to ensure appropriate patient...Degree in a health related field + 3 Years Utilization Management or case management within a hospital… more
- Sharp HealthCare (San Diego, CA)
- …(ICM) team the Utilization Manager (UM) II position supports utilization review functions to ensure appropriate patient status before the patient is ... compliance with all local, state and federal regulations governing utilization review activities and/or care management. Expected...in Healthcare or a related field + 3 Years Utilization Management or case management within a hospital… more
- AmeriHealth Caritas (Newark, DE)
- ** Utilization Management Plan Oversight Manager ** Location: Newark, DE Primary Job Function: Medical Management ID**: 34207 **Job Brief** Qualified candidates ... + Assist in preparation, coordination, and participation in and follow up of Utilization Management audits, such as readiness review , Data Validation, CMS… more
- Universal Health Services (Dearborn, MI)
- …of post-graduate related experience in psychiatric or substance abuse treatment required. Hospital utilization review / utilization management experience ... Responsibilities Utilization Management Case Manager Beaumont Behavioral...medical terminology, experience in case management, discharge planning, and/or utilization review preferred. + Familiarity with EPIC/EMR,… more
- Prime Healthcare (Montclair, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/162306/case-management- manager utilization ... Overview Montclair Hospital Medical Center is a 106-bed acute care,...to case managers, social workers, case management coordinators/discharge planners, utilization review coordinators and utilization … more