• Utilization Management

    LA Care Health Plan (Los Angeles, CA)
    Utilization Management Admissions Liaison RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 ... required to achieve that purpose. Job Summary The Utilization Management (UM) Admissions Liaison RN II is primarily responsible for receiving/reviewing… more
    LA Care Health Plan (10/03/25)
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  • Associate Director, Admissions

    University of Pennsylvania (Philadelphia, PA)
    …resources, and ensure compliance with institutional privacy policies. As the school's liaison for Graduate Admissions User Groups and the Provost Office, ... required. Qualifications: A Bachelor's degree with 3-5 years of experience in admissions operations, enrollment management , or higher education recruitment is… more
    University of Pennsylvania (09/09/25)
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  • Hospital Admissions Rep IV

    University of Rochester (Rochester, NY)
    …Subtype: Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 500016 Admissions Center-SMH Work Shift: UR - Rotating (United States of America) Range: ... **Responsibilities:** GENERAL SUMMARY Coordinates or manages inpatient and outpatient admissions , including bed assignments and the completion of preliminary… more
    University of Rochester (08/07/25)
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  • Registered Nurse III - Admissions Nurse

    State of Massachusetts (Chelsea, MA)
    …to supervise, engage, and lead health care employees utilizing sound performance management practices including coaching and mentoring. * Utilization of ... MVH at Chelsea is actively seeking an Admissions Nurse (Registered Nurse III) to join their...will complete preadmission screening assessments, serve as a clinical liaison with outside agencies, supervise other nurse leaders surrounding… more
    State of Massachusetts (09/17/25)
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  • Hospital Admissions Rep IV

    University of Rochester (Rochester, NY)
    …Subtype: Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 500016 Admissions Center-SMH Work Shift: UR - Rotating (United States of America) Range: ... financial eligibility, secures account for billing and coordinates account management through discharge Completes appropriate forms to complete Death Certificate… more
    University of Rochester (08/07/25)
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  • RN Admissions Case Manager - OLGMC - 7p…

    Ochsner Health (Lafayette, LA)
    …(CCM), Certified Professional Utilization Review (CPUR), Certified Professional in Utilization Management (CPUM) or Certified Professional in Healthcare ... in the delivery of patient care. Preferred - Experience in case management or utilization review. **Certifications** Required - Current Registered Nurse… more
    Ochsner Health (10/04/25)
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  • Administrator of Admissions , Outreach…

    Calvary Hospital (Bronx, NY)
    …pertinent data. 8. Knowledge of and experience in Quality Assessment and Improvement, Utilization Review. 9. Ability to develop management systems to track data ... Outreach, Admitting and Intake implementing changes when appropriate. Acts as liaison between Calvary Hospital and referring institutions and providers. Actively… more
    Calvary Hospital (08/20/25)
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  • Utilization Management Nurse - 20…

    Omaha Children's Hospital (Omaha, NE)
    …equal opportunity employer including veterans and people with disabilities. **A Brief Overview** Utilization Management (UM) is a specialty area of Nursing Case ... physician advisor, and NCM in various aspects of denial management . UM will serve as a liaison ...settings. + Skills in negotiation and problem solving with utilization management . + Should be a creative,… more
    Omaha Children's Hospital (09/05/25)
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  • Utilization Management Nurse…

    Omaha Children's Hospital (Omaha, NE)
    …equal opportunity employer including veterans and people with disabilities. **A Brief Overview** Utilization Management (UM) is a specialty area of Nursing Case ... physician advisor, and NCM in various aspects of denial management . UM will serve as a liaison ...settings. + Skills in negotiation and problem solving with utilization management . + Should be a creative,… more
    Omaha Children's Hospital (09/05/25)
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  • Senior Registered Nurse - Hospital…

    Ventura County (Ventura, CA)
    Senior Registered Nurse - Hospital Management Utilization Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5061650) Apply  Senior Registered ... Nurse - Hospital Management Utilization Salary $118,668.43 - $141,888.74 Annually...doctor to coordinate and screen for the appropriateness of admissions and continued stays. They make recommendations to the… more
    Ventura County (09/21/25)
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  • Director Utilization Mgmt (Do Or MD…

    Wellpath (Lemoyne, PA)
    utilization of medical services. The Medical Director of Utilization Management serves as a key liaison with external partners and stakeholders, and ... **How you make a difference** The Medical Director of Utilization Management leads and oversees utilization...to reduce length of inpatient stays and decrease ED admissions . + Evaluate and recommend policy improvement related to… more
    Wellpath (08/08/25)
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  • Utilization Review Nurse - Remote

    Martin's Point Health Care (Portland, ME)
    …Nurse required; BSN preferred. + 3+ (total) years clinical nursing experience + Utilization management experience in a managed care or hospital environment ... has been certified as a "Great Place to Work" since 2015. Position Summary The Utilization Review Nurse works as a member of a team responsible for ensuring the… more
    Martin's Point Health Care (09/25/25)
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  • Inpatient Utilization Review Registered…

    Emory Healthcare/Emory University (Atlanta, GA)
    …programs + And more **Description** We're seeking an **Inpatient Registry Utilization Review Nurse (PRN)** who is responsible for conducting medical necessity ... with the attending physician and/or physician advisor. This individual will: + Perform utilization review by completing a timely and comprehensive review of all new… more
    Emory Healthcare/Emory University (10/03/25)
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  • Hospital Liaison - PHA

    Somatus (Antioch, TN)
    …accessing resources to adhering to a physician's treatment plan upon discharge. The Hospital Liaison will work with the RNCM, case management and care givers to ... leadership and/or provider engagement to build relationships with case management teams at strategic facilities in assigned area as...ongoing conversations and plans to address areas to reduce admissions and cost utilization + Other duties… more
    Somatus (09/23/25)
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  • Clinical Inpatient Rehab Liaison - Per…

    Sharp HealthCare (San Diego, CA)
    …with Rehab Medical Director and other Physicians regarding potential patient admissions . + Data Management Effectively monitors, collects, and reports ... management systems to monitor referral source patterns and utilization . Reports activity by referral source; and appropriately/strategically adjusts plans to… more
    Sharp HealthCare (09/14/25)
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  • Associate Director of Outreach

    The Arc Erie County NY (Williamsville, NY)
    …the Intake and Admissions team, including supervision, coaching, and performance management . + Serve as a liaison between intake staff, program leadership, ... program utilization . Compliance & Quality Assurance + Ensure all admissions processes are compliant with federal, state, and local regulations, including OPWDD… more
    The Arc Erie County NY (08/23/25)
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  • ED RN Case Manager - UR & Discharge Planning

    Beth Israel Lahey Health (Plymouth, MA)
    …unit cost, 4) reducing readmissions. **Duties/Responsibilities:** **A. Utilization Management ** Performs review of anticipated admissions utilizing InterQual ... This role is structured around four major functions + Utilization Management + Care Coordination + Discharge...satisfaction with the discharge from the ED Prevents unnecessary admissions for social reasons Functions as a liaison more
    Beth Israel Lahey Health (08/10/25)
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  • RN Care Manager - Rex Case Management

    UNC Health Care (Raleigh, NC)
    …of care and cost effectiveness through the integrating and functions of case management , utilization review and discharge planning. The Care Manager must be ... discharge plan. Refer administrative tasks (eg, faxing, form processing) to Care Management Assistant. Consult Social Worker and/or Utilization Manager per… more
    UNC Health Care (09/28/25)
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  • Physician Advisor

    Virginia Mason Franciscan Health (Tacoma, WA)
    management committee, in defining operational strategic objectives for the Utilization Management Program and serves as the liaison to other medical staff ... * Act as physician liaison between case management / utilization management and providers to...* Review and report on PEPPER metrics; (LOS, CMI, Re- admissions , OBS rates, and governmental audit measures) to Hospital… more
    Virginia Mason Franciscan Health (09/06/25)
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  • Medical Director, Ventura County Health Care Plan

    Ventura County (Ventura, CA)
    …medical policy with the Health Care Agency Director and Insurance Administrator, Utilization Management staff and Quality Assurance Staff. + Participates, as ... surgical procedures, referrals, tests, medication approvals requiring authorization.) + Develops utilization management standards and guidelines for approval by… more
    Ventura County (09/12/25)
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