- 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 ... Guidelines (MCG) + Experience and understanding of federal and state regulations governing utilization management + Accredited Case Manager (ACM) - American Case… more
- Sharp HealthCare (San Diego, CA)
- …Will Do** As a member of the System Integrated Care Management (ICM) team the Utilization Manager (UM) II position supports utilization review functions to ... Guidelines (MCG) + Experience and understanding of federal and state regulations governing utilization management + Accredited Case Manager (ACM) - American Case… more
- Immigration and Customs Enforcement (IN)
- …this position. Responsibilities DUTIES AND RESPONSIBILITIES: Serves in the capacity of Regional Utilization Manager and subject matter expert in the oversight of ... may be required - estimated 15%. Travels TDY as needed to provide clinical care support at IHSC-staffed detention...the ground and at sea. SUPERVISORY CONTROLS: The Regional Utilization Manager works under the supervision of… more
- Beth Israel Lahey Health (Burlington, MA)
- …Hours:** 40 **Work 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 ... Case Manager for Hospital at Home Care Transitions coordinates utilization review, discharge planning and monitors quality assurance for Lahey Clinic inpatient… more
- Universal Health Services (Panama City, FL)
- Responsibilities Utilization Review Manager Opportunity Emerald Coast Behavioral Hospital provides inpatient treatment services to children, adolescents and ... therapy for chronic depression. Visit us on-line at: https://emeraldcoastbehavioral.com/ The Utilization Review Manager is responsible for oversight of… more
- Catholic Health (Lockport, NY)
- …Holiday Rotation Hours: 8:00a-4:00p, 9:00a-5:00p, 10:00a-6:00p, 11:00a-7:00p 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 to patients and families in… more
- Providence (WA)
- …best people, we must empower them._** **Providence Health Plan is calling a Manager Utilization Management RN, Prior Authorization who will:** + Be responsible ... for Management and supervision of the PHP Utilization Management (UM) or Care Management (CM) clinical programs,...coordinators, technicians and may include other support staff as needed + Foster, develop and maintain key working relationships… more
- Trinity Health (Darby, PA)
- …Coordinator under direction and in collaboration with the RN Care Coordination Manager , provides support to the utilization management, denials and appeals ... to provide support to the Emergency Department Case Manager , Utilization RNs, and Utilization ...denial management + Collaborates with health care teams as needed to identify appropriate utilization of resources… more
- Samaritan Daytop Village (Rhinebeck, NY)
- …and goal of sustaining high quality care/service delivery to persons served, the Utilization Manager works to assist CASAC Counselors and supervisory staff as ... needed with assuring compliance with external and internal utilization review/quality and appropriateness requirements. What qualifications do you need: +… more
- Mountains Community Hospital (Lake Arrowhead, CA)
- Full Time - Exempt position SUMMARY The Case Manager is responsible for utilization management and case management of patient admissions at MCH by collecting and ... recording all information and data needed for utilization review as requested and required by third party payers. Monitors and audits medical record charts for… more
- Hackensack Meridian Health (Hackensack, NJ)
- **Overview** The Senior Utilization Review Physician Specialist collaborates with the healthcare team in the management and resolution of activities that assure the ... population and HackensackUMC. These include but are not limited to utilization review, hospital reimbursement, clinical compliance, case management, and transitions… more
- Billings Clinic (Billings, MT)
- …to learn more! RN - Utilization Review (Full-time/Billings) CARE MANAGEMENT (Billings ... for tuition loan reimbursement Under the direction of department leadership, the Utilization Review/ Management RN. This position is to conduct initial, concurrent,… more
- LA Care Health Plan (Los Angeles, CA)
- Supervisor, Utilization Management RN Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time ... safety net required to achieve that purpose. Job Summary The Supervisor of Utilization Management (UM) RN is responsible for executing the day-to-day operations of… more
- Tenet Healthcare (Detroit, MI)
- …care and appropriate level of care Mentor and monitor work delegated to Utilization Review LVN/LPN and/or Authorization Coordinator as needed . (5% daily, ... RN Utilization Review FT Days - 2406002204 Description :...preferred. Active and valid RN license required. Accredited Case Manager (ACM) preferred. Skills Required Analytical ability, critical thinking,… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist LVN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full ... the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist LVN II will facilitate, coordinate and approve medically… more
- McLaren Health Care (Detroit, MI)
- **Position Summary:** Responsible for providing assistance to the Utilization Manager (UM) RN in the coordination of patient admission and continued stay ... based on medical necessity. 2. Performs concurrent and retrospective utilization management-related activities and functions to ensure that appropriate data… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full ... the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II will facilitate, coordinate, and approve medically… more
- Hackensack Meridian Health (Hackensack, NJ)
- …and regulatory/payor requirements. The role integrates and coordinates utilization management, care coordination, discharge planning functions and performance ... to meet staffing needs, manage the length of stay, and promote efficient utilization of resources; specific functions within this role include: a. Facilitation of… more
- Texas Health Resources (Arlington, TX)
- …CareConnect1 or other Utilization Management tool. Discusses working DRG issues as needed with Care Transition Manager 30% **Additional perks of being a ... **RN/Registered Nurse- Utilization Management, Clinical Reviews** **Work location:** 100% remote...preferably in the Dallas-Fort Worth **Work hours:** PRN (As needed ), Weekday and weekend shifts with variable hours **Department… more
- Milford Regional Medical Center (Milford, MA)
- Per diem, 8a-4;30P as needed weekends + occ/ holidays About Us Milford Regional Medical Center is a full-service, community and regional teaching hospital located in ... to our community with dignity, compassion, and respect. Statement of Purpose: The Utilization Review Nurse is responsible for utilization management at MRMC. The… more