- UNC Health Care (Raleigh, NC)
- …_We are currently seeking an experienced nurse to join our dynamic team as an RN Utilization Manager . Role is full time, 40 hours per week, on site._ ... care episode through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management… more
- Gentiva (Mooresville, NC)
- …a lasting difference in people's lives every day. **Overview** We're looking for a ** Utilization Manager ** to join our team. This position will directly report ... to the Director of Utilization Management and is responsible for planning, coordinating, implementing,...a Remote position with travel expectations. **About You** + Registered Nurse preferred + Bachelor's degree preferred… more
- Veterans Affairs, Veterans Health Administration (St. Louis, MO)
- Summary The Registered Nurse - Utilization Case Manager position in Technology, Innovation & Development is located at John Cochran Medical Center at VA ... Saint Louis Health Care System. The RN is responsible for providing competent, evidence-based care to...planning for inpatient settings. Responsibilities The Registered Nurse - Utilization Case Manager … more
- Commonwealth Care Alliance (Boston, MA)
- …procedures, and facilities under the provisions of CCA's benefits plan. The Manager , Utilization Management is responsible for overseeing and managing the ... daily operation of the Utilization Management Review Nurse and Specialist staff...decisions and organizational determinations. Essential Duties & Responsibilities: The Manager , Utilization Management reports to the Director… 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 ... : Holy Cross Hospital **Position Purpose:** As a Case Manager in Utilization Management, you will be...resource for navigating post-acute care services. **Minimum Qualifications:** + RN licensed by the State of Maryland or Compact… more
- Catholic Health Services (Melville, NY)
- …Health was named Long Island's Top Workplace! Job Details Position Summary: The Utilization and Appeals Manager (UAM) proactively conducts clinical reviews and ... from payors for additional clinical documentation. Acts as liaison between the Utilization and Appeals Management Department and the physician of record, as… more
- Children's Hospital Boston (Boston, MA)
- 80451BRJob Posting Title:Per Diem RN Case Manager , Utilization Management/ReviewDepartment:Patient Services-Patient Care ... per Week:1 Job Posting Category:NursingJob Posting Description:The Per Diem RN Case Manager (inpatient and/or ambulatory) will...two years of employment. + Experience as a Case Manager (Discharge Planning and or Utilization Management)… more
- LifePoint Health (Gallatin, TN)
- …or related healthcare field. **Job:** **Nursing* **Organization:** ** **Title:** * Utilization Mgmt Case Manager FT* **Location:** *Tennessee-Gallatin* ... Monitors adherence to the hospital's utilization review plan to ensure appropriate use of...- Case Management Minimum Education Associate's, Bachelor's degree or RN Diploma in Nursing - Required Required Skills Requires… more
- Beth Israel Lahey Health (Burlington, MA)
- … Utilization Review Nurse **Job Description:** The Inpatient Registered Nurse ( RN ) Case Manager for Hospital at Home Care Transitions coordinates ... to meet the needs of the department. **Minimum Qualifications:** Education: * Registered Nurse , Bachelors Degree or commensurate experience preferred. Licensure,… more
- Beth Israel Lahey Health (Plymouth, MA)
- …a job, you're making a difference in people's lives.** Full Time **Job Description:** ** Utilization Review & Denials management manager - Full Time** **Who We ... Our Team of Experts and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager , you will:** + Directs staff performance… more
- HCA Healthcare (Richmond, VA)
- …Licensed Clinical Social Worker (LCSW), or Licensed Professional Counselor (LPC), or ( RN ) Registered Nurse CJW Medical Center (http://www.cjwmedical.com/) is ... to join an organization that invests in you as a(an) Case Manager Behavioral Utilization Management? At Chippenham Hospital, you come first. HCA Healthcare has… more
- Scottish Rite for Children (Dallas, TX)
- …committed to giving children back their childhood! Job Posting Title: Case Manager and Utilization Review Coordinator Location: Dallas - Hospital Additional ... + Maintain effective communication with patient care team members related to utilization management + Verify medical necessity of all Inpatients using established… more
- Central Maine Medical Center (Lewiston, ME)
- …for our community and for each other every day. Position Summary: The Utilization Management Nurse is responsible for a comprehensive clinical review to ... RN licensure.*Three (3) or more years of previous experience in Utilization Management and/or Care Management.*BSN preferred.Certified Case manager required… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …initiatives/opportunities for improvement through departmental committee assignments. Qualifications: + Registered Nurse or Licensed Practical Nurse . ... healthcare needs of the patients using the functions of Utilization Resource Management, Transition of Care, Discharge Planning, and...+ Current and valid license to practice as a Registered Nurse or Licensed Practical Nurse… more
- Ascension Health (Baltimore, MD)
- …job transfer date required. American Heart Association or American Red Cross accepted. + Registered Nurse obtained prior to hire date or job transfer date ... required. Education: + Required professional licensure/certification AND 3 years of experience and 1 year of cumulative leadership experience required. **Additional Preferences** \#ATP **Why Join Our Team** Ascension associates are key to our commitment of… more
- Ascension Health (Pensacola, FL)
- …evaluation of staff. **Requirements** Licensure / Certification / Registration: + Licensed Registered Nurse credentialed from the Florida Department of Health ... **Details** + **Department: Utilization Review** + **Schedule: Full time days** +...at the time of the offer._ **Responsibilities** Manage effective utilization review processes, including management of patient statusing processes… more
- Commonwealth Care Alliance (Boston, MA)
- 013650 CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management (UM) ... timely clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring… more
- Ochsner Health (Lafayette, LA)
- …medical management, or other related MCO departments/functions. **Certifications** Required - Current registered nurse ( RN ) license in state of practice. ... *MSW accepted in lieu of registered nurse ( RN ) licensure. Preferred - Certification in Case Management (CCM) or Certified Professional in Healthcare… more
- UNC Health Care (Hendersonville, NC)
- …issues with complex patients and identify trends. Formulates potential solutions with Utilization Manager and Social Worker and continuously monitor cases/follow ... of the unique communities we serve. Summary: The Care Manager - RN provides ongoing support and...Requireds + Must be licensed to practice as a Registered Nurse in the state of North… more
- Prime Healthcare (Montclair, CA)
- …experience post-graduation of an accredited school of nursing and a current state Registered Nurse license.2. Grandfathered prior to April 1, 2015. Minimum 5 ... an accredited school Of Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred.3. Five years acute care nursing experience… more