- Dallas Behavioral Healthcare Hospital (Desoto, TX)
- The Utilization Review Case Manager is responsible for working with insurance companies and managed care systems for the authorization, concurrent and ... help patients access the full range of their benefits through the utilization review process. + Conducts admission reviews. + Conducts concurrent and extended… more
- Trinity Health (Mason City, IA)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** **JOB SUMMARY:** The Utilization Review Case Manager responsibilities include ... members of care team to effectively ensure appropriate acute utilization management + Interacts with outside review ...acute utilization management + Interacts with outside review agencies and payors to inform them of extended… more
- Trinity Health (Lavonia, GA)
- **Employment Type:** Full time **Shift:** **Description:** The RN Case Manager (RN CM), works in collaboration with a multidisciplinary team by identifying and ... level of care throughout hospitalization in compliance with CMS and organizational utilization management requirements. RN CM helps to ensure medical necessity is… more
- Beth Israel Lahey Health (Burlington, MA)
- …a job, you're making a difference in people's lives.** Joint role of Case Manager and Utilization Review Nurse Onsite at Lahey Hospital and Medical ... 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
- Avera (Sioux Falls, SD)
- …from Avera facilities as Swing Bed transfers. + Supports compliance with Utilization Review Process. Case Manager will have ongoing conversation with ... Transfer Center RN and accepting physician. The Transfer Center Case Manager reviews patients for medical necessity,...Utilization Review staff on patients status and ongoing coverage +… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Case Manager is responsible for all aspects of case management/ utilization review for an assigned group of inpatients, ED ... experience as in homecare, long term care or utilization review preferred. + Discharge Planner or Case Manager preferred. + Manager or a minimum… more
- Mount Sinai Health System (New York, NY)
- …Requirements** + Previous experience as in homecare, long term care or utilization review preferred. + Discharge Planner or Case Manager preferred. + ... **Job Description** **RN/ Case Manager MSH Case ...a. Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case… more
- Mount Sinai Health System (New York, NY)
- …preferred. + Previous experience as in homecare, long term care or utilization review preferred. + Discharge Planner or Case Manager preferred. + ... **Job Description** The Case Manager (CM) will be responsible...1. Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case… more
- Children's Hospital Boston (Boston, MA)
- 79378BRJob Posting Title:Per Diem RN Case Manager , Utilization Management/ReviewDepartment:Patient Services-Patient Care ... two years of employment. + Experience as a Case Manager (Discharge Planning and or Utilization Management) preferred. Office/Site Location:BostonRegular,… more
- Prime Healthcare (Lynwood, CA)
- …education, credentials and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/204105/ case - manager %2c-rn utilization - review ... 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
- Lowe's (Charlotte, NC)
- …of experience in a clinical position. + 3-5 Years of Experience as a Case Manager or Utilization Review Nurse in worker's compensation + Experience in a ... Office + Unrestricted RN license in home State + CCM - Certified Case Manager + CRRN - Certified Rehabilitation Registered Nurse + CDMS - Certified Disability… more
- UNC Health Care (Kinston, NC)
- … case management, utilization review and discharge planning. The Case Manager must be highly organized professional with great attention to detail ... adaptable to frequent change, and compliant with regulatory and departmental guidelines and policies. **Responsibilities:** + Patients/Families, Hospital staff, Medical staff, Community agencies, and Insurance Companies are served by conducting interpersonal… more
- Houston Methodist (The Woodlands, TX)
- At Houston Methodist, the Case Manager PRN (CM) position is a licensed registered nurse (RN) who comprehensively plans for case management of a target ... l criteria, initiates discussion with attending physicians, coordinates with the external case manager to facilitate discharge planning, seeks assistance from… 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
- CoreCivic (Brentwood, TN)
- …with a 10% bonus eligible._ **SUMMARY:** The Manager , Utilization Management/ Case Management provides Utilization Review and Case Management ... better the public good. CoreCivic is currently seeking a ** Manager , Health Services Audits** located at our corporate office...requests. + Collaborates with management for oversight of the utilization review process to ensure services being… more
- LifePoint Health (Gallatin, TN)
- …management or related healthcare field. **Job:** **Nursing* **Organization:** ** **Title:** * Utilization Mgmt Case Manager FT* **Location:** ... Monitors adherence to the hospital's utilization review plan to ensure appropriate...admissions and extended hospitals stays. Reports to: Director - Case Management Minimum Education Associate's, Bachelor's degree or RN… more
- Prime Healthcare (National City, CA)
- …and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/205657/ case - manager utilization ... to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity,...a related field. At least one year experience in case management, discharge planning or nursing management; + CCM… 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 ... and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager...administration or related field preferred or commensurate experience and Case Management Certification required + Minimum of 3 years… more
- Catholic Health (Buffalo, NY)
- …Holiday Rotation Hours: 8:00 am to 4:00 pm Summary: The Registered Nurse (RN) Care Manager - Utilization Review , as an active member of the Care Management and ... clinical skills and discharge planning principles, the RN Care Manager , Utilization Review collaborates with...experience + Preferred prior insurance /managed care/ utilization review experience in the role of a Case… more
- Ascension Health (Baltimore, MD)
- …specialist for staff in the areas of utilization criteria, appeal and review process, and case management system documentation. + Conduct hiring, training, ... salary range at the time of the offer._ **Responsibilities** Manage effective utilization review processes, including management of patient statusing processes… more