- Appcast (Randallstown, MD)
- Utilization Review Nurse RN Randallstown, MD NORTHWEST HOSPITAL NW CARE MANAGEMENT Full-time - Day shift - 8:00am-4:30pm RN Other 92327 $38.20-$59.21 Experience ... system that values bold ideas and community-centered care. The Utilization Review Nurse RN conducts initial, concurrent...potential and actual denials and coordinates with nurse Care Manager and/or Social Worker for any follow up necessary.… more
- Legend Biotech USA, Inc. (Raritan, NJ)
- …MSAT, Facilities, C&Q, Project Management, and Quality.Work closely with Sr. Manager , Strategic Initiatives to support various strategic initiatives focusing on site ... of site operational models to better understand and assess resource utilization , equipment utilization , change impact, etc.Support assessment of facility… more
- JobElephant (Bowling Green, OH)
- …for BGSU Firelands Events Management activities. This position acts as project manager for external clients to meet personalized event needs, including processing of ... client relationships, executing sales strategies, and ensuring optimal space utilization through targeted marketing and outreach efforts.Responsible for ensuring… more
- The Career Sphere (Los Angeles, CA)
- …clinical site? Supervise medical providers including providing timely performance feedback, review of peer review findings, performance evaluations, continuous ... policies and procedures? Work in conjunction and collaboratively with the Nurse Manager and Clinic Manager to establish effective efficient streamlined processes… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- *_SUMMARY:_* We are currently seeking a* Utilization Review Manager * to join ourTransitional Care Team.This is a full-time role and will be required to work ... ) required or completed within three years of hire **Title:** * Utilization Review Manager * **Location:** *MN-Minneapolis-Downtown Campus* **Requisition… 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 ... Our Team of Experts and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager , you will:** + Directs staff performance… more
- Behavioral Center of Michigan (Warren, MI)
- …skills to help educate the staff and physicians regarding charting. REPORTS TO: Utilization Review Lead/ Manager QUALIFICATIONS: + High School Diploma or ... Under general supervision, the Utilization Review Coordinator provides professional assessment,...those duties include all tasks requested by the UR Manager , CEO or Medical Director to meet the needs… more
- Children's Mercy Kansas City (Kansas City, MO)
- …of, and training oversight of programs and services. Responsible for effective utilization review and proper resource management of patients, including patient ... reporting, quality, and Lean process improvements, and facilitating the quarterly Utilization Review Committee meetings. Provides evidence based and outcome… more
- Virtua Health (Pennsauken, NJ)
- …UR Tech and AA to support UR and revenue cycle process.Position Responsibilities: Utilization Management* Utilizes Payer specific screening tools as a resource to ... resource group and payers.Documentation* Appropriate and complete documentation of clinical review and denial management in the case management documentation system… more
- Devereux Advanced Behavioral Health (Malvern, PA)
- …could be longer based on the presenting symptoms. Every day as an Admissions & Utilization Review Manager you will + Supervise overall operations of DCBHC ... can take your career to the next level. **Being an Admissions & Utilization Review (UR) Manager Devereux Children's Behavior Health Center has its… more
- University of Miami (Miami, FL)
- …Department of UMHC SCCC Business Operations has an exciting opportunity for a full time Utilization Review Case Manager to work to work remote. The incumbent ... retrospective chart reviews for clinical utilization and authorization. The Utilization Review Case Manager coordinates with the healthcare team for… more
- Catholic Health Services (Melville, NY)
- …services and coordinates utilization /appeals management review . + Assist Utilization and Appeals Manager in setting up communications with payors and/ ... as well as all financial metrics associated with front-end review process. + Collects data, prepares analysis, and oversees...and facility departments. + Develops/validates daily work lists for Utilization and Appeals Manager . + Assist with… more
- University of Miami (Miami, FL)
- …please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . Utilization Review Case Manager RN - ... Miami is currently seeking a Prior Authorization Nurse Case Manager . The incumbent purose is to conduct initial chart...forth by the payer or clinical guidelines + Accurate review of coverage benefits and payer policy limitations to… more
- Beth Israel Lahey Health (Plymouth, MA)
- …Hospital-Plymouth** is expanding its **Care Transitions Department** and seeking an experienced ** Manager of Utilization Review & Denials Management** and ... + CCM, ACM, or other case management certification preferred or in progress ** Manager - Utilization Review & Denials Management** This role is ideal for a… more
- Mount Sinai Health System (New York, NY)
- …+ Previous experience as in homecare, long term care or utilization review preferred. + Discharge Planner or Case Manager preferred. + Manager ... **Job Description** **RN/Case Manager MSH Case Management PT Days** The Case...a. Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case management… more
- Actalent (Sunrise, FL)
- Job Title: Behavioral Health Utilization Review NurseJob Description The Utilization Management Nurse (UMN) plays a crucial role in reviewing requests for ... collaboration with the interdisciplinary team, the UMN handles tasks related to utilization review across various specialties, medical treatments, and services.… more
- State of Connecticut, Department of Administrative Services (East Hartford, CT)
- Utilization Review Nurse Coordinator (40 Hour) Office/On-site Recruitment # 250924-5613FP-001 Location East Hartford, CT Date Opened 9/30/2025 12:00:00 AM Salary ... - is accepting applications for a full-time Utilization Review Nurse Coordinator (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=5613FP&R1=&R3=)… more
- University of Utah Health (Salt Lake City, UT)
- …and as a team member. **Qualifications** **Qualifications** **Required** + One year Utilization Review or Case Management experience. **Licenses Required** + ... of InterQual Criteria, knowledge of ICD-9, DRG's and CPT Codes. + Utilization Review Certification designation. + Knowledge of CMS Regulations. **Working… more
- Dayton Children's Hospital (Dayton, OH)
- … TeamSchedule:Full timeHours:40Job Details:Under the supervision of the Manager of Utilization Management, the Utilization Review RN conducts medical ... information to payers in accordance with contractual obligations. The Utilization Review RN serves as a resource...a resource to the physicians, collaborates with the Care Manager in the development and implementation of the plan… more
- Commonwealth Care Alliance (Boston, MA)
- …Knowledge, Skills & Abilities (must have): * Expertise in managing utilization review processes including prior authorization, concurrent and retrospective ... facilities under the provisions of CCA's benefits plan. The Manager , Utilization Management is responsible for overseeing...for overseeing and managing the daily operation of the Utilization Management Review Nurse and Specialist staff… more
