- Trinity Health (Fresno, CA)
- …services rendered while supporting the healing mission of Saint Agnes Medical Center. The Manager Utilization Management will ensure the timely delivery of ... , leadership, and coordination of the departments of the Utilization Manager Team to ensure payor reimbursement...utilization review, discharge planning and support case management and the psychosocial services to patients, families, and… more
- UCLA Health (Los Angeles, CA)
- …the next level. You can do all this and more at UCLA Health. As a Manager for Medicare Advantage Utilization Management , you'll provide direct management ... RN licensure in CA required * Bachelors of Science, Nursing (BSN) degree required * Five or more years...(BSN) degree required * Five or more years of utilization management required * Four or more… more
- Centene Corporation (Sacramento, CA)
- …Review Clinical Review team to ensure appropriate care to members. Manages utilization management issues related to member care, provider interactions, and ... facilitates operations within utilization management . + Manages prior authorization, concurrent...management principles preferred. **License/Certification:** + RN - Registered Nurse - State Licensure and/or Compact State Licensure required… more
- Corewell Health (Grand Rapids, MI)
- …Health. Scope of Work Manages and coordinates the clinical functions of the Utilization Management Department. Oversees the efficiency and effectiveness of the ... utilization management teams, made up of ...utilization management teams, made up of utilization ...and match savings Qualifications + Required Bachelor's Degree in Nursing ; OR Master's degree in Social Work or health… more
- Prime Healthcare (Weslaco, TX)
- …#patientrentry #patienttreatmentplan Connect With Us! (https://careers-primehealthcare.icims.com/jobs/156984/registered- nurse -case- manager utilization - ... intensity of service and severity of illness. RN Case Manager a plus Qualifications Education and Work Experience Required...related field. At least one year experience in case management , discharge planning or nursing management… more
- Prime Healthcare (Anaheim, CA)
- …and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/157767/case- manager utilization - management ... in a related field or at least one year experience in case management , discharge planning or nursing management ; + CCM or obtained within 6 months of hire.… more
- Lucile Packard Children's Hospital Stanford (Palo Alto, CA)
- …performance/quality improvement activities that lead to optimal patient outcomes. A Case Manager differs from other roles in professional nursing /health care ... nature, level and purpose of the job. Case Managers are licensed nursing professionals responsible for coordinating continuum of care and discharge planning… more
- Universal Health Services (Dearborn, MI)
- Responsibilities Utilization Management Case Manager Beaumont Behavioral Health (a UHS Facility) A growing 144-bed behavioral health facility - Beaumont ... more information, please visit our website: https://beaumontbh.com/ PositionSummary The Utilization Management Case Manager is...in social work, counseling or a Michigan licensed Registered Nurse is required. + Full licensure in the State… more
- Trinity Health (Fresno, CA)
- …Review of Acute Care seeking your next adventure?** **Duration:** 13-week Assignment The Interim Utilization Management , RN Manager is responsible for ... healing mission of Saint Agnes Medical Center. The RN Manager of Utilization Management will...and hospital staff **Requirements** + State of California Registered Nurse (RN) License. + Current American Heart Association (AHA)… more
- Prime Healthcare (Montclair, CA)
- …and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/153574/case- manager -%28rn%29 utilization - management ... years work experience post-graduation of an accredited school of nursing and a current state Registered Nurse ...experience preferred. At least one year experience in case management , discharge planning or nursing management… more
- Prime Healthcare (Chino, CA)
- …licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/160153/case- manager -%28rn%29-- utilization - management ... years work experience post-graduation of an accredited school of nursing and a current state Registered Nurse ...experience preferred. At least one year experience in case management , discharge planning or nursing management… 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 ... knowledge of state and federal regulations. EDUCATION/EXPERIENCE Current California Registered Nurse License Five years nursing experience required CERTIFICATES,… more
- UNC Health Care (Raleigh, NC)
- …through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management staff to ... Utilization Management Plan. In addition, the Utilization Manager is responsible for revenue protection...and obtains observation status as appropriate. Partners with physicians, nursing , and other care providers to help ensure timely… more
- Corewell Health (Southfield, MI)
- …to the Clinical UM Supervisor's role is to assist the regional Clinical Utilization Management Manager with implementing operational changes and serve ... work remotely and report directly to the regional Clinical Utilization Management Manager . + Responsible...and match savings Qualifications + Required Associate's Degree in Nursing OR Bachelor's Degree in Nursing (Preferred)… more
- AdventHealth (Tampa, FL)
- …customer experience._ **The value you'll bring to the team:** **_._** **_Assists Utilization Management Manager to successfully implement practice ... Management RN Supervisor reports directly to the Divisional Utilization Management RN Manager and...you'll need to succeed** **:** . Associate Degree in Nursing . . RN License. . Minimum three years acute… more
- Sharp HealthCare (San Diego, CA)
- …System Integrated Care Management (ICM) team the Transfer and Admissions Utilization Manager (UM) partners with the Centralized Patient Placement Center ... American Case Management Association (ACMA); California Registered Nurse (RN) - CA Board of Registered Nursing...Experience and understanding of federal and state regulations governing utilization management + Accredited Case Manager… more
- Beth Israel Lahey Health (Boston, MA)
- …for the health of patients, families, and communities. The Nurse Case Manager provides utilization management , care coordination and discharge planning ... degree in Nursing required. Bachelor's degree in Nursing preferred. 2. License Registered Nurse required....1. Certified Case Manager . 2. Previous clinical nursing experience and/or case management experience. Competencies:… more
- Dignity Health (Rancho Cordova, CA)
- …home.** **Position Summary:** Under the guidance and supervision of the department Manager /Director, the Supervisor of Utilization Management is responsible ... Guidelines, InterQual, Health Plan Benefit Interpretation Guidelines and Medical Management Policies, and DHMF Utilization Management... skills. - Graduate of an accredited school of nursing . - Clear and current CA Registered Nurse… more
- LA Care Health Plan (Los Angeles, CA)
- …Certification in Certified Professional in Utilization Review (CPUR), Certified Case Manager (CCM), Utilization Management or Compliance Salary Range ... the coordination of member care with internal LA Care departments such as Care Management (CM), Utilization Management (UM), Managed Long Term Services and… more
- YesCare Corp (Brentwood, TN)
- …Communicate and document any issues relating to the outpatient/inpatient UM process to the Manager of Utilization Management . + Assist with the data ... **Experience & Requirements** + Experience Level: 3 - 5 year's experience in utilization management , case management , quality management . Experience with… more