- LA Care Health Plan (Los Angeles, CA)
- Supervisor, Utilization Management RN ( Outpatient ) Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 ... 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… 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 ... For more information, please visit our website: https://beaumontbh.com/ PositionSummary The Utilization Management Case Manager is primarily responsible… 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 ...nurses providing care and services in 22 hospitals, 300+ outpatient locations and several post-acute facilities-and Priority Health, a… more
- EM Key Solutions, Inc. (Eglin AFB, FL)
- Eglin AFB, FL, USA | Full Time Registered Nurse - Utilization Manager Onsite Position EM Key Solutions is seeking Registered Nurse (RN) for a full-time ... are not limited to the following: + Develops and implements a comprehensive Utilization Management plan/program in accordance with the facility's goals and… more
- EM Key Solutions, Inc. (Eglin AFB, FL)
- Eglin AFB, FL, USA | Hourly | Full Time Registered Nurse - Utilization Manager Location: Eglin Hospital at Eglin AFB, Fort Walton Beach, FL. Position Type- ... are not limited to, the following: + Develops and implements a comprehensive Utilization Management plan/program in accordance with the facility's goals and… more
- Beth Israel Lahey Health (Burlington, MA)
- …of three years of medical/surgical nursing care experience. -Two years of Case Management or Utilization Management experience desirable. - Demonstrated ... Day (United States of America) Joint role of Case Manager and Utilization Review Nurse Hospital at...to ensure a timely process. Registered Nurses (RNs) with utilization review experience, case management experience, and… more
- Billings Clinic (Cody, WY)
- …to learn more! RN Care Manager Outpatient - Cody OUTPATIENT CARE MANAGEMENT ... care. * Maintains respectful and professional communication skills. * Insurance and Utilization Management * Maintains working knowledge of CMS requirements and… more
- ERP International (Tinker AFB, OK)
- …and Tasks: Duties may include but are not limited to** : Provides Utilization Management activities and functions by using MTF-specific Quality Improvement ... algorithms, CM software, and databases for community resources. * Integrate CM and utilization management (UM) and integrating nursing case management with… 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 ... UM Supervisor will work remotely and report directly to the regional Clinical Utilization Management Manager . + Responsible for providing daily, regional… more
- Virginia Mason Franciscan Health (Bremerton, WA)
- …annual bonus eligibility, and more! **Responsibilities** **Job Summary / Purpose** The Utilization Management (UM) Director is responsible for the market(s) ... development, implementation, evaluation and direction of the Utilization Management Program and staff in support of the CommonSpirit Health Care Coordination… more
- Sharp HealthCare (San Diego, CA)
- …time for routine, urgent and expedited referrals as outlined in SCMG's Utilization Management Plan.Decisions will be communicated to the appropriate persons ... + Knowledge of medical terminology, healthcare finances, alternative care options, utilization management , health plan criteria, established criteria such as… more
- The Mount Sinai Health System (New York, NY)
- The Utilization Review Manager for the Selikoff Centers for Occupational Health is responsible for the management of program operations within a particular ... records, and internal and external regulatory and survey requirements. + The Utilization Review Manager collaborates with multiple professionals to support and… more
- St. Luke's University Health Network (Allentown, PA)
- …we serve, regardless of a patient's ability to pay for health care. The Outpatient Care Manager , Social Worker (OP CM SW) is responsible for providing ... by the policies and procedures of the entity and Outpatient Care Management Department. The OP CM...needs. The OP CM SW also collaborates with the Outpatient Care Manager RN, Community Health Worker… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Admissions Liaison RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position ... to support the safety net required to achieve that purpose. Job Summary The Utilization Management (UM) Admissions Liaison RN II is primarily responsible for… more
- Beth Israel Lahey Health (Boston, MA)
- …treatment, clinical excellence, and latest in research. We are looking for a manager to oversee pharmacy teams working in outpatient oncology practice in ... not limited to: *Guides and directs clinical practice initiatives in outpatient oncology ambulatory and infusion practice *Creates and maintains pharmacist staffing… more
- Covenant Health (Lubbock, TX)
- …services for a targeted patient population. Carries out activities related to utilization management , discharge planning, care coordination and referral to other ... care experience in an acute care hospital in a leadership role. + Case management or utilization management experience. **Why Join Providence?** Our… more
- UPMC (Shrewsbury, PA)
- UPMC Pinnacle Medical Group, Outpatient Care Management Team is adding an OP Nurse Coordinator I (Registered Nurse, RN) to their team in Hanover/York area. This ... position will support the Outpatient UPMC Pinnacle primary care providers from patients from...management are to maintain clinical stability, promote appropriate utilization of services, enhance patients' ability to better manage… 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 ... observation) based on medical necessity. 2. Performs concurrent and retrospective utilization management -related activities and functions to ensure that… more
- UTMB Health (Galveston, TX)
- Nurse Manager - Outpatient (Oncology - Galveston) **Galveston, Texas, United States** Nursing & Care Management UTMB Health Requisition # 2400834 **Job ... Summary:** The Nurse Manager is accountable for the effective delivery of competent,...for clinical operations and human resources, financial, and quality management . **Minimum Qualifications:** RN with Bachelor's degree in Nursing.… more
- Universal Health Services (Sacramento, CA)
- …Sierra Vista Hospital is seeking a talented and dynamic Director of Utilization Management to join our team of dedicated healthcare professionals! ... outpatient chemical dependency services. Position Summary: The Clinical Director of Utilization Management is responsible for the development of best practice… more