- 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...degree in social work, counseling or a Michigan licensed Registered Nurse is required. + Full licensure… more
- Cedars-Sinai (Los Angeles, CA)
- …Coordination **Req ID** : 1072 **Working Title** : CSMC 8750000 Utilization Management Utilization Review Case Manager FR 48010 Allen 429 1.00 ... (BLS) **Experience:** 3 years In acute nursing 2 years Case Management 1 year CPT coding **Physical...**Department** : Utilization Management **Business Entity** : Cedars-Sinai Medical… more
- AmeriHealth Caritas (Newark, DE)
- …Degree. + Current and unrestricted RN license in Delaware. + 3+ years utilization / case management experience in relevant scope preferred, one year ... ** Utilization Management Plan Oversight Manager** Location:...Qualified candidates must reside in Delaware. Current and unrestricted RN license in Delaware. Your career starts now. We… more
- UNC Health Care (Raleigh, NC)
- …stay, and discharge reviews in accordance with federal regulations & the Hospitals? Utilization Management Plan. In addition, the Utilization Manager is ... medical discharge planning issues, continuing care needs by initiating appropriate case management referrals. Initiates appropriate social work referrals. 3.… more
- McLaren Health Care (Detroit, MI)
- …and implementing process improvement projects as needed. _Required:_ + State licensure as a registered nurse ( RN ) + Bachelor's degree in nursing from ... experience with an acute care hospital** _Preferred:_ + Experience in utilization management / case management , critical care, clinical documentation, or… more
- RWJBarnabas Health (Livingston, NJ)
- Case Manager Registered Nurse ( RN ), ...hospital setting + Minimum of one year experience in Case Management / Utilization Management ... 94 Old Short Hills Road, Livingston, NJ 07039 The Case Manager Registered Nurse develops...on other classifications of patients as designated by the Utilization / Case Management Review Plan. Coordinates… more
- Beth Israel Lahey Health (Burlington, MA)
- …Full Time Days 8:00am-4:30pm weekend and holiday rotations required **Job Description:** The Inpatient Registered Nurse ( RN ) Case Manager for Hospital at ... Shift:** Day (United States of America) Joint role of Case Manager and Utilization Review Nurse...a timely process. Registered Nurses (RNs) with utilization review experience, case management … more
- Sharp HealthCare (San Diego, CA)
- …Case Manager (ACM) - American Case Management Association (ACMA); California Registered Nurse ( RN ) - CA Board of Registered Nursing; Certified ... Degree in a health related field + 3 Years Utilization Management or case ...clinical experience as defined by the CBA + California Registered Nurse ( RN ) - CA… 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 ... net required to achieve that purpose. Job Summary The Utilization Management (UM) Admissions Liaison RN...health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse ( RN ) - Active,… more
- UCLA Health (Los Angeles, CA)
- …all this and more at UCLA Health. Under the direction and supervision of the RN Assistant Director, the Case Management Coordinator is responsible for ... assist the next level of reviewer in review, and health plan contracts. The Case Management Coordinator will also be responsible for: * Preparation and… more
- R1 RCM (Pittsburgh, PA)
- …role, you must have experience in a clinical inpatient environment and hospital-based utilization or case management experience. Proficiency in basic ... analytics, AI, intelligent automation, and workflow orchestration. As our ** Utilization Review Nurse ** , you will help...onsite at a hospital setting. **Required Skills:** + Active Registered Nurse license For this US-based position,… 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 ... to support medical necessity and intensity of services. Collaborates with physicians for case management and conducts daily Medical Surgical Case … more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN ...in an acute hospital setting. At least 2 years Utilization Management / Case Management ... achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II...health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse ( RN ) - Active,… more
- Prime Healthcare (Ontario, CA)
- …or another relevant field + A minimum of seven (7) years' experience in Clinical Utilization Review or Case Management with a large Health Plan + ... https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf Responsibilities The Corporate Director of Clinical Utilization Management (UM) provides comprehensive… more
- Universal Health Services (Conway, SC)
- …is hiring for a Part Time RN Utilization Review Coordinator. Utilization Review / Risk Management Lighthouse Behavioral Health Hospital is a 105-bed, ... care, CD Rehab and intensive outpatient programs. Benefits for UR- Registered Nurse ( RN ) include: +...REQUIREMENTS : One to three years of experience in utilization review, case management , or… more
- McLaren Health Care (Lansing, MI)
- …barriers to D/C). 4. Identifies unsigned level of care (LOC) orders; communicates with utilization management nurse and obtains orders from providers. 5. ... per Standard Operating Procedure (SOP). **Qualifications:** **Required** * State licensure as a Registered Nurse ( RN ) * Bachelor's degree in nursing from… 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** ... + Demonstrated knowledge of payers, payer systems, cost effective utilization management and InterQual criteria. + The...+ Current license to practice as a Registered Nurse in the State of Utah,… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …Nurse in the State of Florida. + 3 years minimum experience in discharge planning, utilization management , or case management . + Basic proficiency in ... healthcare needs of the patients using the functions of Utilization Resource Management , Transition of Care, Discharge Planning, and Case Management . +… more
- Mohawk Valley Health System (Utica, NY)
- Registered Nurse - Case Management - Full Time - Days Department: CASE MANAGEMENT Job Summary Reports to and is under direct supervision of ... regulatory compliance. Education/Experience Requirements Required: + Minimum of two (2) years utilization review/ case management experience or social work… more
- Prime Healthcare (Weslaco, TX)
- …#hiringrns #patientrentry #patienttreatmentplan Connect With Us! (https://careers-primehealthcare.icims.com/jobs/156984/ registered - nurse - case -manager ... medical necessity, intensity of service and severity of illness. RN Case Manager a plus Qualifications Education...a related field. At least one year experience in case management , discharge planning or nursing … more