- Veterans Affairs, Veterans Health Administration (Roseburg, OR)
- …Learning (SAIL) outcomes and External Peer Review Program (EPRP) metrics. Acts as the Utilization Management nurse for the inpatient acute psychiatric unit. ... on older adults and mental health. Acts as the Utilization Management (UM) nurse for...religious or pregnancy). VHA HCPs do not include remote workers who only infrequently enter VHA locations. If selected,… more
- Fallon Health (Worcester, MA)
- …a Registered Nurse in a clinical setting required. + 2 years' experience as a Utilization Management nurse in a managed care payer preferred. + One year ... fallonhealth.org or follow us on Facebook, Twitter and LinkedIn. The UM Nurse uses a multidisciplinary approach to organize, coordinate, monitor, evaluate and modify… more
- McLaren Health Care (Mount Clemens, MI)
- …barriers to D/C).4. Identifies unsigned level of care (LOC) orders; communicates with utilization management nurse and obtains orders from providers.5. ... and maintenance of continuing education requirements **Preferred:** * Experience in utilization management /case management , critical care, or patient… more
- Trinity Health (Philadelphia, PA)
- …terms, etc. Comments: 4 "Interviews patients/significant others within one working day of Utilization Management Nurse , ED Case Manager, Care Transition ... terms, etc. Comments: 4 "Interviews patients/significant others within one working day of Utilization Management Nurse , ED Case Manager, Care Transition … more
- St. Luke's University Health Network (Quakertown, PA)
- …but not limited to: RN and Social Work care managers, assistants, coordinators, utilization management staff, and director. + Facilitates communication among all ... patient's ability to pay for health care. The Registered Nurse or Social Worker Care Manager is...continuum of care. Also works with the providers, registered nurse care managers, social workers , and multi-disciplinary… more
- St. Luke's University Health Network (Easton, PA)
- …other members of care management , including but not limited to: Social workers , assistants, coordinators, utilization management staff, and director. + ... patient's ability to pay for health care. The Registered Nurse or Social Worker Care Manager is...continuum of care. Also works with the providers, registered nurse care managers, social workers , and multi-disciplinary… more
- Lancaster General Health (Lancaster, PA)
- …Pennsylvania Board of Nursing. + Bachelor's degree in Nursing (BSN). + Knowledge of utilization review or managed care. + Care management experience in a managed ... + Coordinates care across the continuum (inpatient/outpatient/community) to assure appropriate utilization of clinical and community resources. + Oversees and guides… more
- St. Luke's University Health Network (Bethlehem, PA)
- …other members of care management , including but not limited to: Social workers , assistants, coordinators, utilization management staff, and director. + ... Manager, Per Diem coordinates the overall progression of care, resource utilization , and discharge planning for designated patient populations across the continuum… more
- Universal Health Services (Colorado Springs, CO)
- …WILL CONTINUE UNTIL THE POSITION IS FILLED. We have a Full Time Utilization Management Care Coordinator opportunity available, this position reports to the ... Director of Utilization Management . Schedules vary. About the Position:...accordance with Colorado state public health order, all healthcare workers must be vaccinated, and the Company must verify… more
- Lucile Packard Children's Hospital Stanford (Palo Alto, CA)
- …include coordinating all facets of a patient's admission/discharge; performing utilization review activities, including review of patient charts for timeliness ... of services as well as appropriate utilization of services; and ensuring optimum use of resources,...delivery and quality of patient care. A hospital-based case management system has as its primary goal to ensure… more
- CVS Health (Salt Lake City, UT)
- …clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and is knowledgeable ... opportunities to promote quality effectiveness of healthcare services and benefit utilization . Required Qualifications - Must have active current and unrestricted… more
- Prime Healthcare (Montclair, CA)
- …Us! (https://careers-primehealthcare.icims.com/jobs/153574/case-manager-%28rn%29 utilization - management /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) ... serving an underserved community. Come Join a Team of Dedicated Healthcare Workers Montclair Hospital Medical Center is nationally recognized, locally preferred, and… more
- Bassett Healthcare (Cooperstown, NY)
- …Forbes America's Best-In-State Employer 2022! What you'll do The Licensed Master Social Worker (LMSW) will work Per Diem, Various Shifts and Weekends and provides ... case management services as appropriate throughout the life span and...span and in various settings. The Licensed Master Social Worker evaluates discharge needs upon admission, ensuring each patient… more
- Billings Clinic (Billings, MT)
- …leadership and Physician Advisor, per department process or procedure *Insurance and Utilization Management *Maintains working knowledge of CMS requirements and ... prior to starting. Click here (https://billingsclinic.csod.com/ats/careersite/search.aspx?site=15&c=billingsclinic) to learn more! Utilization Review RN CARE MANAGEMENT (Billings Clinic… more
- Actalent (San Bernardino, CA)
- Description: As a part of the Utilization Management team the Utilization Review RN is a member of the Care Coordination team. The goal of care coordination ... directed to contracted in-network vendors when possible. Must be knowledgable of utilization management criteria, contract vs. non-contracted. - Must be familiar… more
- ChenMed (Pembroke Pines, FL)
- …expanding and we need great people to join our team. The Community Social Worker overall goal is to help people who have chronic, life threatening or altering ... family situations. Additional duties and responsibilities include working closely with the nurse case managers to transition patients to the appropriate level of… more
- Universal Health Services (Newark, DE)
- …the United Kingdom. Qualifications Job Requirements: + Education: Master's prepared Social Worker or Licensed Registered Nurse . + Experience: Previous experience ... inpatient behavioral health facility in DE, offers an experienced and tenured senior management team, and serves New Castle County and northern Maryland. Visit us… more
- Centene Corporation (Tallahassee, FL)
- …MONDAY-FRIDAY, 8AM - 5PM. THESE ROLES WILL BE SUPPORTING BEHAVIORAL HEALTH UTILIZATION MANAGEMENT FOR MEDICAID. **Position Purpose:** Performs a clinical review ... 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive… more
- Sutter Health (Santa Rosa, CA)
- …by implementing and following applicable policies and procedures. * Effectively communicates Utilization Management Program and action plan goals and objectives ... Sutter health philosophies and initiatives. Participates as member of the utilization Management committee (UMC). Strong problem resolution abilities and… more
- Universal Health Services (Jacksonville, FL)
- …the hospital. Qualifications Registered Nurse , LPN or Master's level Social Worker with experience in Utilization Management , preferred. Good ... whole. We are pleased to announce the following available position: PRN Utilization Review Coordinator This position is responsible for monitoring the treatment… more