- Cedars-Sinai (Los Angeles, CA)
- **Job Description** **Job Summary: Key Job Responsibilities** The Utilization Review Case Manager validates the patient's placement to be at the most ... **Req ID** : 1072 **Working Title** : CSMC 8750000 Utilization Management Utilization Review Case Manager FR 48010 Allen 429 1.00 **Department** :… more
- University of Miami (Miami, FL)
- …. The University of Miami is currently seeking Utilization Review Case Manager ... and retrospective chart reviews for clinical utilization and authorization. The Utilization Review Case Manager coordinates with the healthcare team… more
- Dallas Behavioral Healthcare Hospital (Desoto, TX)
- The Utilization Review Case Manager is responsible for working with insurance companies and managed care systems for the authorization, concurrent and ... help patients access the full range of their benefits through the utilization review process. + Conducts admission reviews. + Conducts concurrent and extended… more
- Cedars-Sinai (Los Angeles, CA)
- **Job Description** **Job Summary: Key Job Responsibilities** The Utilization Review Case Manager validates the patient's placement to be at the most ... care based on nationally accepted admission criteria. The UR Case Manager uses medical necessity screening tools,... follows the UR process as defined in the Utilization Review Plan in accordance with the… more
- Trinity Health (Fresno, CA)
- …Utilization Management will ensure the timely delivery of utilization review , discharge planning and support case management and the psychosocial services ... responsible for management, leadership, and coordination of the departments of the Utilization Manager Team to ensure payor reimbursement for services rendered… more
- Beth Israel Lahey Health (Burlington, MA)
- …Hours:** 40 **Work Shift:** Day (United States of America) Joint role of Case Manager and Utilization Review Nurse Hospital at Home Full Time Days ... Manager for Hospital at Home Care Transitions coordinates utilization review , discharge planning and monitors quality...Case Manager experience as well as Utilization Review experience ( review medical… more
- Actalent (Oklahoma City, OK)
- Description: Utilization Review Nurse perform integrated case management (CM) and disease management (UM) activities demonstrating clinical judgment and ... care, acute, nurse, clinical, healthcare, Case management, Utilization management, Utilization review , Insurance...Active Oklahoma RN license required. * Case Manager , Discharge Planner, UR experience. * Utilization … more
- Prime Healthcare (Bloomington, IN)
- …and maintain current. #LI-AS2 Connect With Us! (https://careers-primehealthcare.icims.com/jobs/141999/ case - manager utilization - review ... to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity,...Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred. + Five years acute… more
- Prime Healthcare (Lynwood, CA)
- …education, credentials and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/156578/rn- case - manager utilization - review ... to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity,...Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred.3. Five years acute care… more
- CommonSpirit Health Mountain Region (West Jordan, UT)
- …and leaders who care about your success. As a Registered Nurse, RN Case Manager you'll advocate for patients while collaborating closely with interdisciplinary ... that help them maintain and build on positive outcomes. In the role of RN Case Manager , you will also: + Utilize clinical expertise, discretion, and independent… more
- Henry Ford Health System (Wyandotte, MI)
- …therapy experience, safety planning, psychiatric assessment, COPE and DWIHN knowledge, utilization review . GENERAL SUMMARY: The Case Manager is a member ... meet an individual's and family's health care needs. The goals of the case manager are to promote patient safety, quality of care and cost-effective outcomes.… more
- Providence (Medford, OR)
- …based on population focus. Duties also include complex discharge planning and utilization review . The Nurse Case Manager must be competent to analyze ... **Description** The RN Case Manager is an expert professional...year home health, mental health, substance use, hospice, and/or utilization review + Progressive nursing leadership experience,… more
- LA Care Health Plan (Los Angeles, CA)
- …current and unrestricted California License Certified Professional in Utilization Review (CPUR) Certified Case Manager (CCM) Certified Professional ... Manager , Delegation Oversight Clinical Audit Job Category: Clinical...with the Director, Delegation Oversight Audit on clinical issues/clinical review and interfacing with external agencies including other Local… more
- Dignity Health (San Bernardino, CA)
- …requirements specific to Utilization Review and Discharge Planning. The Case Manager partners with the medical staff, utilizes scientific evidence for ... and excellence). Primary elements of the case manager role include: Care Coordination, Utilization Review and Discharge Planning. This position requires… more
- Catholic Health Initiatives (Omaha, NE)
- …reliability test for Utilization Review product(s) used. **Preferred** Certified Case Manager (CCM), Accredited Case Manager (ACM-RN), or ... **Overview** Utilization Review RN is responsible for...effectively with multiple stakeholders Professional communication skills. Understand how utilization management and case management programs integrate.… more
- LA Care Health Plan (Los Angeles, CA)
- …California License. Licenses/Certifications Preferred Certified Professional in Utilization Review (CPUR) Certified Case Manager (CCM) Required ... Manager , Enhanced Care Management (RN or LCSW) Job...ECM services to medically and behaviorally complex members. + Review systems and processes, making recommendations for improvement to… more
- LA Care Health Plan (Los Angeles, CA)
- …California License. Licenses/Certifications Preferred Certified Professional in Utilization Review (CPUR) Certified Case Manager (CCM) Required ... Information Preferred: Certification in Certified Professional in Utilization Review (CPUR), Certified Case Manager (CCM), Utilization Management or… more
- Lucile Packard Children's Hospital Stanford (Palo Alto, CA)
- …responsibilities include coordinating all facets of a patient's admission/discharge; performing utilization review activities, including review of patient ... and performance/quality improvement activities that lead to optimal patient outcomes. A Case Manager differs from other roles in professional nursing/health care… more
- UNC Health Care (Raleigh, NC)
- …care episode through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management ... and care delivery is coordinated across the continuum. The Utilization Manager completes admission, continued stay, and...of patient data and treatments. Communicates daily with the Case Manager to manage level of care… 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