- Sheppard Pratt (Amesbury, MA)
- …Cycle. Communicate with clinical programs and other internal departments as needed. Updates the Hospital Utilization Review Plan and ensures that the plan is ... supervision, provides day-to-day leadership of the utilization review process of patients admitted to the Hospital...Need for Medical Necessity Annually reviews and revises the Hospital 's Utilization Review Plan to… more
- Fort Duncan Regional Medical Center (Eagle Pass, TX)
- …rounds. Manage department budget, staffing, and training needs. Function as Utilization Review /Denials Manager as required. Qualifications Registered ... CCM-RN) preferred. Proven leadership experience in acute care, utilization review , case management. Strong working knowledge of hospital billing, managed… more
- Kaiser Permanente (Panorama City, CA)
- …the general and specialized principles, practices, techniques and methods of Utilization review /management, discharge planning or case management. Working ... during case review or other activities. Reviews, analyses and identifies utilization patterns and trends, problems or inappropriate utilization of resources… more
- American Traveler (Boston, MA)
- American Traveler is seeking an experienced RN Case Manager with acute case management experience and an active MA RN license. Job Details *Position is based in a ... hospital setting within the case management department, *Day shift schedule from 08:00 to 16:30, five 8-hour shifts weekly, *A 20-week contract is available, with… more
- Riverside County, CA (Moreno Valley, CA)
- …in an accredited acute care hospital . Professional experience in case management and utilization review in a hospital is preferred. Schedule: 9/80 after ... The department is looking for only option 1 (Case Manager ) experience at this time. OPTION I Education: Graduation... hospital . Professional experience in case management and utilization review in a hospital … more
- Kaiser Permanente (Aurora, CO)
- …requests, including discharge planning activities when needed (collective referred to as Utilization Review ) for the Colorado region. Manages utilization ... concurrent requests. Responsible for the planning and decision-making related to utilization review . Develops and implements departmental policies and… more
- Ascension (Baltimore, MD)
- …travel rate Department: Ascension Travel Program & Interim Leadership Schedule: Full-time Hospital : St. Agnes Location: Baltimore, MD * Rates may vary by location ... and specialty. Stipends follow GSA guidelines based on the zip code of the facility. Please consult with your Recruiter to learn more. Will serve as an Interim Travel Nursing leader with the potential to serve various Ascension hospitals. For more information… more
- Baton Rouge General (Baton Rouge, LA)
- …abilities with a track record of team support and development Minimum 3 years of hospital utilization review experience preferred At least 1 year of ... skills Ability to manage multiple priorities in a fast-paced hospital environment Why You'll Love Working With Us: At...our employee perks here! What You Will Do: As Manager of Utilization Review , you'll… more
- Singing River Health System (Ocean Springs, MS)
- …BCLS certification upon hire and/or transfer. Prefer ACM or CCM (Certified Case Manager ), Certification in Utilization Review , Certified Professional in ... Utilization Review Surgery Nurse - RN Ocean Springs Hospital | Full-Time | Monday-Friday rotating weekends/Holidays | 3109 Bienville Blvd Ocean Springs,… more
- Mount Sinai Hospital (New York, NY)
- Job Description Process Improvement Manager I-Health System Operations -Corporate-Full-Time Days-Hybrid The Health Systems and Process Improvement (HSPI) Manager ... that advance Mount Sinai Health System's strategic priorities. The HSPI Manager II plans, manages and executes complex improvement initiatives and performance… more
- Concord Hospital (Laconia, NH)
- …liability regarding the hospital admission. Bases care management and utilization review actions by applying principles of purposeful, organized thinking ... specialty or Care Management, Discharge planning, Quality Improvement and Utilization Review . Demonstrates effective interpersonal, organizational and… more
- NYC Health Hospitals (New York, NY)
- …premier acute care hospitals. Located in Downtown Bronx, Lincoln is a teaching hospital renowned for its Centers of Excellence, and a recognized industry leader in ... and monitors the management of patient-centered quality care, ensuring optimal utilization of resources, service delivery, and compliance with external review… more
- HCA Healthcare (Austin, TX)
- …and retrospective review of patient medical records for purposes of utilization review , care coordination compliance with requirements of external review ... for our NICU Case Manager Austin Market Float Pool PRN opening. We review all applications. Qualified candidates will be contacted by a member of our team. We… more
- Kaiser Permanente (Arlington, VA)
- …collaborates with rounding MAPMG Hospital Based Service Physicians, patient/family, nursing, utilization review and other members of the healthcare team to ... (CWD) rounds reporting on patient progression towards the established discharge plan. Review and document discharge plan in accordance with KP discharge planning… more
- Cedars Sinai (Marina Del Rey, CA)
- …the established/communicated timeframe Documents appropriate reviews for assigned patients using utilization review tool. Provides telephonic review for ... Will Do in This Role: A Registered Nurse Case Manager plans and coordinates care of the patient from...vulnerable residents. About the Team Cedars-Sinai Marina del Rey Hospital is a nonprofit community hospital committed… more
- Pennsylvania Medicine (Philadelphia, PA)
- …BSN (Required) Registered Nurse - PA (Required) 5yrs prior experience as a Nurse Case Manager with knowledge of utilization review and 3rd Party Payors ... and contractual requirements to assure optimal reimbursement for the hospital for services provided. Responsibilities: Interact with medical staff...*And 5+ years Prior experience as a nurse case manager with knowledge of utilization review… more
- Roper St Francis Healthcare (Summerville, SC)
- …critical thinking. Ability to run effective shift safety huddles, report safety concerns, review device utilization , report staffing concerns, and review ... Position will start in 10/2025. Roper St. Francis Berkeley Hospital : Expanding to Serve More Our community is growing...ED and as designated by specialty standards and/or clinical manager and should be obtained within 6 months of… more
- The University of Chicago Medicine (Chicago, IL)
- Job Description Manager , Central Sterile Processing, Full-Time, Day University of Chicago Medicine, Hyde Park, Illinois We're hiring a full-time Manager for ... 7 days a week accountability for maintaining departmental operations in all hospital sterile processing areas. Operates, directs and supervises the department and… more
- Regional One Health (Memphis, TN)
- …monitoring/re-evaluation/updating care plans as needed * client-specific advocacy * review of service utilization Identifies designated population without ... Case Manager (Ryan White Part A Grant) A Brief...to access available social support services. Works collaboratively with hospital case management, outside agencies, providers and referral agencies… more
- Kaiser Permanente (Seattle, WA)
- …week, with opportunity to cover other day or night shifts as needed. Onsite Hospital Night Shift Supervisor for KPWA Capitol Hill growing hospital services that ... and what resources to engage when needed. Job Summary: Supervises nursing and hospital operations on assigned shift at Central Hospital . Coordinates patient bed… more
