- Geisinger (Wilkes-Barre, PA)
- …regarding the utilization of evidence based practice.Provides input to the manager for performance appraisals of care delivery team members.Precepts and ... care . EducationGraduate from Specialty Training Program-Nursing (Required)Certification(s) and License(s) Licensed Practical Nurse - Default Issuing Body; Basic Life… more
- Geisinger (Scranton, PA)
- …regarding the utilization of evidence based practice.Provides input to the manager for performance appraisals of care delivery team members.Precepts and ... Job Title: LPN - Experienced Inpatient Licensed Practical Nurse (Geisinger Community Medical Center, Scranton)Location:...and dependents Pre-tax savings plans with healthcare and dependent care flexible spending accounts (FSA) and a health savings… more
- Geisinger (Scranton, PA)
- …regarding the utilization of evidence based practice.Provides input to the manager for performance appraisals of care delivery team members.Precepts and ... Job Title: LPN - Graduate Inpatient Licensed Practical Nurse (Geisinger Community Medical Center, Scranton)Location:...and dependents Pre-tax savings plans with healthcare and dependent care flexible spending accounts (FSA) and a health savings… more
- Geisinger (Wilkes-Barre, PA)
- …regarding the utilization of evidence based practice.Provides input to the manager for performance appraisals of care delivery team members.Precepts and ... Job Title: LPN - Graduate Inpatient Licensed Practical Nurse (Geisinger South Wilkes-Barre)Location: Wilkes-Barre, PennsylvaniaJob Category: LPN - Licensed … more
- Geisinger (Lewistown, PA)
- …and Nursing SupportSchedule: Days Work Type: Full timeDepartment: GLH Care Management Clinical TeamDate Posted: 09/19/2025Job ID: R-85318Job SummaryOur Geisinger ... more, we'd love to hear from you!Job DutiesThe RN Hospital Case Manager assesses, plans, implements, coordinates, monitors and evaluates all options and services… more
- Monster (Bethlehem, PA)
- …AND/OR GIVEN BY): Works under the supervision of the Patient Care Manager and Clinical Coordinator.May supervise licensed practical nurses and home health ... according to agency standards for the provision of quality care , appropriate service utilization , and compliance with...of an approved school of professional nursing who is licensed as a Registered Nurse by the state in… more
- UNC Health Care (Smithfield, NC)
- …through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management staff to ... met and care delivery is coordinated across the continuum. The Utilization Manager completes admission, continued stay, and discharge reviews in accordance… more
- Molina Healthcare (GA)
- …of healthcare services professionals in some or all of the following functions: care management, utilization management, behavioral health, care transitions, ... performance of one or more of the following activities: care review, care management, utilization ...care team (ICT) meetings. * Functions as hands-on manager responsible for supervision and coordination of daily integrated… more
- Centene Corporation (Phoenix, AZ)
- …Tempe and/or Tucson offices.** **Position Purpose:** Manages the behavioral health (BH) utilization review clinicians to ensure appropriate care to members. ... Oversees and works with senior leadership on utilization management issues related to member care ,...+ LCSW- License Clinical Social Worker required or + LMHC- Licensed Mental Health Counselor required or + LPC- Licensed… more
- Beth Israel Lahey Health (Plymouth, MA)
- …a job, you're making a difference in people's lives.** Full Time **Job Description:** ** Utilization Review & Denials management manager - Full Time** **Who We ... and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager , you...care determination and the appeal/denial process. + Oversees utilization review workflow processes to ensure timely response to… more
- Helio Health Inc. (Syracuse, NY)
- …to track, review, and analyze data relating to continuous quality improvement. The Utilization Case Manager will work on a Full-Timebasis supporting our ... Assist in developing and administering policies and procedures for utilization . + Negotiating access to care for...also take into account information provided by the hiring manager and program Job LocationsUS-NY-Syracuse Category Case/ Care … more
- Children's Mercy Kansas City (Kansas City, MO)
- …nursing + required within 4 years of hire + 1-2 years experience + Experience in Utilization Review + One of the following: Licensed RN - MO, Registered Nurse ... and training oversight of programs and services. Responsible for effective utilization review and proper resource management of patients, including patient statusing… more
- Magellan Health Services (San Diego, CA)
- …that directly influence quality of care . General Job Information Title Behavioral Health Care Manager Remote, must be Licensed and Reside in California ... and substance abuse services provided in inpatient and/or outpatient care settings. Collects and analyzes utilization data....Maintains an active work load in accordance with National Care Manager performance standards. + Works with… more
- Molina Healthcare (GA)
- …healthcare services professionals in some or all of the following functions: utilization management, care management, behavioral health and other programs. Leads ... oversees one or more of the following key health care services functions: care management, utilization...education and experience. * At least 3 years health care management/leadership required. * Registered Nurse (RN), Licensed… more
- Houston Methodist (Nassau Bay, TX)
- FT position for experienced UR/CM nurse. At Houston Methodist, the Utilization Review Nurse (URN) position is a licensed registered nurse (RN) who ... of utilization management, case management, performance improvement, and managed care reimbursement + Ability to work independently and exercise sound judgment… more
- Magellan Health Services (Boise, ID)
- …supervision and coordination of clinical and/or nonclinical management staff, including utilization management and intensive care management staff, providing ... for RN, Masters or Doctoral level provider. General Job Information Title Clinical Manager , Behavioral Health (UM) - Licensed , Remote in Idaho Grade 27 Work… more
- Veterans Affairs, Veterans Health Administration (Grand Junction, CO)
- …the EDRP application. Former EDRP participants ineligible to apply. Responsibilities The Licensed Professional Mental Health Counselor (LPMHC) Program Manager is ... of the REACH-VET Coordinator, who is an advanced practicing licensed social worker, and the REACH VET Nurse Case... social worker, and the REACH VET Nurse Case Manager , who is a registered nurse. Works with Mental… more
- Pearle Vision (Columbus, OH)
- GENERAL FUNCTION: The major responsibility of the Store Manager is to drive profitable sales growth through the delivery of outstanding patient experience. Lead team ... in a positive and productive environment, modeling exemplary patient care . Develop and maintain outstanding associate and doctor satisfaction and retention. MAJOR… more
- Excellus BlueCross BlueShield (Dewitt, NY)
- …and collaboration to ensure delivery of consistent and quality health care services. Examples may include: Utilization Management, Quality, Behavioral ... program criteria; assessing for opportunities to educate, support, coach, coordinate care and review treatment options, through collaboration with providers and… more
- Elevance Health (Asheville, NC)
- …services. Primary duties may include, but are not limited to: + Manages resource utilization to ensure appropriate delivery of care to members, adequate coverage ... so that they receive seamless, integrated, and coordinated health care . Within the Children and Families Specialty Plan (CFSP),...an accommodation is granted as required by law._ The Manager Placements & Transition ( Manager I GBD… more
