- Cottage Health (Goleta, CA)
- Job Description Cottage Health seeks a Utilization Review Manager , Registered Nurse for their Clinical Denials and Appeals department responsible for the ... The manager 's primary responsibility is to oversee utilization review functions and to ensure accurate...denials trends, prevention, issues related to utilization review or patient status. The manager will… 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 ... review , and transitions to prevent readmissions. Liaise with medical staff, utilization review , social services, payors, and community providers. Track and… more
- Novo Nordisk Inc. (Boston, MA)
- …collateral development Achieve or exceed assigned sales objectives through effective utilization of all available resources, strategies and tactics Collaborates with ... exceeding the Novo Nordisk points threshold assigned based on review of Motor Vehicle Records. Qualifications A bachelors degree...this job family are as follows: Rare Endocrine Therapy Manager $ 96,670 to $ 178,840 Sr Rare Endocrine… more
- Novo Nordisk Inc. (Olive Branch, MS)
- …improved patient health. Internally, the OCS reports to the District Business Manager of the specific sales territory. The OCS also interacts and collaborates ... sales and marketing resources to expand the breadth and depth of appropriate utilization Novo Nordisks products, consistent with label and company policy Analyze and… more
- Novo Nordisk Inc. (San Diego, CA)
- …the Specialty Field Sales Representative reports to the District Business Manager of the specific sales territory. The Specialty Field Sales Representative ... appropriate patients that would benefit in order to ensure early trial and utilization Generates advocacy for Novo Nordisk products and services by sharing approved… more
- MedPro Healthcare Staffing (Bel Air, MD)
- …RN Travel, Travel Nurse, Contract Nurse, Agency Nurse, Travel Contract, Travel Nursing, Case Manager , Case Management, Utilization Review , Case Manager ... Joint Commission-certified staffing agency, is seeking a quality Case Manager Registered Nurse (RN) for a travel assignment with...months of recent experience in an Acute Care Case Manager setting Active RN License BLS Certifications Degree from… more
- Merck & Co. (Durham, NC)
- …several years; currently Durham employs 1,000+ people. This role as a Manager , Operations will be an energetic, leader with strong interpersonal, leadership, and ... culture by reducing waste and constantly driving continuous improvement. -Responsible to review and approve compliance documents, as per procedures or need.Supply -… more
- Novo Nordisk Inc. (Plainsboro, NJ)
- …a strong collaborator across MAPA and NNI, a self-starter who is self-led and keeps their manager up to date on progress and ensures no surprises and is seen as a ... their placement in the treatment continuum as well as appropriate utilization and treatment guidelines Proactively leverages detailed knowledge of all applicable… more
- American Traveler (Salem, MA)
- American Traveler is hiring an experienced RN Case Manager with strong case management and discharge planning skills for a dayshift inpatient role. Job Details *Work ... through AHA required, *ACLS certification through AHA required, *Case Management, Utilization Management, and Discharge Planning skill set required, *Certified Case … more
- American Traveler (Madison, WI)
- …Traveler is seeking an experienced RN Case Manager for a daytime rehab utilization review position requiring an active RN license and two years of ... based in a rehabilitation hospital setting, *Role is within the Utilization Review department, *Day shift schedule from 08:00 to 16:30, Job Requirements… more
- American Traveler (Roseville, CA)
- …prior to consideration, Additional Information *Responsible for comprehensive case management, utilization review , and coordination of care within an integrated ... American Traveler is seeking an experienced RN Case Manager with at least 2 years of recent...*Must have a broad knowledge base of healthcare delivery, utilization review , observation status, and post-acute levels… more
- Optum (Portland, ME)
- …Maintains a working knowledge of care management, care coordination changes, utilization review changes, authorization changes, contract changes, regulatory ... etc.; serves as an educational resource to all Health System staff regarding utilization review Assumes roles in assessment physical, psychosocial, & economic… more
- Soma (Hilton Head Island, SC)
- …best culture in retail. Join our team today! POSITION OBJECTIVE: The Assistant Store Manager is responsible for supporting the Store Manager in promoting a ... KPIs to determine the needs of the business; In partnership with Store Manager , executes in store business and sales strategies. Establishes and communicates clear… more
- Riverside Health System (Hampton, VA)
- …and Care Management team members based upon a thorough medical record review and knowledge of federal and evidence-based guidelines, including CMS Conditions of ... Communicates effectively and professionally regarding modality. Provides education regarding utilization management to patients, families, and other members of the… more
- EvergreenHealth (Kirkland, WA)
- …provides intervention to facilitate patient care in an optimal timeline. Oversees utilization review process including education, support, and training of team ... for equipment, and arrange for additional services in the community. Utilization Management/Case Management Nurses provide clinical information to our payers and… more
- NORTH EAST MEDICAL SERVICES (Burlingame, CA)
- …Salary Range $128752.00 - $165048.00 Salary Description SUMMARY OF POSITION: The Utilization Management (UM) Nurse is a licensed nursing professional responsible for ... The UM Nurse will work closely with the UM/QI Manager , MSO UM team, MSO Medical Director, and MSO...inpatient UM process, including initial and concurrent case reviews, review of inpatient skilled nursing and rehabilitation treatment requests,… more
- Blue Shield of California (Oakland, CA)
- …Behavioral Health Utilization Management Clinician, Experienced, will report to the Manager of Behavioral Health Utilization Management (BH UM). In this role ... Job Description Your Role The Behavioral Health Utilization Management team performs prospective & concurrent ...you will conduct clinical review of mental health and substance use authorization requests… more
- Optum (Minnetonka, MN)
- …Must have strong analytical, critical thinking and organizational skills Knowledge of Utilization Review , Medicare Requirements processes as well as State and ... meaning behind Caring. Connecting. Growing together . The Case Manager RN is responsible and accountable for coordination of...Federal regulations pertaining to Utilization Review and Discharge Planning The salary… more
- Cambridge Health Alliance (Cambridge, MA)
- …on quality improvement and compliance initiatives with the Quality and Compliance Manager *Participate in utilization review , operational planning, and ... We are seeking a dynamic and experienced PACE Operations Manager to serve as a key leader in the...the PACE model. Key Responsibilities *Serve as the "Center Manager " and model of care expert in PACE operations… more
- Blue Shield of California (El Dorado Hills, CA)
- …The Behavioral Health Utilization Management, Consultant (Lead), will report to the Manager of Behavioral Health Utilization Management (BH UM). In this role ... Job Description Your Role The Behavioral Health (BH) Utilization Management (UM) team performs prospective, concurrent, retrospective utilization reviews and… more
