- Covenant Health (Nashua, NH)
- …of the health care team. + Annual goals are achieved. + Attends pertinent case management / utilization review programs to maintain current knowledge ... + Maintains/enhances professional development/skills required to function as a Utilization Review Case Manager +...Minimum of five years broad clinical experience preferred + Case management and/or Utilization … more
- Holzer Health System (Gallipolis, OH)
- …and financial outcomes. Serves as a clinical expert and resource in Utilization Review and Case Management . Partners with Social Workers to refer ... related field will be taken into consideration. . Professional experience with case management , utilization review , or discharge planning highly… more
- Baptist Memorial (Meridian, MS)
- …Required: RN with 3 years of clinical experience Preferred/Desired: RN with Case Management or Utilization Review experience in a hospital or payer ... Overview RN Utilization Review Weekender Job Code: 22818...against standard criteria per payer guidelines + Prioritizes observation case review + Assists with level of… more
- Baptist Memorial (Memphis, TN)
- …Required Preferred/Desired RN with 3 years of clinical experience RN with Case Management or Utilization Review experience in a hospital or payer setting ... RN with 3 years of clinical experience RN with Case Management or Utilization Review experience in a hospital or payer setting Desired Licensure,… more
- Children's Hospital Boston (Boston, MA)
- 80451BRJob Posting Title:Per Diem RN Case Manager, Utilization Management /ReviewDepartment:Patient Services-Patient Care ... + Experience as a Case Manager (Discharge Planning and or Utilization Management ) preferred. Licensure/ Certifications: + Current Massachusetts license as a… more
- Actalent (Sunrise, FL)
- …and experience. + Valid Florida Driver's License. + Knowledge of case management and utilization review concepts, including InterQual and Milliman ... + Clinical review + Utilization review + Utilization management +...Managed care + Patient care + Medical record + Case management + Concurrent review … more
- UNC Health Care (Raleigh, NC)
- …promote continuity of care and cost effectiveness through the integrating and functions of case management , utilization review and discharge planning. ... and well-being of the unique communities we serve. **Our Case Management team is seeking a System-wide...Refer administrative tasks (eg, faxing, form processing) to Care Management Assistant. Consult Social Worker and/or Utilization … more
- HCA Healthcare (Henderson, NV)
- …level. + Lead centralized case management function, including Clinical Case Management , Utilization Review Services, and Clinical Documentation ... Lead centralized case management function, including Clinical Case Management , Utilization Review Services, and Clinical Documentation… more
- HCA Healthcare (Salt Lake City, UT)
- …level. + Lead centralized case management function, including Clinical Case Management , Utilization Review Services, and Clinical Documentation ... Lead centralized case management function, including Clinical Case Management , Utilization Review Services, and Clinical Documentation… more
- Novant Health (Wilmington, NC)
- …operations, monitoring ongoing quality, productivity, and efficiency for both Utilization Review and Case Management activities. Is available for staff ... Certification (CCM), preferred. + Additional Skills Required: Current practice in case management / utilization review ; regulatory/governing standards,… more
- RWJBarnabas Health (New Brunswick, NJ)
- …, Discharge Planning, & Community Health Nursing Preferred: + Case Management certification preferred. + Utilization review and/ or discharge ... knowledge of current concepts, research needs and research strategies related to case management , utilization review and discharge planning, + Maintains… more
- Tenet Healthcare (Detroit, MI)
- …Establish goals and objectives that support overall strategic plans of the Case Management and Utilization Review strategy · Lead Group hospital Case ... Management model, staffing and skill mix, complex Case Management , and centralized utilization review · Participate in new hospital Director of … more
- Seattle Children's (Seattle, WA)
- …caring for children with medical complexity Current or previous hospital case management or utilization review experience Current or previous case ... provides leadership, supervision, and oversight of day-to-day operations of the Case Management department. Serves as the central resource to the director to… more
- Ellis Medicine (Schenectady, NY)
- …services provided by the Case Manager include, but are not limited to, utilization review , case management , care transition, collaboration with ... years of inpatient experience in a hospital environment preferred. + Previous case management , utilization review , and discharge planning experience… more
- Stony Brook University (Stony Brook, NY)
- …the design, development, implementation, and monitoring of the organization's case management and utilization review functions. + Lead initiatives to ... Management leadership and staff functions related to case management and utilization ...and collaboration with Social Work Services * Knowledge of Utilization Review and Denial/Appeals * Knowledge of… more
- LifePoint Health (Hickory, NC)
- …license). Minimum Work Experience Five years hospital- based clinical experience. Experience in Case Management , Utilization Review and/or Discharge ... Job Summary Manager of Case Management in the departments activities and resources to achieve departmental and organizational objectives and will take the lead… more
- Ochsner Health (New Orleans, LA)
- …- 3 years of hospital-based experience in discharge planning, case management or utilization review . **Certifications** Required - Current registered ... plans based on patient's individualized needs. Registered Nurse (RN) Case Manager - Case Management ...of the conditions of participation as it relates to utilization review and discharge planning. + Maintains… more
- McLaren Health Care (Petoskey, MI)
- …Bachelor's degree in coding/medical records/billing or UM * Two years of case management or utilization review experience * Three years of recent ... between patients, colleagues and community. 5. Performs concurrent and retrospective utilization management -related activities and functions to ensure that… more
- Prime Healthcare (Inglewood, CA)
- …supervision to case managers, social workers and case management coordinators/discharge planners, utilization review coordinators and utilization ... We are seeking a strategic and compassionate Director of Case Management to lead our dynamic ...Clinical Coordinators. This leader will oversee all facets of utilization management , discharge planning, and care coordination… more
- Banner Health (Tucson, AZ)
- …agencies, provider networks, and regulatory agencies. Must possess knowledge of case management or utilization review as normally obtained through the ... regulatory requirements. 6. Educates internal members of the health care team on case management and managed care concepts. Facilitates integration of concepts… more