- Beth Israel Lahey Health (Burlington, MA)
- …just taking a job, you're making a difference in people's lives.** Joint role of Case Manager and Utilization Review Nurse **Job Description:** The Inpatient ... determine appropriateness for inpatient and outpatient care. 3) Utilizes clinical expertise to determine the appropriate level of care...effectively with medical and hospital staffs. - Case Manager experience as well as Utilization Review… more
- Trinity Health (Silver Spring, MD)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** **Job Title:** RN Case Manager - Utilization Management **Employment Type:** Full Time ... **Location** : Holy Cross Hospital **Position Purpose:** As a Case Manager in Utilization Management,...and payers, and streamline care plans to align with clinical and regulatory standards. By optimizing resource utilization… more
- Covenant Health (Nashua, NH)
- …and procedures. + Maintains/enhances professional development/skills required to function as a Utilization Review Case Manager + Completes all mandatory ... team. + Annual goals are achieved. + Attends pertinent case management/ utilization review programs to maintain current...five years broad clinical experience preferred + Case management and/or Utilization Management experience is… more
- Helio Health Inc. (Syracuse, NY)
- …efforts to track, review, and analyze data relating to continuous quality improvement. The Utilization Case Manager will work on a Full-Timebasis supporting ... position and also take into account information provided by the hiring manager and program Job LocationsUS-NY-Syracuse Category Case /Care Management Position… more
- Children's Hospital Boston (Boston, MA)
- 80451BRJob Posting Title:Per Diem RN Case Manager , Utilization Management/ReviewDepartment:Patient Services-Patient Care ... required, pediatric experience preferred. + Experience as a Case Manager (Discharge Planning and or Utilization Management) preferred. Licensure/… 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 potential ... in related field will be taken into consideration. . Professional experience with case management, utilization review, or discharge planning highly desirable. .… more
- Houston Methodist (The Woodlands, TX)
- …plan of care and ensures prompt notification of any denials to the appropriate case manager , denials, and pre-bill team members, as well as management. **PEOPLE ... recognized guidelines. Manages assigned patients and communicates and collaborates with the case manager to assist with appropriate interventions to avoid denial… more
- Prime Healthcare (Montclair, CA)
- …school Of Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred.3. Five years acute care nursing experience preferred. At least ... https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf Connect With Us! (https://careers-primehealthcare.icims.com/jobs/215040/ case - manager -%28rn%29 … more
- Prime Healthcare (San Dimas, CA)
- …school Of Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred.3. Five years acute care nursing experience preferred. At least ... https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf Connect With Us! (https://careers-primehealthcare.icims.com/jobs/214914/ case - manager -%28rn%29 … more
- Prime Healthcare (Lynwood, CA)
- …school Of Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred.3. Five years acute care nursing experience preferred. At least ... https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf Connect With Us! (https://careers-primehealthcare.icims.com/jobs/212260/ case - manager %2c-rn … more
- LifePoint Health (Rutherfordton, NC)
- …**Job:** **Please select a valid job field* **Organization:** ** **Title:** * Clinical Case Manager * **Location:** *NC-Rutherfordton* **Requisition ID:** ... hospital by facilitating initiation of care starting.2. The ED Case Manager starts initiation and utilization...as indicated.13. Discusses payer criteria and issues on a case -by- case basis with clinical staff… more
- UNC Health Care (Chapel Hill, NC)
- …through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management staff to ... 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
- LifePoint Health (Hickory, NC)
- *Registered Nurse (RN), Clinical Case Manager * PRN * * *Your experience matters* At Frye Regional Medical Center, we are driven by a profound commitment to ... in employment." **Job:** **Nursing* **Organization:** ** **Title:** *Registered Nurse (RN), Clinical Case Manager PRN* **Location:** *NC-Hickory*… more
- Genesis Healthcare (York, PA)
- …meaningful impact in the communities we serve. Responsibilities The Manager , Case Management is responsible for the clinical , administrative, and financial ... Manager will also perform the functions of the Case Management Job Description and will be measured based...clinical nursing experience is required. Prior experience in utilization review, case management or discharge planning… more
- Commonwealth Care Alliance (Boston, MA)
- …procedures, and facilities under the provisions of CCA's benefits plan. The Manager , Utilization Management is responsible for overseeing and managing the ... of service decisions and organizational determinations. Essential Duties & Responsibilities: The Manager , Utilization Management reports to the Director of … more
- CVS Health (Austin, TX)
- …and more compassionate. And we do it all with heart, each and every day. ** Clinical Case Manager Behavioral Health** **Position Summary** This is a remote ... Dallas, Texas as well as the surrounding areas. The Clinical Case Manager utilizes advanced...with their provider in healthcare decision-making. + Analyzes all utilization , self-report and clinical data available to… more
- Beth Israel Lahey Health (Burlington, MA)
- …care experience, including experience in a leadership role. Two years of case management or utilization management experience desirable. **Key Relationships:** ... Coding & UR: Receives direction regarding priorities, assignment, coordination and outcome. Clinical Leaders: Receives direction and training from Case Managers:… more
- CVS Health (Columbus, OH)
- …do it all with heart, each and every day. **Position Summary** The Care Plan Reviewer ( Clinical Case Manager BH) utilizes advanced clinical judgment and ... Quality of Care: + Application and/or interpretation of applicable criteria and clinical guidelines, + standardized case management plans, policies, procedures,… more
- Sharp HealthCare (San Diego, CA)
- …other requirements for the position, and employer business practices. **What You Will Do** The Clinical Case Manager 's (CCM) role is to be a patient advocate ... options for patients and are provided excellent care. The Clinical Case Manager will be...community service data for at high risk persons for under- utilization of oncology health services. + Implements Plan of… more
- CVS Health (Norman, OK)
- …appropriate treatment/services. + Applies and interprets applicable criteria and clinical guidelines, standardized case management plans, policies, procedures, ... knowledgably participate with their provider in healthcare decision-making. + Analyzes utilization , self-report and clinical data available to consolidate… more